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Malarial Fever is only responsible for two European deaths, one of them being an infant under one year of age. The dangers of chill are exemplified by the six deaths from diseases of the liver and kidneys, while a too liberal dietary may also have had something to do with the causation of these deaths. Diseases of the chest are more common than might have been expected, although rapid changes of temperature are not uncommon, and at certain seasons of the year, ordinary catarrhal affections appear to be as prevalent here as at home.
Deaths among the Chinese population :----
1. Chest diseases.
The Chinese suffer considerably from diseases of the chest, no less than 1,136 deaths being recorded under this heading; this represents a death-rate of 4.8 per 1,000. The disease is more fatal among the boat population than among the land population, the rate among the former alone being 5'9 per 1,000. The causes of this high mortality from chest diseases, and notably from Consumption, which accounts for more than one half of these deaths, and which alone represents more than 11 per cent. of the total death-rate among Chinese, are undoubtedly the same as have been found to operate elsewhere, namely, overcrowding, back-to-back houses, and that want of efficient ventilation which is so marked a feature of the present class of Chinese dwellings, while an additional predisposing cause is to be found in the damp and dark basement dwellings, many of which abut against the hillside for the entire depth of one or more of their retaining walls. The operations of Ordinance 15 of 1894 will undoubtedly produce a marked reduction in the deaths from this cause, by reducing the number of these insanitary dwellings, but it will, I fear, be some years before the full benefits derivable from the provisions of this Ordinance are realized, for in many cases the fault lies, not so much in the construction of the dwelling but rather in its misuse by ignorant and uncleanly tenants.
2. Deaths from Nervous diseases.
Diseases of the nervous system bulk largely in the death returns for the Chinese population, owing to the enormous infant mortality from convulsions; the deaths from these causes total 1,192, and no less than 6-25 per cent. of them occurred in infants under one month old, while the number of deaths from Convulsions, Tetanus and Trismus was 1,107 or 92-8 per cent. of the total death-rate from diseases of the nervous system.
Twenty-four deaths, mostly adults, were due to Meningitis, probably the result of insolation in most cases, while various forms of Paralysis account for other 56 deaths; three deaths were due to Epilepsy and two to Mania.
3. Deaths from Malarial Diseases.
The Chinese suffer severely from Malaria, no less than 757 deaths being recorded from this cause alone; this represents a death-rate of 3.2 per 1,000. It is noteworthy to observe that the death-rate from this disease among the boat population is almost double as great as among the land population. The ignorance of the Chinese respecting the value of such drugs as Quinine in the treatment of malarial diseases no doubt largely accounts for this high death-rate, for the rate among resident Europeans, who should be at a great disadvantage in comparison with the native population is only 0.75 per 1,000.
Beri-beri, which is classed with the malarial diseases, claims 0.6 per 1,000 of the Chinese popula- tion, but the disease is apparently not recognized in the villages, as only one death is recorded as having occurred outside the city, while 139 occurred within it; four deaths from this disease are debited to the non-Chinese community, none of which were, however, Europeans, three being Japanese sailors and the fourth a Iascar.
4. Deaths from Dysentery.
There were 99 deaths from this disease among Chinese during the year, seven among Europeans i (already referred to) and three among the foreign community, one being an Indian soldier, one an Indian Police Constable and one a Japanese.
The high mortality among the Chinese is doubtless due more to that ignorance of effective reme- dial measures, of which I have already spoken, than to any extensive endemicity of the disease.
INFECTIOUS DISEASES.
At the latter end of the year the Sanitary Board largely extended the scope of its bye-laws relating to the notification of infectious diseases and brought them more into line with the provisions of the Imperial Infectious Diseases Notification Act of 1889. Prior to November the special bye-laws upon the subject related only to Small-pox and Bubonic Plague, and the onus of notifying the disease fell upon the medical attendant, without fee, while in the absence of a medical practitioner " of any nation- ality" which included therefore the Chinese so-called "doctors" this duty was imposed upon the nearest male adult relative or the occupier or keeper of the premises. The present bye-laws apply to Small-pox, Bubonic Plague, Cholera, Diphtheria, Scarlet Fever, Typhus Fever, Enteric Fever, Relapsing Fever,
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