1 1 The Code on Com'ictj designates degrees of punishment for an escape, for absence, for escaping in Siberia, for escaping outside Siberia, for the first, second, third, fourth and subsequent escapes. A convict is considered to have been absent and not to have escaped if he is caught within less than 3 days or if he voluntarily returns within less than 7 days from the time of his escape. For senlers the period of absence is increased in the first instance ro 7 days and in the second to 14. Escape beyond the boundaries of Siberia is considered a more serious crime than escape within Siberia. This difference in the punishments is probably ^red on the idea that an escape to Euro^nn Russia requires a far greater intensity of deliberate evil than an ^rape into some Siberian g11b^»iya. The mildest punishment for ^ape is usually 40 lashes and an increase in the sentence of 4 years of penal servitude; the severest punishment is 100 lashes, an unlimited term of penal servitude, being chained to a ball for 3 years and being retained in the reform category for 20 years. Se ^nides 445 and 446 of the Code on Convicts, edition of 1890.
XXIII Diseases and Mortality of the Convict Population - The Medical Organization The Hospital in Alexandrovsk
IN 1889 the three districts had a combined total of 632 fecblc and incapacitated convicts of both sexes, which is i o.6 percent of the total. Thus there is one feeble and incapacitated convict for every ten persons. Even the population which is capable of working does not look com- plctcly healthy. You will not find well-fed, stout and red- checkcd pcople among the convicts. Even the settlers who do nmhing arc gaunt and pale. Of the i 3 i convicts work- ing on the road in the Tarayka in the summer of i 889, 37 were ill, while the remainder as described by the visit- ing island commandant "presented a horrifying appearance: they were in rags, many had no shins, they were full of mosquito bites and scratches from twigs, but nobody com- plaincd" (Order No. 3 i 8, i 889).
There were 1 1,309 cases requiring medical assistance in i 889. The medical report from which I obtained this figure docs not differentiate betwcen convicts and free men but the writer of the report notes that the penal convicts con- stituted the largest group of patients. Since soldiers are treated by their own army doctors, while officials and their families receive medical treatmcm at home, it can be pre- sumed that the 11,309 consisted only of convicts and their families, the convicts being in the majority, and that there- fore every convict and everyone connected with the con- victs requested medical assistance at least once that year.J
I can only judge the illnesses of the convict population by the Report of 1889. Unfortunately it is based on data contained in the "True Books" of the infirmaries, which are maintained in a most slovenly fashion, and therefore I was forced to seek assistance from church records and to extract therefrom thc causes of death for the past ten years. The causes of death arc almost always registcred by thc priests in accordancc with the rcports of donors and medical as- sistants, and thcy contain many fantasics,2 but in general this matcrial is csscntially thc samc as that in thc "True Books," and is ncithcr beucr nor worse. It is undcrstandable that both thcsc sourccs wcrc far from adcquatc and every- thing thc rcadcr finds below conccrning sickncsscs and mortality is not a truc picturc but mcrely a mcagcr sketch.
Thc infcctious and cpidemic discascs, which arc rc- cordcd in thc rcport undcr scparatc groupings, have not bccn widcsprcad on Sakhalin to datc. Thus, in 1889 mcasles was rccordcd thrcc timcs, whilc therc is no rccord of scarict fcvcr, diphthcria or croup. Dcath from thcsc discascs, which usually auack childrcn, is rccordcd only 4 5 timcs in thc church books of thc past 1 o ycars. This number included "wnsillitis"' and "inflammation of thc throat," which arc of an infcctious and cpidcmic charactcr and always indicatc that a numlx-r of childrcn will dic within a short pcriod of timc.
Thc epidemics usually bcgan in Septcmbcr or Octobcr, whcn thc sick childrcn arrivcd in thc colony on thc ships of thc Voluntary Flcct. Thc coursc of thc cpidcmics was prolongcd, but thcy wcrc not vcry scrious. Thus, in 1880, tonsillitis bcgan to occur in the Korsakov parish in Octobcr and cndcd in April of thc following ycar, causing dcath to only tcn childrcn. Thc diphthcria epidcmic of 1888 bcgan in thc Rykovskoyc parish in thc fall and continucd through the cntirc winter; it thcn jumpcd to thc Alcxandrovsk and Duc parishcs and finally cndcd in Novcmbcr, 1889—i.e., it prcvailcd tor an cntire ycar; 20 childrcn dicd. Smallpox is rccordcd oncc; 18 pcrsons dicd of it in 10 ycars. Thcrc wcrc two cpidcmics in thc Alcxandrovsk district, thc first in 1886 from Dcccmber to Junc and thc second in thc fall of 1889. Thosc tcrriblc smallpox cpidcmics which oncc ran rampant over all thc Japancsc islands and thc Okhotsk Sca, including Kamchatka, and occasionally annihilatcd whole tribes, such as the Ainus, no longer occur here, at least there is no report on them. Pockmarked faces are fre- quently seen among the Gilyaks but this is due to chicken pox (varicella), which in all probability is not infectious among forcigners.:i
As to types of typhus, 2 3 cases of typhoid fever were recorded, with a 30 percent mortality, and three cases of relapsing typhoid and typhus occurred. There were no deaths. The church records reveal 50 deaths from various forms of typhus and fevers, but these are individual cases scattered throughour the books of all four parishes during a ten-year period. I did not see any indication of the vari- ous forms of the typhus epidemics in the correspondence and in all probability there were none. According to re- ports, typhoid fever was observed only in the two north- ern districts. The causes were found to be the lack of clean drinking water, contamination of the soil near prisons and rivers, as well as the crowded and congested conditions. I myself did not sec even one case of typhoid fever on Nonhern Sakhalin, although I vsitcd all the huts and was in the infirmaries. Some physicians assured me that this form of typhus is nonexistent on the island and I am my- self inclined to believe it. I relate all cases of relapsing fever and typhus on Sakhalin to incursions of scarlet fever and diphtheria. The supposition is that serious infectious diseases have so far found unfavorable ground for their de- velopment.
"Inexactly definable feverish illnesses" are recorded in seventeen cases. The report describes this type of illness as follows: "It appeared chiefly during rhc winter months with symptoms of a remittent type of fever, sometimes with the appearance of roscola4 and a general depression of the brain centers. In a short time, within five to seven days, the fever passed and complete recovery occurred rap- idly." This form of typhoid is very prevalent here especially in the northern districts, but not even a hundredth of the cases arc recorded, because the sick are not usually treated; they suffer on their feet or lie on their stoves at home. I became convinced during my short visit to the island that colds play the main role in the etiology of this illness, those who are stricken being people who work in the taiga in cold and raw weather and who sleep under the open sky. People suffering with this illness are most frequently seen on roadwork and on new settlement sites. This is veritable febris sachalinensis.
In 1889, 27 bccame ill with croupous pneumonia; a third of them died. This illness was evidently just as dan- gerous to the convicts as to the people who were free. Church records for the ten-year period give croupous pneumonia as the cause of 125 deaths; 28 percent of these were recorded in May and June with the start of the bad, changeable weather, when convicts were sent to work far from the prison. Forf-six percent died in December, Jan- uary, February and March, i.e., during the winter.:; The main causes of illness from croupous pneumonia arc the extreme cold in the winter, sharp changes in the weather and hard labor during inclement weather. The rcport of March 24, 1889, by Dr. Perlin, the phpician of the district infirmary, says: "I was constantly dismayed by the tre- mendous morbidity of penal servitude workers suffcring from severe inflammation of the lungs." These were the causes, in Dr. Perlins opinion: "Logs 6 to 8 vershoks in diameter and 4 sazhcns long being hauled 8 versts by 3 workcrs, the approximate weight of the log being 25 to 35 p<Xxis, the snow-covcred roads, the warm clothing, the accelerated activit' of the respiratory and circulatory sys- tems," ctc."