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Small-pox is one of the commonest diseases in China, and its spread is said to be due largely to the practice of variolisation, which is still performed by in- serting a pledget of small-pox crusts into the nostrils.
Cholera.
35 cases of this exotic disease were brought to the Public Mortuary during the past year.
Almost all the cases of the disease occurred during the months May, June, and July. All the cases were typical, both pathologically and bacter- iologically.
Just as in the case of small-pox, cholera is endemic in Southern China. In Canton, this is especially true. The annually recurring outbreaks of the disease in Hongkong, are due to successive introductions of the infection from Canton and the surrounding country.
Diarrhoea.
This was returned as the cause of death in 69 cases. The majority of the cases occurred in infants, and usually the factors, at work in the production of the loose evacuations, could not be determined.
Similar to what obtains in Western countries, diarrheal troubles account for the death of a very large number of children in the first years of life in Hongkong and surrounding districts.
With the present state of our knowledge in regard to diarrhoeal disorders, any attempt to bring so-called cholera infantum into relation with a definite cause or group of causes, must fall far short of scientific accuracy. In many instances, diarrhoea must simply be regarded as a symptom, occasioned by improper feeding, neglect, and innumerable other temporary and accidental causes. These, unquestionably, account for much of the heavy infantile mortality amongst the Chinese.
Dysentery.
In one case only, dysentery was found to be the cause of death. Although this disease is rife in China, and common in Hongkong and Canton, it would not appear to figure largely as a cause of death. Post-mortem evidence of old and chronic dysentery, is frequently found, the individual having succumbed to some intercurrent infection.
So far I have been been unable to determine the varieties of dysentery met with in tongkong. Amabæ have been frequently found in the stools of cases of dysentery, and even in other pathological conditions of the intestine. There is accumulating a considerable amount of evidence to show that amabæ play the exciting part in the production of certain forms of this important discuse. This variety amoebic dysentery-certainly exists in Hongkong. Again, it is doubtful if ambæ are ever found in the normal intestine. The bulk of evidence is against the transient appearance of these protozoa in the normal intestine. As MUSGRAVE and CLEGG (Manila) have recently shown, amoeba are not harmless, and in the Orient, the presence of amoeba in the dejecta ought to be regarded as diagnostic of a pathological intestine and a sufficient guarantee for the com- mencement of therapeutic measures.
Beri-beri.
181 cases of the disease were examined during the past year. Towards the end of last year, an investigation into the cause of this disease was commenced by Dr. Koch and myself. Experiments of the most varied character have been made, the results of which are still incomplete. Dr. Koca and I intend to prepare a Special Report on the results of our various investigations.