Observations on foreign-body swallowing in prisons.

THE swallowing of foreignbodies is more prevalent in prisonsthan in mental hospitals. Is it that there is something in the prison environment which causes some prisoners to swallow foreign bodies, or should the clue be sought for in the personalities of the swallowers? A few prisonswallowers are insane, the great majority are not. Most of the swallowers I have seen were psychopathic personalities of various types. They had long histories of emotional instability, anti-social propensities and social incapacity. They swallowed, often repeatedly, a varietyof foreignbodies,such as knives,forks,spoons,toothbrushes,needles and pieces of metal, glass and razor blades. They did so heedless of the imme diate consequences, and with a lack of reflection or appreciation of long-term consequences which is characteristic of the psychopath. It is significant that very few of them swallow foreign bodies when at liberty. Some swallowers are of a paranoid type. One swallowed the handle of a safety razor which he passed, then a fork and later another fork, both removed surgically. He told me that the swallowing of foreign bodies was―a deliberate plan to cause the prison authorities as much trouble as possible.― His ideas were warped and his outlook paranoid. He seriously suggested that the police “¿ manufacture― crime, and said that he felt it his duty to expose a brutal and unjust penal system. To him everything a fellow prisoner did was right, and everything the authorities did was wrong. Others are of a hysteroid type, the cardinal feature being an emotional instability, and apart from the swallowing there is usually other evidence of a hysteroid personality. They frequently complain of subjective symptc ms with no signs of organic disease. The most is made of any minor physical disability in an effort to obtain preferential treatment in prison. A diagnosis of psychopathic personality in one of the Services is regarded as the best excuse for their crimes and for misconduct in prison@ They are adepts at self deception. Others are the explosive or aggressive type of psychopath, showing as main features an excitable character, unreliability, and anti-social propensities. In prison they show “¿ short circuit― psychopathic reactions of various kinds, and a large proportion of them have convictions for serious crimes of violence.