LUNATIC ASYLUMS IN BENGAL.                                                    9

Comparison with
other institutions.

48. In statement No. 7 is shewn the rate of mortality from dysentery and diarrhœa in
the hospitals of native troops, and in jail, metropolitan, and provincial hospitals, during 1874.

                            STATEMENT No. 7.

It will be observed that while the rate of mortality from these diseases was higher in the
asylums than in the hospitals of the native army, and to a slight extent higher than it
was in the metropolitan hospitals, it was below that of jail and provincial hospitals.

The excess of fatal bowel complaints in these asylums may be dependent on an
unhealthy year, on the low physical state of the asylum population, on the well-recognized
fact that sickness occurring amongst insane patients has a much greater tendency to
terminate fatally, or on a combination of all these circumstances; but, nevertheless, no exertion
should be spared to have these unfortunate people placed in the best hygienic conditions as
regards food, housing, ventilation, and clothing.

Overcrowding.

49. As the question of overcrowding of the insane patients may be considered to have
a close connexion with their rate of mortality, perhaps this will be. the most appropriate part
of this report in which to introduce it.

Accommodation in
each asylum.

50. Statement No. 8 shews the accommodation each asylum can afford for male and
female patients, calculated at the capacity of 50 superficial feet per patient; also the average
strength of the asylum population and the excess of average strength over capacity.

                                                            STATEMENT No. 8.

Overcrowding with
reference to
mortality.

In the Dullunda Asylum, there was no overcowding of the male patients, but the females
were nearly 24 in excess of the regulated number, and bowel complaints, cholera, and phthisis,
caused a high death-rate amongst them.

The male patients in the Dacca Asylum were overcrowded by a number of 72, and
although their death-rate was moderate, it will be noticed that phthisis caused upwards of
40 per cent. of their total mortality. In the Patna Asylum also there was nearly as great
overcrowding of the male patients; and here again, with a moderate death-rate, phthisis
caused one-fifth of the total deaths. In the Cuttack Asylum there was some overcrowding,
but the Superintendent relieved it as far as he could by distributing the patients at night in
the verandahs and in a female ward which could be spared for them, and apparently with
the best result. The females in the Moydapore Asylum were overcrowded, and their death-
rate was high. In the Berhampore Asylum there was no overcrowding of either males or
females, yet still the death-rate of the former was high, and their mortality was caused
by bowel complaints, fevers, cholera, and brain diseases.

Conjecture as to
the high mortality
of females in the
Dacca Asylum.

51. Regarding the large death-rate of the female patients in the Dacca Lunatic Asylum,
who were not at all overcrowded, the Deputy Surgeon-General of the Dacca Circle writes
as follows:—" Regarding the comparatively large mortality among the female prisoners,
is it possible that what is considered superior accommodation can have anything to do
with it? The cells they occupy are large and lofty, 20 × 6 and 15½ high; ventilation
consists of 8 feet high iron open work doors at each end and roof apertures. In the winter,
and during part of the rains these cells must be very cold, as the doorways have only tât
Purdahs to keep out the wind."

52. It is quite unnecessary here to enter into the subject of ventilation, but with
reference to the question raised by the Deputy Surgeon-General in the preceding paragraph,
it will suffice to state in general terms that ventilation may be considered good when there
is ample provision made for the exit of air rendered impure by respiration, &c., and for the
entrance of the necessary amount of the outside air with which to maintain the atmosphere of

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