197
The majority of, these cases presented all the symptoms of Asiatic Cholera, viz :-" Violent vomiting, purging, with cramps, prostration, collapse, suppression of urine, and in three cases rice- water stools."
"
The first record of Cholera in Hongkong is that by Dr. CHALDECOTT the Acting Colonial Surgeon in 1859. In his Annual Report for 1858 he states that previously to Autumn of that year no well authenticated case of cholera was recorded to have happened in Hongkong and so confident were the Medical Practitioners of the immunity of the place that it was at first thought by them that the cases of the disease at first reported were in fact merely severe cases of Diarrhea, but it was soon evident that the disease amongst us was true Asiatic Cholera, for no single symptom was wanting and it des- troyed its victims in an equally short space of time.
At the same time the Portuguese in Macao suffered severely from the disease and cases occurred at Canton the disease afterwards visited the East Coast reached Shanghai and it is also reported raged with great virulence over a great part of the Japanese Empire."
I would simply note that in a similar manner last year Macao suffered from an outbreak of this disease, it has also been reported as being rife all through the Kwangtung Province, the disease also I am informed visited the Coast ports and from the Physicians Report of the Shanghai General Hos- pital I find that from August 1st to September 17th of last year there were 8 cases of Cholera treated there of which 6 died a mortality of 75 per cent.
7. Dysentery contributed 54 cases of which 5 were fatal, a mortality of 9.26 per cent.
8. Malarial Fever contributed 371 cases of these 3 died giving a mortality of 81 per cent. With reference to the causes of Malarial Fever I quote from the Report of the Fever Commission page viii
1.
"Earth Cuttings. According to W. C. MACLEAN, C.B., M.D., Professor of military medicine, in the Army Medical School, Netley, who was encamped 'in Hongkong before it was ceded to the British Government, the soil was but little disturbed and the troops did not suffer; but, when excavations were made at a subsequent time, for the construction of the City of Victoria, a fatal form of remittent fever appeared, which caused great mortality. From this and many subsequent experiences, earth cuttings, both in Hongkong and other countries, have been considered as an important factor in the production of conditions tending to the outbreak of fever. At the same time it is observed in some districts of Hongkong and more especially, at the present excavations going on at Kowloon, an im- munity from fever seems to exist in some places. In the Western District, however, earth cuttings of a recent date and of an extensive character have been in progress for some time, and the Commissioners cannot neglect the fact in the face of previous experience.'
"
Dr. R. YOUNG, formerly Superintendent of this Hospital, has kindly given me a short memo- randum on an outbreak of Malarial Fever at Kowloon in 1878.which I append to this. (Appendix B.)
There are doubtless many causes necessary for the evolution of the Malarial Miasm, however almost universal Medical testimony points to earth-cutting as one of these causes, our experience at the Government Civil Hospital during the past year certainly seems to bear this out.
I would strongly advise that the recommendation of the Fever Commissioners, or some slight modification of the same, with reference to the limitation of the period of earth cuttings be entertained.
The type of this Fever in Hongkong certainly seems to have been modified.
Nothing is more certain than that Aguish Districts may be rendered healthy by drainage so we may hope that in future years the type of this disease may be less severe than it is at present.
4
Last summer in the cases of Remittent Fever under treatment there were some abnormally high temperatures in one of the cases that died the temperature taken per rectum registered 110·2° F. 9. Beri-beri-There were 16 cases of Beri-beri under treatment one of which died, this latter was a case of," Beri-beria Hydrops," the other 15 were of dry variety "Beri-beria Atrophia," all these with exception of two came from the Water Police.
The Sanitary Board having asked for information from the medical men in the Colony, concerning the prevalence, nature and habitat, of this disease as occurring in Hongkong I sent for their perusal a short memorandum the results of an enquiry I made with reference to the existence of this disease amongst the Water Police.
Appended to this report is the memorandum. (vide Appendix 4.) The first record of this disease as occurring in Hongkong I find in the Report of the Colonial Surgeon Dr. WILLIAM MORRISON for the year 1852. In this he states that :-
"Amongst the natives Dropsies assuming the character of Beri-beri afforded the greatest number of deaths.
Beri-beri has hitherto been regarded as a disease peculiar to Ceylon and its appearance in Hong- kong excited some surprise."
Two cases of Beri-beri were also reported by Dr. DEMPSTER in Colonial Surgeon's Report for 1856.