these circumstances this cannot be taken as a cause of the disproportion of the births and deaths. On this subject the Committee are of opinion that a very large number of births under one month remains unregistered, perhaps amounting to between one-third and half the total number. The chief cause of this non-registra- tion is the national training or ideas of the Chinese community, for it is well known that in China, registration of males alone is carried out in the Ancestral Temples and then only after they are one month old. This idea is practised in this Colony too and accounts for the disproportion between births and deaths which had been so repeatedly drawn attention to by the Medical Officer of Health in his various reports.
6. The returns supplied by the Acting Medical Officer of Health from July 1902, to June, 1903, (Enclosure A.) show that the greater number of infantile deaths under the heading of "Infantile Convulsive Diseases," occurs in the two Convents. Of the total 1,073 infantile deaths in the Colony of children under one year, we find 495 were from Tetanus, Trismus and Convulsions, i.e., 46.1 per cent. Of this latter figure (495) the French Convent supplies 370 or 74.7 per cent. In this Convent during the above period there were 1,392 admissions and 1,271 deaths equal to 91.3 per cent. of deaths to admissions; of these deaths we have 277 or 21.8 per cent. due to Trismus and Tetanus.
In the Italian Convent we have 341 admissions to 168 deaths, i.e., 49 per cent. ; of these deaths again we have 25 or 14.8 per cent, due to Trismus.
7. The returns given by the Government Bacteriologist of autopsies per- formed by him during the same period as above, namely July, 1902, to June, 1903, are important. (Enclosure B.) The most prominent point brought out by his return is that of all the autopsies performed by him 22 per cent. are on children under 2 weeks; while 53 per cent. of the whole come from the two Convents with a preponderance of females over males of 65 per cent. to 35 per cent. respectively in these institutions. It is also significant that of all these autopsies, in no case has Dr. HUNTER, been able to find the Tetanus Bacillus even in deaths under two weeks. In these cases examination of the cord showed "hoards of micro-organisms but not the Bacillus tetani. The largest number of deaths, as revealed by Post-mortem are grouped by Dr. HUNTER under the title of "Marasmus"; this accounts for 205 cases out of 606 under 2 years, equal to 33 per cent,
8. Analysis of returns from the two Convents:-(Enclosure C.)
French Convent,
Italian Convent,
•
Admissions.
1,392 341
Deaths. 1,271
Per cent.
91.3
168
49.0
Deaths.
Trismus and Tetanus.
Per cent.
277
21-8
162
25
14.8
Causes---French Convent,...............1,271
Italian Convent,
Sexes-French Convent:--
Admissions-Males, ...
Females,
9. 3 ""
>>
"
funder one month 207 or 15 6 per cent.
one to 12 months 129
18.18 funder one month 253
one to 12 months 355 21. 9 ...under one week 491 38. 4 Females, ......under one week 620,
Deaths-Males,
""
71
19
48. 7
The
9. From the above figures it will be seen that the percentage of deaths to admissions is much higher in the French than the Italian Convent. So also the pro- portion of Trismus cases is much higher, being 14.8 and 21.8 respectively. This is accounted for by the sources from which these Convents draw their cases. French Convent draws largely from the lowest classes in Wanchai and out-lying districts, Kowloon, and the boat population, while the Italian Convent supply is mostly from the City of Victoria and a better class of the Chinese population.