Castle A Review of the Health of
Dr Ruth Munro, M.B.E.
It is just twenty-six years
since Castle Huntly became an Open Borstal Institution to take suitable
boys from the main Institution at Polmont. It was quite an experiment, as
it was the first Open Borstal in Scotland, no one knew what type of boy
would benefit in an Open Borstal, and I was the first woman medical
officer to Borstal boys.
We started with fifteen
boys, among whom there were some highly skilled cat burglars and
pickpockets and these boys found the freedom of an Open Borstal suited
their talents. They shinned up drainpipes, and raided the officers’
rooms. At night they slid down drainpipes and went out housebreaking. They
stole the butcher’s wallet while he was delivering meat at the kitchens.
One even stole the Governor’s wrist-watch.
At intervals more boys were
transferred from Polmont until there were about thirty. Among these were
some of the gangster type, and they also enjoyed the liberty of an Open
Borstal. They were insubordinate; they defied the officers; they bullied
the little boys and were guilty of some horrible acts of cruelty to
But there was also a steady
intake of weakly little boys, the products of parental neglect —
underfed, underweight and undersized, while many showed the results of
untreated illnesses in childhood. These boys thrived in the open-air life
with nourishing meals; all put on weight; some grew two or three inches in
height; they became rosy and sunburnt. Their teeth, tonsils, eyes, ears
and other maladies were treated; with games and PT their chests expanded;
and on liberation all these boys showed a noticeable improvement in
During the second year I
had a short conversation with Dr. Inch, at the end of which he asked if I
had any suggestions to make — for the moment my mind was blank; then
with a sudden inspiration I said "yes"! "You are sending us
the wrong kind of boy. Here there are practically sanatorium conditions
and those young toughs don’t need them — send us the weakly delicate
boys and we will do what we can for their health."
Dr. Inch took this
suggestion seriously, and after consultations and discussions it was
decided that we should take the "Bruisables" — boys who on
account of physical or nervous disability were at a disadvantage in
Borstal Institutions but not mental defectives or boys with severe
Consequently for many years
every boy in the Castle had something amiss, malnutrition and old rickets
were common, and many were still suffering from the affects of
inadequately treated childish illnesses — pneumonia and emphysema,
bronchioctasis from whooping cough; corneal opacities from measles;
rheumatic fever and mitral stenosis, acute and chronic otitis medis. There
were also a good many diabetics, and cases of bone and joint tuberculosis
with an occasional pulmonary tuberculosis, and a few cases of venereal
disease. Enuresis was common. In addition they had almost every variety of
minor trouble, from alopecia to ingrowing toenails.
As the years went by the
pattern of these disabilities began to change. The health service was
started a year after the Castle opened, though it took a long time for its
benefits to show in the boys’ health. But not every child was registered
with his own doctor and childish illnesses were increasingly well treated.
Antibiotics have made pneumonia and rheumatic fever less dangerous and
mitral stenosis are very rare. Immunisation against infectious diseases
has put an end to their sequelse, so bronchioctasis and corneal opacities
are no longer seen. Otitis media and enureses still occur, but much less
frequently. School meals and milk have lessened malnutrition and it is no
longer a rarity to see a perfect set of teeth.
But neglect at home still
goes on. Malnutrition is still too common. School doctors and dentists
notify parents that their children’s tonsils, eyes, ears and teeth
require attention, but are ignored. Children are left to play in danger
spots, like demolition areas, and there is a big increase in the number of
old fractures many inadequately treated and some quite untreated. Recently
there have been a good many head injuries and fractured skulls. These are
usually attributed to "a car crash" but sometimes "I fell
off a wall". To me falls occurred while running away from the police
— several of these head injuries have led to epilepsy.
A very regrettable cause of
injury is violence among boys. It is nearly ten years since I first saw
the scar of a stab wound; since then there have been a good many.
Fortunately most wounds were superficial, but some had penetrated lungs
and abdominal viscera.
There have been no deaths
at the Castle, but two boys were granted compassionate liberations on
account of fatal disease. One had leukaemia and the other a sarcoma of the
thigh with secondaries in the lungs. Both boys had a short time at home
before the inevitable end.
I think that the great
problem of the future will be drug taking. For twenty-five years we have
been free of this evil, but last year two boys admitted to having tried
drugs, and recently an addict confessed to drug taking for four or five
years. But the desire for something "with a kick" has been
present all the time as I discovered in an unusual way. In the fifth
winter, when the matron was absent through illness, there was an epidemic
of pyelitis, amounting to twenty-six cases out of fifty boys. The pyelitis
was always right sided with **tenderness, ** and dysuna and also**. Two
boys with symptoms of appendicitis and were submitted to hospital. The
first case had a badly inflamed appendix removed and soon recovered. The
second boys appendix was normal but was also removed. A few days later the
resident of the ward said "we know that boy has pyelitis, but there
is no pus in the urine. He should have a heavy deposit of pus but the
urine is clear". This made me think that it indicated a chemical
"irritant" rather than a bacterial, so I started an enquiry at
the Castle. There, I was assured that there was nothing harmful within the
boys reach but the epedemic went on till matron returned to duty.
In her presence I exclaimed
that I wished I knew what the boys were taking, and she replied, "I
can tell you, it’s Brasso", she had overheard some of the senior
boys telling the newcomers what a grand time they had had at New Year,
putting Brasso in their lemonade. Consequently Brasso and all cleaning
materials were kept under lock and key out of the boys’ reach, while
Matron and I devised a course of treatment — a week in bed on an
adequate but monotonous milk diet, followed by a week of sitting up for
short periods in the Sick Bay on a very light diet. This soon put an end
to the epidemic. Five years later there was another outbreak of pyelitis
in which Brasso as the cause was eliminated — it took some time to trace
the cause to floor polish. From time to time there have been a few similar
cases, but bed and milk diet were efficient preventatives, until five
years ago, when there was another epidemic of pyelitis — we never
discovered the causal irritant, which may have been a different one, as
there was more ileo-colitis and six cases of acute appendicitis in five
If boys are prepared to
drink horrible concoctions and to risk acute illness and operation for the
sake of "getting a kick", they will be easy victims of the
insidious lure of drugs.
During these twenty-six
years there have been 1,619 boys admitted, all naughty boys, some very
naughty boys, and with an exceptionally high rate of morbidity for boys of
their age-group of 17 to 21 years. The daily supervision of their health
has fallen on the two matrons with whom I have worked, Miss Jones and Mrs
Robertson. They have carried out all the treatments, poured out medicines,
done the dressings, made out-patient appointments and seen to it that the
appointments were kept. They have been in close touch with the boys, won
their confidence and brought many troubles to light. Without their daily
care the improvement of the boys’ health would not have been achieved.
As a result the great majority of the boys are liberated with far better
health than they had on admission.