201
Appendix B.
MEMORANDUM re MALARIAL FEVER, KOWLOON POINT.
As near as I can remember it was during the summer or South-west Monsoon of 1878 that I attended an exceptionally large number of cases of Malarial Fever near Kowloon Point.
Coincident with these cases was the extensive fresh cutting of earth required in the preparation of the site for the New Water Police Station.
You will see on reference to the sketch plan of Kowloon Peninsular attached that the prevailing winds of that season would blow over the houses and grounds of the building lots marked (2) on either side of Robinson Road (3.) None of these houses were clear of the fever. In the one marked ×, with the exception of the cook, every one in the establishment was ill and all were attacked about the same time. It was thus not confined to Europeans but was equally bad amongst the Native Servants.
One death occurred in the house under where the Observatory is now, and another member of the same family suffered from repeated attacks and had to remain in Hongkong in order to keep clear of fever.
Dr. J. MITFORD ATKINSON.
Appendix C.
(Signed),
R. YOUNG, F.R.C.S.E. 30th January, 1889.
MEDICAL CASES.
I-CASE OF FRAMBESIA.
Englishman, æt. 38, admitted 6th July, 1888, with the following history:-That he had con- tracted a syphilitic sore at Malta in 1st week of May of this year, this appearing some 16 days after connection with a coloured woman; in about a week after this sore appeared he noticed a small pimple on 4th finger of left-hand, this enlarged and spread until it has reached the size it now is; some two days after this as far as he can remember, a similar sore appeared on fore-finger of right hand, then another on the wrist, and in a few days later the outer side of middle-finger of right-hand became similarly affected evidently from contact with the sore on the right fore-finger, in like manner from the sore on the 4th finger of left-hand the inner side of left little finger became affected.
About 10 days after the first pimple appeared on fingers, ¿e. (in the first week of June)-a similar sore appeared on inner side of right ankle this soon spread discharging fœtid matter and being very painful.
Similarly the second and third toes of each foot became affected.
On admission--he presented sores in all these regions which may be described as "spreading tuber-cular-like ulcerated surfaces, presenting distinct up-growths or excrescences of a more or less convex form, and a dirty pinkish colour-these fungoid growths secreting an offensive ichorous discharge, on removing which flabby granulations were exposed."
Two weeks after admission other similar sores appeared on the face, head and heel; I think the patient must have infected these regions with the discharge from the existing sores by means of his fingers.
Those on the heel were extremely painful, the Yaw eruption evidently commencing beneath the thick cuticle and some days elapsing before the excrescences broke through the skin, when they did, there was a profuse sanious discharge-very offensive. About this time there was slight secondary ulcera- tion of throat.
Treatment.--Consisted in the internal and external administration of mercury, keeping the sores clean, and relieving the pain by the frequent application of a five per cent. solution of Cocaine, first of all the Bichloride was used, and afterwards the Double Iodide of Mercury and Arsenic, the diet being a liberal one; he gradually improved and was discharged perfectly cured on 15th of August.
* Plan not printed.