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1. INTRODUCTORY LETTER.
HONGKONG, 29th December, 1905.
SIR. We have the honour to forward, for the information of flis Excellency The Governor, the following Report on our Researches into the Etiology of Beri-beri.
Beri-beri is a disease which is widespread in the Colony of Hongkong, and like many other disorders of widespread distribution is responsible for enormous national loss from an economic standpoint. A disease, occurring as it does in human beings during the most strenuous and wage-earħing period of life, becomes of serious importance in a community like our own, where our commercial pros- perity is largely dependent on the momentum for labour bestowed on it by the Chinese coolie who, unfortunately, is only too frequently its victim. Its import- unce from this point of view, as well as its power of rendering helpless many the hard working natives of several of our prosperous Colonies, is at once apparent to any one sufficiently interested in the voluminous literature on Beri-beri and the numerous scientific memoirs published by eminent investigators belonging to the many unfortunate commissions which have been organised with the view of elucidating its etiology, and instituting measures likely to stay its march amongst the Oriental population.
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3. In Hongkong where Beri-beri manifests its presence by the occurrence of the severest as well as the most chronic varieties of the disorder, opportunities for a careful study of the disease are obviously many. It was therefore considered that an investigation into the obscurities of Beri-beri as met with in Hongkong might well repay the labour of an earnest research. With a Bacteriologist in the Colony well equipped with scientific apparatus and a laboratory, and the assistance of another Medical Officer, the disease could be investigated fully from ali points of view. Accordingly on arrangements having been made with the Government to start such an investigation, we drew out a plan of research, which appeared to us to afford the greatest hope of success in elucidating the etiological factor of the
disease.
4. Our plan consisted of a thorough revision of the already known facts regarding the clinical and pathological features of the disease, accompanied by a searching investigation into the bacteriological side of the question and the carry- ing on of animal experiments on a hitherto unequalled scale.
5. For the opportunities afforded us in making these experimental researches a success our sincere thanks are due to the munificence of the Government and the ever-helping hand of the several Medical Officers of the Medical Department. Without such assistance the following Report could not have been made so com- plete and convincing as regards certain points of great importance in its etiology.
6. Further, considerable delay has been occasioned in the completion of the Report, our aim being to gather as much information together as possible, and to reconsider and verify many of the conclusions which had been collected by us during the earlier stages of our investigations.
7. Our actual research work commenced in the month of September, 1904. This date was chosen as one particularly favourable for a general consideration of the disease from all points of view, owing to the prevalence of a sharp but short outbreak of Beri-beri among the inmates of the Po Leung Kuk.
8. Previous to this date a considerable amount of work on Beri-beri was constantly being prosecuted at the Public Mortuary, where annually 400-500. cases of the disease are examined post-mortem and records of the most nots- worthy features kept for reference. In addition to this, the bacteriology of the Beri-beri cadavers was studied from time to time. The results of these annual observations are embodied as far as possible in this Report.