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the question, the final determination of the cause of death is a matter of the greatest in- portance. Apart from the presence of injuries, wounds, etc., which may be sufficiently clear in themselves as causes of death, the arrival at a diagnosis of the cause of death in other cases, in a coroner's court, on the evidence of the pathologist alone, is a farce. Expert pathological evidence is extremely valuable, but it would appear to be insufficient for the requirements of justice, and the safety of the public, in the absence at any particular inquest of some other person, and preferably a medical man, who has seen the deceased alive, even if it be only during the death agony.
Tuberculosis, in its many different manifestations, still accounts for the lives of a large number of Chinese of all ages. Koca's theory still holds sway, and in continuation of my researches into the subject, my observations lead to the conclusion, that two distinct. types of tubercle exist, namely, the typus humanus and the typus borinus. Widespread tuberculosis in cattle is propagated almost entirely by the tubercle bacillus of the typus bovinus. Tuberculosis in man, although reproducible by the typrus borinus, is readily induced by direct infection from man to man, and the role played by the consumptive individual is of much greater moment in spreading tubercle bacilli amongst us, than the presence of widespread bovine tuberculosis. In Hongkong bovine tuberculosis is practically unknown amongst Chinese cattle. Therefore our energies in abating this disease—a more insidious and deadly malady than our plague-inust be directed to the prevention of its spread from man to man.
The incidence of Small-pox was small during the year. Its aerial spread necessitates rigid isolation during epidemics, and floating hospitals far removed from the limits of large towns would appear to give the best results in dealing with an outbreak.
Bacillary as well as Amebic Dysentery exists in Hongkong. The latter is the more chronic form of the disease, more likely to recur, and occasionally sets up, as a sequela, tropical abscess of the liver. I am of the opinion that true tropical liver abcess is always due to the presence of amabæ.
Typhoid fever would not appear to be an uncommon disease amongst the Chinese.
The results of a research into the etiology of Beri-beri by Dr. Koch and myself, show that the disease is not of an acute specific infectious nature. Its etiology is probably non- micro-organismal.
The question of Rupture of the Spleen as a cause of death in Hongkong is dealt with more or less fully.
Several interesting pathological conditions are described in detail in the Report.
A considerable number of tumours has also been examined. Tumours (malignant and benign) are by no means uncommon ainongst the Chinese.
136 cases of Plague were examined during the year. Pathologically the cases bore out the conclusions drawn by me in my Special Report on Plague for the year 1904.
The relation, existing between rat and human plague, show the same characteristics as found in previous years.
The amount of rat plague would appear to be increasing in the Colony. During the past year, nearly 5% of the total number of rats examined were found to be plague infected.. It is difficult to account for this gradual spread in the amount of epimuic plague. Stronger measures than ever against rats would appear to be indicated if success in dealing with plague epidemics is to be obtained.
Arguing from the dictum "no rat plague, no human plague" our chances of freeing the Colony from this exotic are but small for some years to come.
Apart from rats, no other auimul has been found suffering from plague during the past year. Birds would not appear to be very susceptible to the disease.
My researches in regard to the role played by the rat in spreading plague are gradually gaining general recognition, and, further, my assertion that ordinary bubonic plague is not highly infectious has received confirmation in several recent Reports.
DANYSZ's virus as an agent for the wholesale destruction of rats has been a complete
failure.