THE EPIDEMIC OF BUBONIC PLAGUE, IN HONGKONG, 1894.
To write an historical introduction upon the subject of Plague should at the present moment be an easy matter, considering the many classical monographs and articles which have been written upon it within the last century. When the pre- seat outbreak occurred in Hongkong, the only authority that I had at my disposal was the article on Plague in Quain's Dictionary of Medicine" by J. N. RADCLIFFE, the experiences that we have had here being to a considerable extent new to the present generation. Latterly, the articles in the Encyclopædia Brittannica and DAVIDSON'S Tropical Medicine-not to mention HECKER'S classical work-were brought to my notice. I have not been able to make myself familiar with the opi- nions of CABIADIs and others in print, consequently the notes on the disease which I now present are almost solely founded on experiences here during the past year.
The history of Plague, as regards the civilised West, has been told times without number, but, with the exception of ROCHER'S papers, the history of the disease in the Far East is a perfect blank. One would expect, seeing that China has the unenviable reputation of being the seat of the plague, that the Chinese classics would show some trace of the existence of epidemics of the disease. I have requested Mr. J. DYER BALL, one of the most eminent, and certainly one of the most painstaking of Chinese scholars, to make careful enquiry into the subject, and the result is that, after months of diligent searching, he finds that Chinese history makes no reference to any epidemic which has left a mark on the inefface- able records of time. The epidemic in Canton of 1894 is by far the most notice- able case (of which there is any record) of the disease carrying off large numbers of the population. The first time in contemporary history that plague bas really made itself felt in China, was in 1844-just after the Egyptian epidemic had left its mark on European medicine, and in this case, by the records at hand, the epidemic did not work nearly so much havoc amongst the population as it did during the year recently finished. Plague has been practically endemic in Pakhoi for over twenty years, as has been recorded by Drs. LowRY and HORDER; the only occasion when it has been at all epidemic being about ten years ago.
The epidemic in Canton, according to the information at our disposal, began early in February 1894. During the four months following it was practically un- known in Pakhoi. In May it broke out in Hongkong, ninety miles from Canton, and three hundred and seventy miles from Pakhoi. Negative evidence is wanting to show that it did not come from Canton. Positive evidence is wanting to show that it came from Pakhoi.
An average of 11,090 passengers came from Canton every week whilst only 64 came from Pakhoi.
There were many patients fleeing from Canton on account of the plague,— none fleeing from Pakhoi.
Most certainly tens of thousands of persons died from plague in Canton, from January 1st to May 1st, 1894, whilst the dead were to be reckoned by tens only in Pakhoi during the same period, there being three or four steamers every day from Canton to Hongkong whilst there were only six in a month from Pakhoi.
Since 1873, it has been endemic in the province of Yunnan, a district about 900 miles from Canton, where the numbers dying of it yearly have been considerable. All this circumstantial evidence goes to prove that the disease was imported to Hongkong from Canton (and not from Pakhoi) although in Canton it has been unknown, until the present outbreak, since 1850.
On March 2nd, 1894, a large Chinese procession was held in Hongkong, and as a result large numbers of people came from the surrounding country, it being estimated that 40,000 of the lowest class coolies came from Canton for the occasion. It has been maintained by some persons that this was the period during which Hongkong became infected. It is possible, but it appears to me that before nine weeks had elapsed the epidemic would have reached such alarming proportions that it must have been noticed earlier. It was only in April that people were reported.
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