GOVERNMENT CIVIL HOSPITAL,
HONGKONG, 1st March, 1895.
SIR,
I have the honour to forward herewith for your information a Report upon the Epidemic of Plague in Hongkong in 1894, so far as it concerns the medical work which I carried out under your directions.
I regret extremely that several important matters-including the epidemiology of the disease-which I could have wished to discuss at some length, have been touched upon very superficially, or passed over altogether in this Report. I will ask
you to accept as an excuse for my shortcomings in these respects the following facts of which you are, I believe, already cognizant :-
(a) The overworked condition of the Medical Department during the Epidemic, and at the present time has necessitated my writing most of these pages during odd half hours which would, under other circumstances, have been devoted to recreation or repose.
(b) The proofs have had to be corrected during a period of convalescence
succeeding a prolonged attack of malarial fever.
(c) The temperature charts and pulse tracings have been reproduced with some difficulty with the scanty appliances at the command of the local printers.
I have written strongly-as I feel strongly-concerning the existence and con- dition of the Tung Wa Hospital, but you will understand that my objections to that institution are based entirely upon professional grounds. Conducted as it is at present, under the patronage and protection of the local Government, a certain amount of countenance is, or at any rate appears to be, lent to what I can only describe as medical and surgical atrocities. In addition to this, I believe that it constitutes a serious menace to the health of the community. I should, however, be sorry to have it supposed that I do not recognise the fact that where a large native population is concerned, some deference has to be paid to the inclinations, and even to the prejudices, of the majority. Personally I believe, however, that a scheme might be devised which would satisfy the wishes of the Chinese without sacrificing the sanitary well-being of the Colony; and I think that it is a matter for congratu- lation that the publicity that has been recently given to the system under which the institution in question has been conducted in the past has already resulted in a marked improvement in the direction of order and cleanliness. In reading over the pages which I send you herewith I am fully conscious that I have expressed myself some- what uncompromisingly upon this and upon some other topics; but I have thought (and I hope that in this I shall have your concurrence) that in writing a medical report I am perhaps justified in taking a purely scientific view of the questions under discussion, leaving it to others to advance what is to be said (and I do not doubt that something is to be said) upon the side of expediency and public policy.
I have the honour to be,
Sir,
Your most obedient Servant,
DR. PH. B. C. AYRES, C.M.G.,
Colonial Surgeon.
JAMES A. LOWSON,
Medical Officer in charge of Epidemic Hospital and Acting Superintendent of Government Civil Hospital and
Lunatic Asylums.
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