“I wish to emphasize the importance of a higher medical and surgical standard for the treatment of prisoners in our penal institutions.
“The officials controlling the Medical Department in ninety-five per cent. of our prisons and workhouses do not provide a proper equipment or staff of trained surgical and medical specialists, and they fail to recognize the importance of the medical department in educational and reform work.
“The proper care of prisoners and the remedying of bodily defects through such treatment as modern surgery and medicine can give, will decrease the prison population. There is not a day that we do not receive unfortunates who are compelled to beg or steal, because of their inability to earn a living on account of some physical infirmity which is readily cured by proper surgical or medical treatment.
“The Chicago House of Correction to-day is looked upon by the police department, the judges, and part of the public, as a city emergency hospital and sanitarium for all the alcoholics, drug habitues, epileptics, chronic incurables, cripples, blind and helpless beggars, cranks, perverts, and general mental and moral defectives who require special medical and surgical attention. Fully twenty per cent. of the cases that we receive are sent here by the judges for medical and surgical care. During last September four hundred and thirty-six cases were treated in the male hospital alone, with eleven deaths. Almost one hundred of these were ‘no paper’ cases, admitted to the Sceleth Emergency Hospital for treatment and observation. Among the cases that have been sent to us as alcoholics, we have found unfortunates suffering from skull fractures, syphilis, softening of the brain, delirium of pneumonia, brain tumors, acute dementia and other forms of insanity.
“Cases of nervous disease, with symptoms which simulate the ‘drunk’ in walk, speech and dull intellect, cases of coma, due to kidney disease, to hemorrhage, or injury of the brain, to exposure, to cold, to apoplexy, to sunstroke, meningitis, narcotic poisoning, etc.
“Please understand this is not a criticism of our ambulance surgeons or our police department, ‘as they need more than a curbstone diagnosis’ but to give you an idea why you need an efficient medical department. A man may be sitting on a curb, or lying in the gutter in a collapsed condition, with cold clammy skin, unable to talk intelligently, with or without an alcoholic breath; he may be on the verge of delirium tremens, or his condition might also be due to heart disease, to arsenic or lead poisoning, to intestinal, kidney or liver colic, to intestinal obstructions, to sunstroke, to the rupture of an artery in his brain, to shock, to the onset of some acute disease, or to a plain fainting spell.
“He may have had a tremor that looks like chronic alcoholism, but it may be a disease of the spine or brain, paralysis agitans or general paralysis of the insane. There was a time not very long ago when these cases were taken to the police station, locked up as drunks and died in a cell, when proper medical or surgical assistance would often have saved a life. Over one-half of our ‘no paper’ cases are not able to give any history of themselves; we know absolutely nothing except that the police brought in an unconscious man to us. This makes a diagnosis almost an impossibility in many cases. A printed history sheet was given to the police department, a sample of which is enclosed, which has been of great assistance to us in making a diagnosis.
“A number of insane cases, which are not responsible to man or God, are sent here for violating some statute. Among them are violent cases who have tried to commit murder, or assault, and would be a danger to any city to have at large; these of course are sent to asylums.
“Another type are unfortunates who are charged with being shiftless, who will not work to support themselves or their families. These are often unrecognized cases of brain or spinal diseases which leave the victim absolutely helpless and unable to work. These are often treated as worthless bums, when they need good medical care and kind treatment.”
Another point of view deserving of strong emphasis is one directly the opposite of that usually held. We know well that alcohol is responsible for many conditions which are daily called upon to treat, but we do not give due consideration to the fact that the alcohol or drug habit had its beginning in an effort to relieve pain due to sickness, or to obtain solace after unsuccessful attempts to obtain or keep a job, when handicapped by some disease, recognized or not. Disease, alcoholism and crime are very closely interwoven.
Especial efforts are made at our institution to detect pulmonary tuberculosis in its early stages. Whenever possible, such cases are transferred to institutions devoted to the care of such patients, the aid of the courts being invoked in many cases to overcome the legal obstacles. If it is necessary for us to retain the tuberculosis patients, we place them under the best possible hygienic conditions. We point with pride to our out-of-door cottage tents, where the three essentials for cure are at hand—fresh air, rest and good food.
The House of Correction has a well deserved reputation for its success in the management of drug and alcoholic cases. But no “cure” such as is employed in most institutions is made use of here. The treatment is essentially educational. The offending drug is withdrawn, and the patient convinced that he can get along without it. Then, upon his release, it is entirely “up to him,” so to speak, as to whether he returns to the habit or not.
This is in no sense intended to underestimate the psycho-therapeutic treatment where it is indicated. However, we do desire to point out the absurdity of psycho-therapeutic treatment in cases suffering with a definite physical ailment where a careful and complete physical examination by competent men is most essential.
We have each week the following clinics:
Three Surgical Clinics,
One Medical Clinic,
One Nervous and Mental Clinic,
Two Eye, Ear, Nose and Throat Clinics,
One Skin Genito Urinary Clinic,
One Gynecological Clinic,
Two Dental Clinics.
In addition to the above, the health of two thousand inmates and the sanitation and food are cared for.
A SCENE FROM “THE MAN INSIDE.”
[This scene gives in special detail Mr. Roland Molineaux’s attitude toward the present-day treatment of the delinquent. “The Man Inside,” written by Mr. Molineaux and presented by Mr. Belasco, had a successful run in New York early in the winter. The following scene was the original, which was somewhat altered because of the exigencies of the stage.]