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54 The Hongkong government GAZETTE, 22ND FEBRUARY, 1868.
The Year 1866 I described in my last Report as "the mildest and most healthy year the Colony has passed through for a very long period" and it is with peculiar satisfaction that I find myself able to state that 1867 has surpassed its predecessor in salubrity nearly as much as 1866 had exceeded 1865. Indeed it is very gratifying to examine Table XI and find the death of only 56 Residents recorded, giving the low ratio of Mortality of 2.60 per cent, or little more than half of the average rate of the last ten years, or than one third of the average rate recorded since 1845 as seen in Table XIV.
The epidemic of Yellow Fever which occurred during the years 1865 and 1866, and which proved so fatal in Gaol, in Hospital, and among the poor of the town, was all but unknown in 1867; only one doubtful case having been recorded as occurring in Victoria Gaol, while not a single case of this disease was admitted into the Government Civil Hospital.
It is only justice to the memory of my predecessor in office, Mr. Morrison, to state that in his Annual Report for 1847 he drew attention to the resemblance which some cases of Hongkong Remittent Fever presented to the Yellow Fever of the West Indies, as I also did in my Report for 1863. He appears however not to have extended his researches in this direction, and no such epidemics as recorded in my last two Reports seem to have come under his observation.
Small Pox, which may be said to be endemic to Hongkong in the cold weather, was first seen in the Civil Hospital on the 13th January, the last case admitted being received from a vessel of war on the 5th June. In February Her Majesty's Ship Princess Royal arrived from Japan with Small Pox on board-56 cases were disembarked into the Convict Gaol at Stone Cutter's Island, which was placed at the disposal of the Naval Authorities by the Colonial Government, into a Gunboat fitted up as a Hospital, and into the Seamen's Hospital-of the whole number 4 died. Up to the present date no case has been admitted this winter into the Civil Hospital, although I understand several have been received into the Seamen's Hospital. This disease raged among the Chinese population at Kowloon during the months of March and April, where it was said to have proved very fatal, while there were comparatively few cases in Victoria; but in the following month it attacked the Portuguese residing in the less healthy parts of the town-such as the neighbourhood of Bridges Street-and there it com- mitted considerable havoc.
It appears to me that there exist unhappy facilities for the propagation of this and other infectious diseases in this Colony, and, having reference to the action taken by the Lords of the Privy Council under authority of the "Diseases Preven- tion Act, 1855," I believe that great benefit would arise to the Community if Medical Practitioners were obliged to report the occurrence of all cases of infectious disease to the Colonial Surgeon, or such other Health Officer as might be appointed, with whom the power should rest-either independently, or in conjunction with a Board of Health to order such case into Hospital, or to take such steps as might be deemed advisable for the isolation of the infected persons, and, at the same time, have the premises in which the disease occurred thoroughly disinfected-I have so frequently seen Small Pox recurrent year by year in the are locality that I believe some such course as I have just recommended to be essential to the well-being of the Colony.
As bearing upon this subject the question of compulsory Vaccination demands attention. It is very evident that, as long as the population of this Colony is as migratory as at present, and while Vaccination is so little known on the mainland, no system for compelling the adoption of this precaution could be enforced, but it is not the less possible to encourage it, to a great extent, by the establishment of Public Vaccinators, who should be paid for their succesful cases only, and by insisting on all persons in Government employ undergoing the trifling operation. By such means something might be done to lessen the number of the valuable lives that succumb to the fearful scourge of Small Pox.
The next subject deserving of notice is the action taken under the "Order and Cleanliness Ordinance," of 1867, by which the liquors sold by the Tavern keepers were submitted to rigid analysis. The character of the liquors was found to be less noxious than had been feared, but a good effect was derived from warning the dealers of the penalty they incurred, and it is probable that the exhibitions of frantic madness produced by the adulterated spirits formerly supplied by unscrupulous dealers will soon become only matter of past record.*
The diseases most prevalent and the most dangerous to life in Hongkong, are undoubtedly Fever-usually of the Remittent type, of which happily there have occurred but few cases last year-Dysentery, Diarrhoea, and diseases of the bowels. Acute Dysentery however is in some cases not sufficiently distinguished from a form of acute inflammation of the rectum, and the correct treatment by large doses of ipecacuan, which proves so successful in the former disease, affords no relief in the latter. It is not always easy to distinguish between the two diseases in the acute stage, and still more difficult when the case assumes the Chronic form.†
The Chinese are remarkable for the peculiarly friable nature of their spleen, so rendering that organ extremely liable to rupture upon the application of slight violence-so very slight indeed, as to leave no external trace on the body. On several occasions I have had to describe in a Court of Justice the condition of this organ as presenting the appearance of a rotten apple or gourd, which had been squashed by a blow. A somewhat singular instance of this peculiar affection was seen in the case of an European Seamen, a notorious drunkard, who got into a disturbance at the Sailor's Home, and whose spleen was ruptured in the struggle to eject hin. The Constable had to stand his trial for manslaughter, but was acquitted as there was no evidence that the man had even been struck in the region of the spleen.
On the 7th and 8th September, and again on the 30th September and 1st October, the island was visited by typhoons which did great damage to the shipping in harbor and the buildings in the Town-but still greater damage to the health giving trees which are so highly cherished, and can be but badly spared. Any one knowing how much the great improve- ment in the state of Health of Hongkong is, at least coincident with the planting and growth of the trees that now adorn it, must have grieved at the havoc a few hours effected, and which years will not repair-what may be the resulting loss of salubrity sustained is not easily estimated.
I shall now proceed to make a few remarks on the condition of the various Institutions of which it is my duty to take cognizance in my Annual Report.
I. THE POLICE.
Numerically this Force is not much above what it was last year-but both the European and Indian element have in- creased at the expense of the Chinese. The death rate is therefore somewhat in excess of what it was in 1866, but still the average is under that of the ordinary residents. The rate of sickness is much lower than it was last year. Considering the nature of the duties to be performed, and the manner in which the men are liable to be exposed to night air and other morbific influences, and the fact that one third of the entire mortality is due to consumption, I consider the result very favorable. The Sikh element, while it has improved the general appearance and bearing of the Force, has not added to its health. It is dif ficult to assign a correct reason for the result, but the fact remains indisputable, that men under military discipline are unhealthy in proportion as they diverge from the character of the true civilian.
* The unlicensed Chinese retailers of Samshu will however still require the utmost vigilance ou the part of the Police.
It may, however, be fairly diagnosed as the local affection, if, without other premonitory symptom, an acute pain referred to the rectum suddenly attacks the patient, and usually at night, a desire to empty the bowel being followed by violent spasms, producing excruciating pain and burning, even in some cases causing syncope, and followed either by a copious discharge of blood, or of a mucous fluid-and all these symptoms without the previous existence of hæmorrhoids, or other local cause of irritation. At first it is almost impossible to relieve the suffering, owing to the spasmodic action of the sphincter, but a sitz bath as hot as the patient can submit to soon allows of the use of warm enemata, which, in the few cases I have seen, have acted beneficially-and by rest, and maintenance of the heat for a sufficient length of time, the disease has sen arrested-but where the case becomes chronic -and a greater number of such instances have come under my notice than of acute inflammation, I have found the electuary of sulphur, internally, with injections of acetate of lead and opium, or Gallic Acid suppositories, the most successful treatment. It is not easy to assign a cause for the disease. but it is of the utmost importance to distinguish it when met with.