278
Plague made its appearance again at the end of April, but did not obtain a footing in the Colony. How far this was due to climatic conditions and how far to the prompt measures which were taken to deal with the disease, it is impossible to definitely say, but it is satisfactory to be able to report that though isolated cases occurred practically for the rest of the year there were only 44 cases in all, in every case excepting one, which was under treatment at the end of the year and afterwards recovered, the disease proved fatal so that the type was evidently of a virulent nature. In appendix A is given a list of all the cases reported during the year. From this it will be seen that 31 cases were admitted alive to Kennedy Town Hospital, of these one recovered. With the exception of three Portuguese all- were Chinese.
Canton was reported practically free of the disease during the year, but Macao was visited with a severe epidemic in the months of April and May.
The system employed was-
1. Isolation of those attacked by the disease at Kennedy Town Hospital.
2. Disinfection of the infected houses.
3. Segregation of the people exposed to the infection in large house-boats to the north of Stone- cutters' Island for a limited period. That this latter is a most important measure was proved by the fact that cases of plague occurred amongst those so segregated (see para. 10 of Report shewing progress' of special work carried out for the prevention of the further spread of Bubonic Plague, dated Sanitary Board, 21st October, 1895). The period of segregation was fixed at ten days, as the maximum incubation period in the 1894 epidemic was found to be nine days. The extent to which isolation of this nature can be carried out is limited in the event of a large number of cases occurring.
Nearly all the Chinese houses are "tenement houses" every floor consisting of three or four cubicles, each with a family residing therein; the people segregated have been generally those living on the same floor as the person attacked.
Notwithstanding all that has been done during the year with reference more especially to cleaning basements, removal of cocklofts and cubicles, licensing of lodging-houses and the increased number of Sanitary Inspectors, no one acquainted with the elements of sanitation and the conditions of filth, overcrowding and ignorance that exists amongst the majority can hope to see for some years to come those conditions necessary for the maintenance of the public health satisfactorily established in this City.
I am of opinion that the only way to materially improve the present unsatisfactory condition of the Town is by the introduction of some such Act into the Ordinances of the Colony as the "Housing of the Working Class Act, 1890."
The following extract from Whitelegge's "Manual of Hygiene and Public Health" gives the general scope of the Act:
(C
46
"Part I. deals with unhealthy areas, and is applicable to urban sanitary districts.
"It is the duty of the Medical Officer of Health to make an official representation to the Sanitary Authority whenever he sees cause to do so, that within a certain area either (a) any houses or courts are unfit for habitation, or (b) the bad arrangement or condition of the streets or houses, or the want "of light, ventilation, or proper conveniences, or any other sanitary defects, are dangerous to the health "of the inhabitants; and that the evils cannot be effectually remedied otherwise than by re-arrangement 14 or reconstruction of some or all of the streets or houses.
"The Sanitary Authorities must consider this representation, and if satisfied of the truth thereof,- "and of the sufficiency of their resources, must declare the area to be an unhealthy one and frame an "improvement scheme.
are:-
With regard to sanitary legislation the most important Acts that have been passed during the year
1. Bye-laws providing for the compulsory reporting of certain communicable diseases were
approved by the Legislative Council on 25th November, 1895. (See appendix.) This is practically the same as the Infectious Diseases Notification Act of 1889 at Home. The object of these bye-laws is to obtain early and complete knowledge of all cases of notifiable diseases and information of the particular district in which they occur.
2. New Births and Deaths Registration Ordinance.
The present unsatisfactory state of the registration of deaths requires early consideration. The obtaining of accurate vital statistics is a matter of great sanitary importance, and I note with satisfaction the intention of the Government to introduce at an early date an amending Ordinance dealing with this subject.
During the year under review all chair and jinricksha coolies applying for licences were medically examined for the first time in the month of December. The result of the examination was as follows:
2,072 men were examined, out of which 124 (6 per cent.) were rejected as unfit for such
employment.
Each coolie is photographed when he receives his licence, but it is feared that many transfer their licences.
The recent introduction of a medical examination before granting a licence, however, affords some protection to the public who have a right to demand the production of the licence and photograph from