CALCUTTA LOCK HOSPITALS.

169

No. 69.

Dated 11th June 1873.

              From—Surgeon-Major A. J. PAYNE, M.D., Superintendent, Calcutta
Lock Hospitals,

              To—The Deputy Inspector-General of Hospitals, Presidency Circle.

     SIR,—On perusing the reports on lock hospitals, submitted by the Officiating
Superintendent, for the year 1872, I find that the figured statements they contain
differ in many particulars from those recorded in the hospitals. I have the
honor of submitting the following information, with a view to the correction of
the errors.

Decline of home
examinations.

     2.   *   *   *   *   *   *   *   I cannot offer any explanation of the
falling off (of women on the home examination list), unless it be that the
women do not find attendance so repulsive as they did at first, and do not
care for exemption on the sanctioned conditions. They clamoured for the
privilege at first when they knew nothing of the system, and more recently put for-
ward attendance at the police office with their applications as a prohibitory
condition. This objection was removed, and still the number fell. The cases of
disease among these have been numerically insignificant in the years 1870, 1871,
and 1872, the percentages being 0.3, 0.2, and 0.04. The last is the least, and it
does not seem to me at all likely that the compulsory confinement in Hospital
of so very few women has influenced the mass.

Disease among the
newly registered.

     3. I observe that the ratio of disease among the women examined for the
first time is stated as 25 per cent. in 1872, against 14 in 1871. It is advisable
to guard against any conclusion being drawn from this. It would be very
interesting if it could be taken as evidence of increasing disease among women
not subject to the Act; but while registration is voluntary even after judicial
conviction, no such inference is sustainable. The Commissioner of Police has
noticed that the existence of disease is a great inducement to consent when a
woman is arrested, and registration is proposed to her; and this is alone sufficient
to create an artificial proportion.

Increase of disease
among regular
attendants.

      Among women under regular inspection, the proportion of disease has
risen from 0.9 per cent. to 1.6. In my absence it became the practice to detain
in hospital indiscriminately all cases of vaginal or uterine discharge, as well
as of simple abrasion of the os uteri. This caused the increased ratio. The
other effects of it will be noticed hereafter.

Period of detention
in hospital—fal-
lacy.

      4. The inference of increased severity of disease, as shown by the periods
of detention in hospital, is vitiated by the admission of several hundreds of
cases of very obstinate, but non-contagious and non-venereal, affections. Of the
working of the Act, Table III in the report is therefore not illustrative. The
cases longest under treatment are not gonorrhœal, but other discharges or
abrasions of the os uteri, which should have no place in this reckoning. It is
clear from paragraph 7 of Dr. Shircore's report, that the most obstinate forms
of syphilis have greatly and progressively diminished,—a fact which accords
with observation in the General Hospitals of Calcutta.

Cause of discon-
tinuing deten-
tion of gonorr-
hœal cases.

      5. In his 5th paragraph the Officiating Superintendent, speaking of the
practice of not confining women having various discharges, ascribes it to the large

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