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tact with the sick, are seldom attacked. On the other hand it has often been transported from one place to another by people, soldiers, for example, moving about. If these observations be accurate, it does not seem too far-fetched a notion, that we have to deal with a disease whose origin and dissemination appear to agree in many respects with those of typhus; and like typhus, many of its special characters may be best explained by supposing an insect to be the carrier of the organism which causes cerebro-spinal fever.
Venereal Diseases.--The evidence available goes to show that there has been an increase in the number of persons who apply for treatment. That there has been a real increase in the amount of venereal disease is uncertain. It seems to me probable that the larger number of cases returned is due to the fact that patients seek treatment more frequently than they used to do because of the greater attention which is paid to the subject today; and, also, to the fact that the modern methods of diagnosis are more commonly used. The returns from several hospitals and institutions for the last ten years are summarised and submitted in this report. They should be regarded as being only approximately accurate,
Tuberculosis.—Dr. H. Scott, the Government Bacteriologist concluded an investigation into tuberculosis as a cause of death in Hongkong, especially with regard to the prevalence and character of the disease in children. He summarises the enquiry thus: “A very brief experience as medical officer in charge of the mortuary sufficed to show that tuberculosis is a frequent cause of death in Hongkong, and I deemed it an investigation well worth undertaking to determine the varieties of the disease as met with here, the portals of entry, the mode of spread, and, if possible, to determine the primal cause or causes responsible for the condition and those aiding its dissemination, with a view to elucidating measures for its prevention."
He is of opinion that the prevalence of the disease is closely connected with social and economic conditions; that the ingestion of tuberculous milk, has no influence here, for Chinese children do not drink it, nor does it arise from the use of tuberculous meat; that the chief predisposing causes of the prevalence of tuberculosis are overcrowding and absence of sunlight from the living room; but the direct cause of this prevalence is the Chinese habit of expectorating at all times and places.
As to the portals of entry and mode of spread of tuberculosis, in a series of 300 examinations Dr. Scott estimates that in 72 per cent. the portal of entry appeared to be by the respiratory tract, and a little more than 12 per cent. was of alimentary origin; in the remainder of the cases the primary portal was not certainly ascertained; but cases of isolated primary tuberculosis of the intestine very rarely occur in Hongkong in his experience.