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General Health of Prisoners.-The committals for the year amounted to 7,273, a larger number than in any previous year. Among them was a large proportion of prisoners debilitated by disease, by exposure, by age, and also a large percentage of opium smokers who have to be carefully looked after in the early days of imprisonment. Notwithstanding this and overcrowding, the general health of the prisoners was good.
The Admissions to Hospital numbered 568, a percentage of 7·80 on the com- mittals. Of these admissions, 274 were really malingering, they were kept under observation in the hospital and discharged within 24 hours. Deducting these the admissions for sickness amounted to 294, a percentage of a little over 4. Incident- ally, it is interesting to note the large proportion of malingerers-48% on the total admissions to hospital-they really give more trouble and cause more anxiety than those who are ill. Prevailing diseases.-Malarial fever and dysentery were most prevalent. Malarial fever, in one or another form, occurred in 95 cases with two deaths-this gives a percentage of 32.3 of cases under treatment in hospital. Among the out-patients only about 2 per cent. suffered from malaria, totalling 33. Its period of greatest prevalence was from March to October, reaching its maximum in May: the remaining four months were comparatively free from it. Dysentery occurred in 41 cases, making 14 per cent., with two deaths. Among the com- mittals 114 prisoners suffered from syphilis in its primary or secondary manifesta- tions, and 46 from gonorrhoea. The daily average of hospital patients was 8-29, and of out-patients was 29-39.
Deaths.-There were 16 deaths from disease and 2 executions-the former making a percentage of 22 on the total admissions to Gaol, and 2·8 on the number in hospital. The majority of the deaths call for no comment, a few of them how- ever do merit same comment. In the case of prisoner No. 601 who died from internal bœmorrhage and collapse due to rupture of spleen, the question arose as to the cause of this rupture. He had made no complaint, was locked up in his cell at 4.15 p.m., ate his afternoon meal at 4.30 p.m., and was found groaning and collapsed at 5.45 p.m. There was no history and no evidence of his having been struck by any one-the presumption was that while using the sanitary bucket he fainted and in falling struck his side, and thus caused the rupture. The spleen was enormously enlarged and the stomach was full of food. The case of prisoner No. S. 113 was also remarkable. He was an opium eater, and was not of robust physique. On admission the heart and lungs were found to be normal. He made no complaint whatever but refused to work. He took his food well and heartily. Four days after committal he was found dead in his cell at 6.9 a.m., having been seen alive at 5.50 a.m., apparently well. On post-mortem examination a small solitary chronic ulcer was found at the pyloric end of the stomach, on its anterior and lower aspect very close to the gastro duodenal junction, and there was a small perforation at its base. The stomach wall was thickened around the ulcer, and there was slight peritonitis; the mucous membrane of the stomach and of the duodenum was thickened and in a condition of chronic congestion. The other organs were normal. Apparently in this case the free use of opium had dulled any pain there may have been, bad stilled peristalsis considerably, and had sup- pressed vomiting. When the opium was stopped it may be presumed that peris- taltic movements became strong again and perforation thus occurred. I may mention that his diet all this time was of the softest-rice and rice congee. The absence of the cardinal symptoms during life, and its sudden termination make the case remarkable. Prisoner No. 252 was admitted into Gaol on 28th November, 1903. He was examined carefully and the thoracic and abdominal organs were found to be healthy. He was however of poor physique aud on this account was put to light labour, which consisted of oakum picking in his cell. He made no complaint at all, did his task daily, went out for his exercise regularly. On the 12th December, 1903, he was found dead in his cell at 6.20 a.m. On post-mortem examination the lower lobe of the left lung was found to be in a state of hepatization. The total absence of symptoms in this case was noticeable-there was no cough, he suffered from no dyspuca, nor was he feverish or even “droopy." In the last case which I shall remark on, the post-mortem appearances were interesting. The prisoner No. 311 was under treatment for dysentery, to which he unexpectedly succumbed. The liver was crowded with small cysts varying in size from a green pea to a walnut. They all contained a clear yellowish fluid-no hooklets were found. The substance of the right kidney was entirely destroyed
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