ABSTRACT
This article, adopted from an official memorandum not designed for publication, deals with the problems of the "negatives" at the Culion Sanitarium, i.e., those inmates whose disease has so thoroughly cleared up that they are entitled to release or discharge. There are 440 such individuals, constituing about 25 per cent of the inmate population. They are of two categories, namely, adults (268) brought from elsewhere as patients, and children (172) born at Culion who have shown manifestations of the disease but are now clean. Among the adults, 216 (81 per cent) are unwilling or unprepared to leave. The reasos most frequently given are difficulties arising from mutilations due to the disease (171 adults have them in some degree), or the desire not to leave spouses or other relatives not ready for discharge. An important factor, discussed from more than one point of view, is the normality of life in the Culion Reservation and the many opportunities of self-help. Incidentally, less than one quarter of the adult negatives had taken any treatment during the past six months. Even among the patients still bacteriologically positive, less than one-half are taking treatment, in some cases because of difficulties with sulfone, but more often because they do not wish to become negative and therefore liable to be discharged. Many, but by no means all, have been at Culion so long that they have lost contact with the outside world. The negative-children group, almost all without interested relatives outside and 15 of them are already married to other inmates, is an especially intersting one from several points of view. They have had no outside contacts and therefore are highly "institution-minded". With a single exception, they have had no antileprosy treatment; their lesions disappeared spontaneously, not one of them showing any deformity resulting from the disease. Such cases have rarely shown any tendency to relapse. The conditions of life of patients at Culion are discussed. Recommendations are offered which, although intended only for local application, have features of wider interest.