725
Venereal Diseases,
Diseases of the Digestive System,
"
+9
Dysentery,... Injuries,
..189
..............189
Respiratory System, ...184
The following diseases caused the greatest number of deaths :-
Diseases of the Respiratory System,.
Malarial Fever,
Effects of Malarial Fever, ......
Enteric Fever,
Dysentery,..
·
...101
...442
28 10
10
8
8
Injuries of various kinds caused 29 deaths.
Dengue. There was an epidemic of this disease in the autumn months, thirty-two cases having been admitted to the Hospital. It was in all likelihood introduced from Singapore cases at the com- mencement of the epidemic were mistaken for influenza but the initial and terminal skin eruptions quite distinguish it from this disease.
On examining the peripheral blood a rod shaped bacillus with rounded ends was found, one or two parts of the bacillus staining darker than the rest.
Attempts were made to obtain a growth on blood serum, gelatine agar and glycerine agar, but all failed with one exception.
From this case, with a well marked secondary eruption, a growth was obtained on glycerine agar, this was inoculated into a guinea pig which died in eighteen hours, (probably from the cold weather); but from the spleen and heart of this guinea pig cultures were obtained which contained similar bacilli to those found in the blood.
Many cases were complicated with malaria.
Enteric Fever-There were 25 cases under treatment with 8 deaths, 11 of these were imported cases and 3 occurred amongst members of the Police Force.
Cholera.-There were no cases suffering from this disease during the year.
Dysentery.-There were 98 cases with 8 deaths.
Diphtherin.-Two cases were admitted, one had been ill for some days before admission and although tracheotomy was performed the patient succumbed, to all appearance she was progressing favourably when she died suddenly of heart failure; the second, who evidently contracted the disease from the first, recovered, he was brought in as soon as the disease appeared. Both were treated with antidiphtheritic
serum.
Beri-beri.—There were 41 cases under treatment, as against 29 in the previous year, with 4 deaths. Malarial Frver.-803 cases have been treated as against 674 last year, all were diagnosed by microscopical examination of the blood, and the results are:-
Malignant (Malignant Tertian) and Estivo-autumnal, Tertian Simple, Quartan Simple,
Mixed infection,
.86.30%
8-21%
1.12%
4-35%
Table XII gives the varieties met with during each month of the year. It will be seen that malaria prevails all the year round, but less in the dry winter months. This is probably due to the fact that we never get any long speli of cold weather, even in the coldest months hot summer-like days in- tervening.
Also it is rare that the hill streams completely dry up so that the mosquito never dies out.
CEREBRAL MALARIA OR MALARIAL COMA.
Six cases of this nature were admitted with three deaths, in none was the temperature high, in other words this form of malarial infection does not at any rate here produce hyperpyrexia, the chest temperature being met with in those suffering from simple tertian.
APYREXIAL FORMS OF MALARIA.
These are difficult to explain on the theory that it is the liberation of the toxins when the spores sporulate which produces fever.
We had at least six cases during the year, where malarial parasites were found in the blood, but there was no rise of temperature, three of the six were suffering from the malignant type, one had mixed infection, simple tertian as well as the malignant, and there were also two cases in which quart- an parasites were present without any fever, in one of these two the parasites were sporulating.
Malaria seems to complicate most of the diseases met with here. This is not to be wondered at when it is remembered that nearly every one contracts malarial fever and it is an undoubted fact that given one attack of malarial fever any illness or injury which reduces the vitality of the patient predisposes
2