407
It will be seen from the report that there was a decrease of 314 in the number of in-patients as compared with 1902, this was accounted for by the fact that for part of the year two of the wards were closed for repairs, and also there were 299 fewer admissions from dengue.
The number of in-patients shows a slight increase,
The rate of mortality was somewhat higher, viz., 5.08 per cent. as compared with 4.5 per cent, in 1902,
The following table gives the mortality rate for the past ten years:—
Year.
1894,. 1895,
1896..... 1897
7
1898.
1899.
1900,
1901,...
Rate of Mortality, Per Cent.
.5.14
4.99
.5.50
.4.86
.5.36
.4.16
.5.16
.5.18
..4.50
..5.08
1902. 1903,
It is satisfactory to note that the diminution in the number of admissions from malarial fevers is maintained, the number for last year being 346 as compared with 349 in 1902, and 787 in 1901.
The type most usually met with is the malignant, the next in frequency is the tertian, the quartan being the least frequent.
With regard to typhoid fever our experience tends to confirm that of Sir Patrick Manson, that it is a much more serious disease in the tropics than at home. A modification of Ross' method of preparing blood films was adopted by Dr. BELL for the microscopic examination of blood for the detection of plague bacilli. By its means many mild cases of plague were diagnosed and cases were detected in an earlier stage.
The microscopic examination of blood for plague, however, should only be used as a confirmatory test and aid to diagnosis; any doubtful cases should be referred to the Government Bacteriologist (Dr. HUNTER) for culture experiment.
As far as our present experience of plague goes one would not be justified in treating patients suffering from this disease elsewhere than in an isolated room or hospital ward.
Judging by Dr. THOMSON's report the treatment of this disease by large doses of carbolic acid-twelve grains every two hours-given internally, seems to offer the best chance of recovery.
Phthisis is very prevalent here and if we believe in the infectivity of tubercle' bacilli the reason is not far to seek, as the Chinese, especially from my experience Eurasians, are very subject to this disease. It is particularly those whose occupa- tion is of a sedentary nature, such as clerks, who are attacked.
Many interesting facts are stated concerning dysentery. Undoubtedly there are many varieties of this disease; indeed it is possible that there are several diseases included under the name dysentery. I anticipate great assistance in the research into this and other tropical diseases when the Bacteriological laboratory, the plans of which have been approved, is in working order.
Attached to this report are the usual tables, and in an appendix are given the notes of several cases of interest which have occurred in the Government Civil Hospital during the year.
LUNATIC ASYLUMS.
Tables IX and X give the admissions and deaths during the year, also the diseases from which the patients were suffering.
As Dr. LAING's report shows there were 35 more admissions than in the previous year, causing considerable overcrowding. Should this continue the question of enlarging the present Asylum, or building an entirely new one, will have to be seriously considered.