Annexe J.
P. 358.
REPORT OF THE GOVERNMENT BACTERIOLOGIST.
The new Public Mortuary has given great satisfaction.
Post-mortem examinations can now be conducted under the most favourable circumstances, even during the hottest seasons of the year.
The construction of the buildings, according to modern principles, has reduced to a minimum the dangers attached to this particular work. The whole compound has been regularly cleansed daily throughout the year. The laboratory accommodation is also so constructed as to allow of the most varied naked eye and microscopic pathology being undertaken.
The Bacteriological Institute was completed towards the end of the year. The internal fittings being somewhat complicated, require considerable care and time. Systematic research, therefore, has not yet commenced. In my next year's Report, I hope to be able to give a full account of this Institution and its special qualifications for carrying out bacteriological research under the best of conditions. In my opinion, the building and its equipment will be difficult to beat Eust of Suez.
During the past year, the routine examination of rats has been carried out by my Laboratory Assistant, Dr. LEE YIN SZE. This officer has performed his duties to my satis- faction. On the termination of Dr. LEE's agreement with the Government, it was considered advisable to recommend the appointment of a qualified Assistant from Eugland. I am glad to say that such an appointment has now been sanctioned and Dr. C. M. HEANLEY, the newly appointed Assistant Bacteriologist, is on his way to Hongkong.
All
No case of sickness occurred amongst the members of my staff during the year. those engaged with me at the Public Mortuary are vascinated annually, as they frequently come into close contact with cases of Small-pux, during the prevalence of this disease in the early part of each year.
The question of "dumping" is specially dealt with in the Report. It would not appear that this practice is more prevalent during plague seasons than at other times. The majority of plague cases is not dumped.
Since I assumed the duties of Medical Officer in charge of the Public Mortuary, I have often come across cases in which a post-mortem examination revealed but little evidence of the cause of death. Such a statement may, on first thought, appear somewhat extravagant to many people, yet its truths are only too apparent in Hongkong, where, in the majority of cases, no reliable previous history of the individual is obtainable. The conditions, under which autopsies have to be performed in the Hongkong Morgue, are very different from those obtained at home. In Europe, apart from a few isolated cases, the pathologist obtains some history of the illness, or other factors, which guide him in arriving at a diagnosis. In Hongkong, however, the diagnosis has to be made from a pure pathological standpoint.
In
This has an important medico-legal bearing Many cases of concealed murder cannot be detected by an autopsy alone, or at least, they are not likely to be discovered except, either by a happy chance or preternatural ingenuity on the part of the medical man. many diseases, it is absolutely impossible to determine the cause of death by a post-mortem examination. One has only to think of some acute zymotics, e.g., whooping cough or a disease like epilepsy, in order to be convinced of the hopelessness of the pathological task in the absence of clinical or other data. In a large number of cases, I return the cause of death in children, as marasmus. I arrive at this diagnosis from the condition of atrophy, wasting, and diarrhoea, yet my post-mortem_examination shows nothing in any internal organ to which death could be ascribed. The autopsy does not show why the thread of life has been snapped. Again, in cases of prematurity, where is the post-mortem evidence of the exact cause of death? In olden times, such cases would have been described as death from the visitation of God. In the great majority of cases of all causes of death, the heart, lungs, liver, kidneys, etc., each or all of them may be diseased. What is the condition in any one or all of them, which is incompatible with life? It is in such cases that the absence of a definite clinical or previous history becomes of so great moment. From pure pathological appearances alone, one must, from a medico-legal standpoint, con- clude, that the presence of extensive discase of such and such an organ, would be sufficient to account for death, and may have caused it now. When we come to the forensic side of
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