528
and where necessary sent to the Government Mortuary for further examination, with the result that no less than 43 cases of Bubonic Plague were thus discovered and the premises dealt with in the usual manner. In previous Annual Reports I have urged that this work should be done by a duly qualified Licentiate of the Hongkong College of Medicine, attached to the Sanitary Staff, and I am still of the opinion that a native practitioner, whether Chinese, Japanese or Indian, should be permanently attached to the staff for such duties as these, which are really outside the scope of an Inspector of Nuisances.
I append a statement of the actual causes of death in the above-mentioned 563 cases :-
1
Forward,...... .191
Enteric Fever,..............
Diarrhoea,.
13
Aneurysm......
Dysentery,
2
Bronchitis,
Bubonic Fever,
43
Pneumonia,
Malarial Fever,
22
Beri-Beri,....
19
Puerperal Fever,
Syphilis,
Debility,.
Old Age,
63
ANONN∞∞
Pleurisy,
Phthisis,
Gastritis,
Enteritis,
Peritonitis,.
Jaundice,
Inanition,
3
Bright's Disease,
Rheumatism, (Chronic),
1
Abortion,
Cancer of lower Jaw,
1
Placenta Prævia,
Cancer of Breast,.
1
Postpartum Hæmorrhage,...
Cancer of Stomach,.
1
Child-birth,
Epilepsy,
2
Ulcers of Leg,
Convulsions,
12
Hæmorrhage from Wound,..
Heart Disease,
16
1
.198
4
1
.125
1
1
1
2
4
1
1
12
1
Carried forward,.................................. 191
AGE DISTRIBUTION OF DEATHS.
563
The number of deaths of infants under one year of age was 1,315, or 18.6 per cent. of the total deaths, a rate which is far too high even for a tropical climate. The infant death-rate among the non-Chinese community during the year has been 129.2 per 1,000 as compared with 122.6 per 1,000 in the previous year, but among the Chinese population the number of deaths of infants under one year of age exceeds the total number of births, even when all deaths under one month are assumed to have been unregistered; this means either that a very large number of births remain unregistered or else that a large number of infants are brought into the Colony from the mainland and die here. In either case the condition is a most unsatisfactory one and calls for some remedial measure.
The great bulk of these deaths of Chinese infants are attributed to diseases of a convulsive type, but I am inclined to think that further investigation might show that not a few of these deaths from convulsions are due to malarial infection, and it was on those grounds that I urged the Board during the past year (and on several previous occasions) to obtain authority to make the fullest investigation into the many deaths of infants which are returned from the various Convents in the City. Should the bulk of these deaths prove to be directly or indirectly due to malaria, we would have the strongest grounds for urging the immediate adoption of a comprehensive scheme for dealing with all Anopheles pools in in the vicinity of domestic dwellings, for it must be borne in mind that by such means not only would the infant death-rate be materially reduced, but the incidence of malaria among the European residents of the Colony would be proportionately minimized, as it has been found in other Colonies that it is mostly the native infants that furnish the necessary malarial organisms to the Anopheles mosquito.
DEATHS AMONG THE CHINESE.
CHEST DISEASES.
The total number of deaths among the Chinese from respiratory diseases was 1,287, or 19.3 per cent. of the total Chinese deaths. This represents a death-rate from these diseases of 4.6 per 1,000 as compared with 5.1 in 1900. As in former years the death-rate from these causes was heavier among the boat population than among the land population, having been 5.2 per 1,000 among the former as against 4.5 per 1,000 among the latter.
The number of deaths of Chinese from Phthisis alone was 695, or 54 per cent. of the total deaths from the respiratory diseases. Phthisis is intimately associated with overcrowded and insanitary dwellings, and it is a significant fact that while the Phthisis death-rate in the City of Victoria is 2.5 per 1,000; in Kowloon, where the evils of surface crowding have fortunately not yet arisen to any great extent this rate is only 1.3 per 1,000, or very little more than half the City death-rate.