18. For the treatment of cases all the methods advocated by modern authorities were made use of but in spite of the most careful attention the death rate was 49.1 per cent,
19. Smallpox.-Every year in the cold season this disease manifests itself in outbreaks which are sometimes sporadic, sometimes epidemic. Whatever the prevalence there is always a tendency for the morbidity rate to decline or disappear with the advent of summer. In the year under review there were 212 cases and 175 deaths.
20. The rescission last year of the Sanitary Board's resolution of 1917 authorising the exemption of smallpox cases from isolation under certain conditions did not, as some had supposed, result in a diminution of the notification rate and an increase of concealment. If anything there was a greater tendency for the cases to seek hospital treatment.
21. The vaccination campaign was continued and during the year 276,424 persons were vaccinated. Valuable assistance was afforded by the St. John Ambulance Brigade and by the Chinese Public Dispensaries. Both bodies engaged in active propaganda and through their efforts many were persuaded who otherwise would have kept aloof. The various sections of the Brigade again carried out street vaccination with excellent results.
22. The Chinese have a preference for vaccination in the spring as being the auspicious season, and for a month or two after Chinese New Year the Chinese Public Dispensaries are crowded with children waiting to be done.
23. The majority of Chinese still hold the opinion that the herbalist treatment of smallpox gives better results than the methods adopted by practitioners qualified in Western medicine. An analysis of the statistics of (a) the Tung Wah Infectious Diseases Hospital where only herbalist treatment is carried out, and (b) the Government Infectious Diseases Hospital where western treatment only is provided shows that this view is not correct. Calculating on the figures for the last 23 years the case death rate at the Tung Wah was 46.63 per cent while that at the Government institution was 14.86 per cent.
24. Plague.-For the last three years no cases of plague have been reported in Hong Kong. The disappearance of this disease not only from this Colony but from the greater part of China and its decline throughout the world are due to factors which are not understood.