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Appendix A.
THE REMITTENT FEVERS OF HONGKONG.
The subject of this paper, viz., the Remittent Fevers of Hongkong, is doubtless one of paramount interest to all of us.
It will be seen from the facts I now propose to lay before you that in this Colony violent and fatal remittent fevers have often appeared, indeed, it seems due to this cause and to this alone that Hongkong derived the unenviable excessively unhealthy reputation which at any rate it had in the early years of the Colony's History.
I purposely limit the scope of my paper to the Remittent Fevers of Hongkong, as it would be impossible in the short time at my disposal to consider the various types of Malarial Fevers that from time to time come to our notice.
Remittent Fever has been very prevalent during the last three years, and, in considering it, I will at the outset define what is meant by the term “ Remittent Fever."
Definition.
"A paroxyomal fever of malarial origin in which the paroxysms do not intermit, but only as the name implies remit (MACLEAN).".
I will now direct your attention to what I may term the Historical aspects of the disease in this Colony.
In perusing the Medical records of the early years of the Colony's history I have obtained much valuable information from the Annual Medical Report of the Colonial Surgeons.
Next I intend to discuss the etiology of the disease concluding with the symptoms treatment and termination of the disease as it has been observed during the past four years at the Government Civil Hospital.
History before 1842.
Dr. MACLEAN, formerly Professor of Military Medicine in the Army Medical School at Netley, who was encamped in Hongkong before it was ceded to the British Government, states :-"that at that time the soil was but little disturbed and the troops did not suffer; but when excavations were made at a subsequent period for the construction of the City of Victoria a fatal form of remittent fever appeared which caused great mortality."
1844.
From the Colonial Surgeon's report for 1844 we learn that Remittent Fever was then the most fatal malady.
1845.
In 1845, Dr. DILL, Colonial Surgeon, states:- "That there were 6 cases of deaths from Remittent Fever :-five of these occurring amongst the Police and Overseers of Roads. It is recorded that one Government Officer at the Supreme Court died of low Remittent Fever, and another Constable who died at Stanley, though not treated by the Colonial Surgeon, presumably succumbed to malarial fever. The death rate this year amongst the Europeans and Portuguese is given was I in 18.3 or 54 per 1,000."
1846..
Dr. YOUNG, in his report of 1846, records 16 deaths from Intermittent, Remittent Fevers, and Dysentery, including that of Dr. DILL, the Colonial Surgeon, owing to whose death these diseases were not differentiated.
The death rate amongst the Europeans and Portuguese in this year is given as 1 in 13-2 or 75 per 1,000. These numerical statements cannot lay claim to great accuracy yet they will afford, it is hoped, a very fair criterion of the state of health and disease in the Colony.
1847.
Dr. MORRISON, Colonial Surgeon, in 1847 states that :-"There can be no doubt that the first colonization of this Island was attended with disastrous consequences to our countrymen and soldiers, and the ravages of Hongkong Fever were as fearful as similar visitations have been in other parts of the world."
There is no classification of the different diseases in his report for 1847, but the death rate of the Europeans and Portuguese is entered as 35 per 1,000.
1848 seems to have been a very fatal year.
1848.
Dr. MORRISON reports of this year that six deaths from Remittent Fever occurred :—
"The first being that of a Policeman whose illness was of six days duration commencing with dysentery, it became complicated with symptoms of Remittent Fever, lastly the periods of exacerbation became indistinct and the disease assumed the form of continued fever with Gastro-enteritic irritation, death was not preceded by delirium. This man who had suffered previously from repeated attacks of fever was brought to Victoria from Stanley."