LOCK HOSPITALS, MADRAS PRESIDENCY.
11
, proportion of cases ; very often indeed it is simply a local disease exhibiting no
subsequent constitutional contamination. True or infecting syphilis on the other hand,
characterized by indurated chancre and followed by secondary symptoms, is far less
generally seen now than formerly, and its constitutional manifestations appear to be
more amenable than they once were -to medical treatment. Among registered
women hard chancre is very rare, but it is by no means uncommon among the unregis-
tered ; in neglected cases it is at times associated with considerable sloughing and
ulceration of the affected parts. Syphilis is not the terrible disease it was 50
years ago and this change in all probability is not due to any change in the power
of the virus but to ' the care with ,which it is early detected and promptly treated
before injury to the constitution takes place. Its whole management and treatment
as regards the British army have undergone a change for the better, and that these
results have been mainly brought about by assiduous medical care, by regimental
and cantonment precautions and by the operation of Lock Hospitals I am fully
convinced. That syphilis exists in India in its dangerous form has been admitted,
and that non-registered prostitutes and native women who may not be prostitutes
are frequent subjects of it is an opinion held by all experienced Medical Officers in
this Presidency. With these facts before us we must not be surprised if we find.
among the evil results of the famine an increased proportion for some years to
come of cases of constitutional syphilis. The increase in venereal diseases in
general was most marked in Bellary. There the ratio of admissions rose to 465-81
per mille, in other words, nearly every second man suffered from one or other form
of venereal disease. The troops at Trichinopoly and Bangalore also suffered
severely, the ratio of admissions at the former station being 323-80 and at the latter
253-60 per thousand. At all these stations there was, as already stated, a great
influx of famine-stricken women, and the increase of venereal diseases generally and -
of primary syphilis more particularly was due to their presence. Registration was
carried out with unusual activity, and in some stations extra detectives were
employed with the result of adding the names of many clandestine prostitutes to
the register. The great obstacle to the effectual working of the Lock Hospital
system in 1877 was, as in former years, clandestine prostitution, an evil which is
rendered all the more formidable from the fact that the British soldier appears to
prefer women of this class to those who are borne on the register.
In G.O., Public Department, No. 11 of the 3rd January 1878, the Government
of India proposed certain measures for the prevention of illicit prostitution and for
the more efficient working of the system of Lock Hospitals. These propositions
embraced the limitation of the area within which preventive measures were to be
enforced, the employment of a special Detective Police under European superinten-
dence, the imposition of increased penalties on women practising illicit prostitution
in cantonments or in the adjoining towns and villages, and the recommendation
of a more hearty co-operation of the Civil and Military authorities as regards preven-
tive and curative measures. In forwarding the above suggestions the Government
of India solicited the views of the Local Government as to the improvement of the
Lock Hospital system generally, and as to the apparent necessity of altering the
Cantonment Act (No. XXII of 1864) so as to bring it in closer conformity with
the Contagious Diseases' Act, No. XIV of 1868. The views of this office on these
important points were communicated to Government in the
No. 73 of 7th February 1878.
letter marginally noted, and as they are germane to the subject
in hand this opportunity may be taken of placing some of them briefly on record.
The Cantonment Act of 1864 has for its object the protection of public health, but
as worked hitherto, it has been restricted in its operations to prostitutes consorting
with European soldiers, a limitation which carries with it an obvious element of
failure. With regard to the proposed alteration of this Act so as to bring its terms
more in agreement with those of the Contagious Diseases' Act, it was observed that
the leading principle of the latter is that no environment shall avail to shield a woman
from the liabilities of a life of prostitution. The practical difficulty in the way of
suppressing venereal disease in cantonments is clandestine prostitution. To meet
this there must be the cordial co-operation of the Military and Civil authorities, and
the good results of such co-operation will be the more assured if, in drawing up a
new Act provision be made, consistently with the liberty of the subject, for facili-