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73. Judging from the death returns the health of the Colony was not so good as in the previous year. The crude death rate was 25.02 per mille as compared with 24.39 the rate for 1931.
74. Respiratory diseases accounted for 43.05 per cent of the total deaths, the percentage for 1931 being 42.25,
75. The principal diseases causing death were broncho- pneumonia, pulmonary tuberculosis, bronchitis, pneumonia, in- fantile diarrhoea and diarrhoea.
76. The overcrowded houses combined with the expectorat- ing habits of the Chinese furnish sufficient explanation for the prevalence of respiratory troubles.
77. One of the most important events in the public health year was the communication to the Sanitary Board of the re- commendations of the Director of Medical and Sanitary Services for the reorganisation of the Medical and Sanitary Services of the Colony, and the debate on the subject by that Body.
78. The Sanitary Board agreed with all the recommend- ations except those bearing on the Sanitary Board and Public Health Advisory Board. They recommended that there be one Board for both objects.
Mosquito-borne Diseases.
79. The mosquito-borne diseases of the Colony are Malaria, Dengue and Filariasis. None of these are notifiable diseases and complete incidence figures are not available.
Malaria.
80. In the early days of the Colony malaria in Victoria was the chief cause of sickness and death and in 1844, coincident with the breaking of the soil for the formation of Queen's Road, the chief arterial road of the town, malaria became such a scourge that there were serious thoughts of abandoning the island.
81. Here as in Malaya disturbances of the soil often result in the formation of small collections of water which for reasons unknown attract the malaria mosquito and in which they deposit their eggs. The breaking of the soil is not a direct cause of malaria but a predisposing factor in a chain of events which favour the spread of the disease.
82. It would seem also that here as in Malaya the danger areas are not the large swamps and paddy fields remote from the hills, but collections of water within half a mile of the latter. Why it is so we do not know, but spring water which not yet
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lost its sparkle does have an attraction for Anopheles minimus and Anopheles jeyporiensis which in this country are the most potent carriers of malaria. Such water may be in seepages, springs, pools or streams or it may be from the irrigation water for wet cultivation on the hill sides or in the valleys in the vicinity.
83. The most malarious areas are, therefore, those in or near the hills. Unless carefully watched and carefully controlled works in the vicinity of the hills which involve disturbance of the soil such as roads, railways, or waterworks are nearly always attended by high sickness and death rates among the labour forces employed. In Malaya this was especially the case when the soil was of granite formation and the same applies in Hong Kong.
84. Today owing to efficient drainage there is practically no malaria in the thickly populated portion of either Victoria or Kowloon. In the outskirts and more open parts the disease still persists and in certain rural areas both on the island and main- land it is very prevalent,
85. Malaria not being a notifiable disease few figures are available to measure the actual extent of incidence throughout the Colony and New Territories.
On the hospital returns and on the returns furnished by certain government departments, such as the Police, it is possible to base a guess as to whether the disease is on the increase or decrease generally, but that is all.
86. The cases admitted to Government Hospitals numbered 465 of which 18 or 2.8 per cent died. In the Chinese Hospitals there were 943 admissions, of which 187 or 19.8 per cent died.
Among those admitted to the Government Hospitals there were 226 tertian, 177 aestivo-autumnal, and 5 quartan infections.
87. The cases admitted to the Government Hospitals during the last eight years are as follows:-
1925
1926
1927
1928
1929
1930
1931
1932
1,142
970
670
485
658
535
585
465
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