365
Pathological Investigations.
ΑΠ
1. Small-pox.-The incidence of Small-pox during the past year has been small as compared with former years. Most of the cases were found during the cool season. types of the disease were examined, and, in the majority of instances, infants and children were the sufferers. So far the etiological factor at work in the production of this terrible scourge, has escaped detection. Small-pox has been known amongst the Chinese from time immemorial, and the practice of inoculating for small-pox is said to have been first practised in China at least 1.000 B.C. Ancient Chinese literature reveal to us that small-pox was placed under the special patronage of a goddess. Temples were dedicated to her, and further, elaborate sacrifices were carried out.
Smail-pox is an ubiquitous disease. It has no regard for lines of longitude or latitude. There would appear, however, to exist no doubt that the disease is influenced by changes in temperature. This is well shown in Hongkong and indeed throughout China where the disease is endemic. Its period of greatest activity is during the cooler portion of the year. This seasonal variation of small-pox is not limited to any particular country, but is uniform throughout the whole extent of both hemispheres of the globe.
Small-pox would appear to be mainly spread by the movements of people. A con- siderable amount of importance must be attached to air as a mode of conveyance of the infection. From the investigations of POWER, of the Local Government Board, there would appear to exist little doubt that the virus of the disease is frequently carried by the air. In fact, there is good reason to believe that the causal agent of the disease may be carried through the air over a distance of a mile, and still retains its virulence. This theory of the aerial convection of small-pox, although opposed by some observers, is receiving general acceptance. and has led to certain modifications of the methods hitherto adopted in order to efficiently isolate cases of the disease. Floating hospitals, right outside the limits of large towns, would appear to give one the best chance of preventing a spread of the disease. This, however, in order to be successful, must be suppleniented by general vaccination and re-vaccination.
2. Plaque.--The number of cases examined is small, owing to the prevalence of a mild epidemic. Considerable interest would appear to be evinced locally as to the prognos- tication of the incidence of plague for each year. Are we to have a mild or a severe epidemic during the coming year? Such a question is difficult to answer, notwithstanding the variability in climate, epizootic and epitnic disease. In my opinion, we have but little control over the incidence of a discase like plague, and any prognosis, as to the incidence of the exotic, if given correctly, can only be due to good luck, and scarcely founded upon an irrefutable scientific basis.
Ench
3. Cholera. Only 3 cases of this exotic were examined during the past year. case was pathologically and bacteriologically typical. Notwithstanding the fact that the disease is endemic in Southern China, it rarely becomes of serious importance in Hongkong. Any outbreak of Cholera in the Colony must certainly be attributed to the introduction of the infection from Canton and the surrounding country.
4. Dysentery.-Four fatal cases of the disease were found during the past year. In cach case the type was amabic. This is the most frequent variety of the disease met with in the Public Mortuary.
Although the disease is rife in China, it would appear to figure somewhat rarely as a cause of death, at least in Hongkong. Evidence of its presence in Chinese cadavers is abundant. This consists of irregular thickenings of the colon, cicatrices, and occasionally superficial ulcerations. Such changes are to be found in an extremely large number of the bodies examined the cause of death being, however, some entirely different disease. Bacillary, as well as amoebic, Dysentery, is also prevalent in Hongkong. My experience of this form of the disease in the Mortuary is very limited.
The statement made by CLEMOW, in his recent book on the "Geography of Disease" that in the Government Civil Hospital in Hongkong, the disease is one of the commonest that comes under treatment" is much exaggerated. Dysentery is rife in China, and prevails in Hongkong, but its incidence in the Colony can hardly be said to be greater than many other disorders locally met with.
5. Diarrhet.—This figures largely as a cause of death amongst the Chinese, especially amongst infants and children. During the year 1905, this, as a cause of death, was returned in 60 cases.