359
while it may moreover be fairly argued that the imported cases probably did not exceed in number the cases which left the Colony for the mainland after they had developed the disease. Strenuous efforts were made to prevent the removal of the sick from the Colony except under proper sanitary supervi- sion, but the facilities for secret removal are so great that it was found quite impossible to prevent it; this is a phase in the management of epidemics which is essentially Asiatic, for not only were the sick secretly removed in large numbers from the Colony but the dying and the dead were cast out into the streets or into the harbour or at best removed to an unoccupied dwelling or godown, and in this way the sanitary authority was deprived of all knowledge of the infected dwellings from which such cases had been removed, and I am of opinion that many of the cases that occurred during the epidemic contracted the infection by taking up their residence in a dwelling from which a case of Bubonic Fever had been surreptitiously removed.
It was mainly for this reason that the Sanitary Board was compelled to declare the districts of Victoria, Yaunati and Hunghom affected by "Plague," and to deal with every Chinese house as if it were infected with such disease; a large staff was accordingly employed to visit, cleanse, lime-wash and disinfect all Chinese dwellings, and although this proceeding met with some little opposition in certain quarters, yet the Chinese community cannot be said to have offered any serious objection thereto. I am convinced moreover that no other measure would have been equally effectual, and until the Chinese can be relied upon to promptly report every virulent infections case which may occur in their dwellings, no other proceeding can be substituted with any hope of success.
The following recent authoritative statement by the medical authorities in Bombay is important in this connection: "Lime-washing is absolutely the best preventive of the spread of the Plague."
It may not be out of place to mention here that the expenditure incurred in the cleansing, lime-washing and disinfection of the Chinese houses throughout the Colony during the prevalence of the epidemic amounted to no less than $36,000, or exactly $30 per case for sanitary measures alone, whereas the average cost of disinfecting, cleansing and lime-washing an entire dwelling after each noti- fied case of infectious disease is $6, so that no less than four-fifths of the total expenditure incurred in dealing with this epidemic was rendered necessary by the deliberate evasion, by the Chinese, of the law requiring the immediate notification by the householder of cases of Small-pox, Cholera or Bubonic Fever to the Sanitary Authority.
One of the most gratifying features however in connection with the financial aspect of this recent epidemic has been its small influence upon the trade of the Colony, as compared with the disas- trous results of the epidemic of 1894. It will be seen from the accompanying figures which have been kindly supplied to me by the Harbour Master, that whereas in 1894 the tonnage of vessels entering and clearing this port fell to 100,452 tons below that of 1893, during the past year there has been an increase of no less than 2,166,831 tons upon the returns for 1893 and of 883,840 tons upon the returns for 1895 and although the mere total annual tonnage of arrivals and sailings may not afford the most accurate estimate of the actual trade done in the Colony, yet for the purposes of comparison it may surely be taken as a fair indication of the relative prosperity of successive years.
Arrivals and Sailings.
1893,
1894,
Tons. 14,349,122
.14,248,675
1895, 1896,
15,632,113 ...16,515,953
It is only fair to add however that another disturbing element existed in 1894, namely, the war between China and Japan and it is impossible to say whether this alone would have had a prejudicial effect upon our trade or the reverse, although the presumption, I take it, is strongly in favour of the latter; whatever therefore the causes may have been, whether in fact familiarity has bred contempt in the breast of the trader, whether the local interference on the part of the Sanitary Authority, with the convenience of the commercial world has been less drastic, or what not, the fact is incontestable that the steady growth of our trade has suffered no sensible check by the somewhat extensive epidemic of 1896.
While however this may fairly be regarded as a subject for congratulation it must not be used as an argument for staying those reforms in regard to the sanitary condition of the Colony which are unquestionably most urgently needed. Although much has been written and still more said, since my Report for 1895 was submitted, I have hitherto seen no reason to abate one word of the opinions contained therein, in regard to the dissemination of Bubonic Fever. I still hold that this disease is not spread by inoculation through wounds (except in rare cases) but is contracted rather by breathing a foul atmosphere containing the materies morbi of the disease (the Plague bacillus of Kitasato) which is given off in practically all the secretions and excretions of the patient. This bacillus will retain its vitality in a damp and filth-laden soil, or upon the damp and dirty walls and floors of the dark and ill-ventilated premises in which many of the Chinese of this Colony still live, and under favourable climatic or other circumstances will convey the disease to man, and the only measures that will prevent a recurrence of these epidemics, now that the disease has gained a footing in our midst, are the admission of light and air to the dwellings, the prevention of overcrowding, and the strict enforcement of cleanliness, both domestic and municipal.