February 5, 1896.]
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CHINA OVERLAND TRADE REPORT. petitions said they were told to pull down their Enfance during the week ending January 11th, sunshades and twenty of them have done so, and I find that no deaths were registered for whilst of those on whom notices have been this Institution for the week ending January served by Mr. Hore only two have removed 4th, and that the deaths registered for the week their sunshades. In the case of the notices ending January 11th really occurred during issued by the latter the Chinese is certainly at the preceding fortnight. I have also in accor fault, and it seems as if in the Saiyingpun dis-dance with the wishes of the Board made some trict in which Mr. Brett's notices were served inquiries into the large number of deaths the interpretation was incorrect.-A. H. Brewin. registered as occurring from tetanus at this Assistant Registrar-General."
Institution, and also as to its death-rate gen- The following minutes were attached :
erally, and I find that during the year 1895 The President-The notices served by the Inspec some 1.075 persons were admitted and that no tors are in the form of a meno, calling attention to less than 817 of these died during the year. The the nuisance. If the receivers of those do not under-great majority of the admissions are infants stand they can make further enquiries, and if neces and mostly females. sary the Secretary will eventually serve the notice on behalf of the Board in accordance with the law.
Mr. Ede-I think it is desirable that the nature of the nuisance Le clearly defined in the Chinese version of notices, and sunshades not removed unless really affecting the healthiness of any premises.
The PRESIDENT pointed out that the memoranda left by the Inspectors of Nuisances simply called the attention of the owners to the condition of the awning or sunshade, and not with the intention of taking proceedings on the notices. If it was necessary to take proceedings the usual form of notice prescribed by Or- dinance 24 of 1887 would be duly served. did not propose to proceed further with matter at present.
The Board concurred.
AN ALLEGED NUISANCE.
"It appears that children are frequently brought to this Institution within a few days of birth, and it 18 these newly born infants which mostly succumb to tetanus, while the deaths from fever (presum- ably malarial) occur chiefly among older chil- dren, who are taken there by the parents, usually in a dying condition, when they find that recovery is not possible. I have made a careful survey of the establishment and have little fault to find with its general sanitary con- ditions, but I have come to the conclusion, from my own observations, that the enormous num- Heber of deaths from convulsions is largely due to the the barbarous treatment to which these newly
born infants are subjected before admission.!
This treatment consists in the cauterization of pertions of the face and body by ignorant midwives or by the so-called Chinese "doctors and in many cases the administration of drastic medicines, while the small estimate of female life, which is a characteristic of the Chinese na- tion. has no doubt something to do with this terrible infant mortality. It is a signifi cant fact, in this connection, that while the male births exceed the female in the proportion of 130 to 100, the male deaths of infants (under one year) amount to only 71 per cent. of the female infant deaths; in other words, the female infant death rate is practically double that of the male infant death rate (ie., 100:54). Again, the deaths of infants under five years of age in the city of Victoria number no less than 26 per cent. of those living at this age-period, while the corresponding rate in London is about 8 per cent, and although great allowances must be made for the tropical climate of this city, yet I am convinced that there are other and re- mediable causes at work to which the attention of the Board must be directed without delay.
A letter was read calling the attention of the Board to the defective and insanitary condition caused by the manufacturing of Chinese sauces or soy on the ground of Inland Lot No. 690, which was said to be injurious to the health of, those living near.
The Medical Officer of Health reported that no nuisance existed from the trade processes.
and the minutes recommended that no action be taken by the Board.
The PRESIDENT moved that the writer of the letter be informed that the Roard could see no reason for interfering. He also moved that the owners of the works be requested to abate a nuisance which was caused by a rubblish heap.
Carried.
MORTALITY STATISTICS.
For the week ended 18th January the death rate was 24.7 per 1,000 per annum, as compared with 19.3 for the corresponding period of last year.
For the week ended 25th January the death rate was 27.8 per 1,000 per annum, as compared with 12.9 for the corresponding period of last
year.
The Acting Colonial Surgeon attached the following minute :—
A marked increase compared with last year at this time. It would be interesting to have last year's return of the same date and compare the two.
The SECRETARY said he thought the popula tion last year was over-estimated, because a very large number of people left the colony.
▲ POLLUTED WELL.
An application was received from the owners of a well at 14, Staunton Street, which had been ordered to be closed, asking the Board to
review its decision.
The PRESIDENT said he regretted that mem- bers were troubled with these applications from owners of wells which the Board had had not the slightest doubt or hesitation in closing. But the letter had been sent for the considera- tion of the Board and he felt it his duty to circulate it to members. The Board always carefully considered each case in the first in- stance and in not one had the Board cancelled an order to close after reviewing an application. He therefore moved that the applicant be in- formed that the notice to close the well must be
complied with. With the concurrence of the Board he did not propose to again circulate similar applications.
Carried.
THE REGISTRATION OF CHINESE DOCTORS AND MIDWIVES.
The following letter was read from the Medical Officer of Health :-
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Sanitary Board Offices, "Hongkong, 24th Jan., 1894. Sir-I have the honour to report, for the information of the Board, that I have inquired into the reason for eight deaths being recorded as occurring from fever at the Asile de la Ste
atrocities in
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I gather that this question has in past years attracted the attention of such eminent mem- bers of the medical profession as Dr. James Cantlie and others, but no remedy has, it appears, yet been tried. I therefore venture to propose that the Government should adopt some means to prevent the continued perpetration of such British colony, and 88 a first step towards the amelioration of the lot of these wretched infants I would suggest that all midwives should be licensed by the Government, and that any person acting in that capacity without a licence should be liable to penalty. No doubt the abolition of such barbarities is largely a question of education, and it is a matter of universal experience that one of the readiest ways of educating a class is to make them personally responsible to some higher authority. This will be effected by the system of licensing and registration, and if these midwives find that a high death rate among the infants under their charge, from such causes as I have enumerated, will imperil the renewal of their licences, or even result in prosecution for wilful injury. there is little doubt that we should soon see a sensible decrease in the mortality bill. I consider, moreover, that a register of Chinese doctors practising in this colony is urgently necessary, for at present any ignorant coolie can pose a Yee Shang and can exercise his ingennity in perpetrating barbarities upon the ignorant masses of the Chinese community (who are, to say the least, under British protection in the colony) with- out let or hindrance from anyone, and although this may be permissible in the case of adults, I cannot for one moment admit that we are justi- fied in tolerating such cruelties when practised upon helpless infants, even under the sacred name of Eastern medicine.
No doubt there are many honourable, in- telligent, and conscientious Chinese doctors
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practising in Hongkong, and it is to their in- terest, no less than to the interest of the community at large, that a check should at last be put upon these ignorant impostors, and that the practice of Chinese medicine should be carried out in accordance with the ordinary laws of humanity and under such restrictions as a humane Government might be reasonably expected to impose.
"I would beg therefore to commend this matter to the most earnest consideration of the Sanitary Board, and I hope that they will see fit to approach the Government with some de- finate recommendation for the relief of these suffering infants and for the reduction of the infant mortality of the colony.
I have the honour to be, sir, &c.,
"F. W. CLARK, "Medical Officer of Health." The following minutes were appended-
per se will have the effect which the M.OH. anti- Mr. Ede--Although I doubt whether registration cipates, there is no doubt something should be done without delay.
1.
The Acting Colonial Surgeon-I am strongly of opinion that Chinese "doctors" should be registered, but there are many difficulties in the way, eg, who is to define a Chinese doctor? We shall have hun- dreds if not thousands claiming to be so registered if they expect to benefit thereby. The Registrar- General will be able to advise the Board in this midwives" with the exception of the few who have matter. I am not aware of the existence of "Chinese been trained by the medical practitioners of the colony.
The President-Register certainly, but how' a:e the difficulties indicated by the Acting Coloniul Sur- geon to be overcome?
The Medical Officer of Headth-The initial diffi- culty in regard to the registration of Chinese 'doctors" must be inet in precisely the same way as the registration of doctors, and later of dentists, has been met in Great Britain, namely, to place upon the register, when first formed, the name and address of every person who can prove that he is practising medicine at the time of its compilation. The sub- sequent addition of other names thereto can then be made dependent upon such proof of education and Board, with the advice possibly of a consulting Medi- training as the Registrar-General or the Sanitary
cal Board, may think fit to require, and in this way a reliable register will ultimately be obtained. With reference to the question of the existence of Chinese midwives, I thought it was a well known fact that practically all Chinese women are, during their ac couchements, under the care of a "Wan Po" or mid- wife, and that male doctors are rarely, if ever, in attendance.
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The PRESIDENT-Under the circumstances I move that this report of the Medical Officer of Health, together with the minutes on the papers, be forwarded to the Colonial Secretary with the recommendation from the Board that the matter receive the careful consideration of the Government, as in the opinion of the Board it is a matter which requires urgent attention.
The ACTING COLONIAL SURGEON seconded. Carried.
ADJOURNMENT.
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The Board adjourned until Thursday week.
THE RECENT RAINS AND THE WATER SUPPLY.
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The rain which we have recently experienced in the colony will not make a vast difference in the amount of water stored in the reservoirs, but just now every inch is acceptable, and so it is satisfactory to learn from the Director of Public Works that an addition of six inches of water was reported on Monday morning from Tytam, while of course the depth at Pokfulam would be still further increased. During the next month or so the recent heavy showers, which are very unusual at this time of the year, will continue to have an effect--a slight one, it is true-on the reservoirs as the water percolates through the ground, but it will take many heavy storms to make a really appreciable increase in the amount of water stored and to justify the Water Authority in making an alteration in the existing hours for tuning on the supply. It is very doubtful whether the rains will continue for long, and most probably we shall have to wait until after genuine rainy season has set in before residents can have the benefit of a full service. During the past few months a very important work has been proceeded with