Health Issues and Medical Care in the Ohio Penitentiary, 1833–1907

Ohio, once part of the West, rapidly became a center for settlement and transportation as America continued to expand. Though not of the geographical size or population density of larger cities such as New York, Ohio cities such as Cincinnati, Cleveland, and Columbus became hubs for industrialization and transportation even as the surrounding rural regions contributed significantly to the agricultural production of the United States. Columbus became Ohio's capital city in 1816. Around the same time, the first buildings of what would become a large state penitentiary were located along the waterfront. Growing into one of the most significant penal institutions in the nation, the Ohio Penitentiary would occupy a central place in the state's history for the next century and a half. Located on the corner of Spring Street near the Scioto River, the institution eventually covered twenty-five acres and held thousands of prisoners.

Early in its history, the penitentiary's officials recognized that inmate health should be a primary concern in day-to-day operations. A physician was appointed, and his reports began to be included in the annual reports to the governor. These documents included aggregate information about the health of all incarcerated inmates. Because these inmates were drawn from all over the country, examining their health and health care opens a window into the medical history of diseases present in the United States from 1833 to around the turn of the century. This project's goal is to examine the state of health within the penitentiary walls as it was reported by the board of managers, warden, and prison physician. This project encompasses several primary investigative questions: What infectious illnesses were being treated? What chronic diseases were present? What were the most common causes of mortality within the prison? How were female health issues addressed? How was mental health assessed and treated? Did the viewpoints and treatments of these health issues reflect trends in American medical care through time (such as the nineteenth-century focus on hygiene)? To answer these questions, this article analyzes quantitative and qualitative data to illuminate morbidity and mortality patterns within the Ohio Penitentiary for a seventy-four-year period between 1833 and 1907, ultimately addressing prison medical care in the late nineteenth century.

Materials and Methods

The materials for this project originated from two types of Ohio Penitentiary records. The first was yearly reports issued by the officers of the Ohio Penitentiary to the governor of Ohio for the years 1833–1907. Each contained a statement from the heads of the departments in the institution regarding the state of their area of supervision (e.g., chaplain, physician, and gasworks supervisor). This article specifically draws on the annual reports of the board of managers, warden, and physician; these constitute an incredibly rich source of data about the Ohio Penitentiary, the people involved in running the institution, attitudes about criminal behavior and even glimpses into broader American culture in the nineteenth century.¹ The basic report format was similar across years; however, the internal configuration of every section was left to the discretion of the prison official. Typically, each physician's report included a written statement of the inmates' health, deaths in the prison, and any other issues he wished to be present in the official record. Exceptions to this pattern were the reports from the years 1837–39, where the physician included only charts, no written report. Usually incorporated were summaries of illnesses treated during the year; some reports list by month the numbers of prisoners treated for specific illnesses, diseases, or trauma, and others list only yearly totals for the diseases. Occasionally, a reporting physician became disillusioned by this record keeping task and refused to include such lists, questioning their usefulness.²

These variations as well as variation in the fiscal year and the number of months reported necessitated only using part of the available data to incorporate as many years as possible into the study.³ The second source of data for this project came from the...