RECORD OFFICE
Reference:
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The diseases most prevalent and the must dangarous to life in Hongkong, are undoubtedly Fever-usually of the Remittent type, of which happily there have occurred but few cases last year-Dysentery, Diarrhoea, and diseases of the bowels. Acute Dysentery however is in some cases not sufficiently distinguished from a form of acute inflammation of the rectam, and the correct treatment by large doses of ipecacuan, which proves s successful in the former disease, afonds no relief in the Istter. It is not always easy to distinguish between the two diseases in the acute stage, ant still more difficult when the case assumes the Chronic fürın.*
The Chinese are remarkable for the peculiarly friable nature of their spleen, so rendering that organ extremely liable to rupture upon the application of slight riðlenca-so very slight in leed, as to leave no external trace on the body. On several occasions I have had to describe in a Court of Justica ihe candition of this organ as presenting the appearaes of a rottes apple or goard, which hal bees squashed by a blow. A somewhat singular instance of this peculiar affection was seen in the case of an Europeau Segames, a notorious drunkard, who got into a slisturbance at the Sailor's Home, and whose spleen wa ruptured in the struggle to ejset him. The Constable hat to stand his trial for manslaughter, but was acquitted as there was na evidence that the man had even been struck in the region of the spleen.
On the 7th and 8th September, and again on the Pa September and 1st October, the island was visited by typhoons which did great damage to the shipping in harbor and the buildings in the Town-but still greater damage to the health giving trees which are so highly cherished, and can be but bully spared. Any one knowing how much the great improve. ment in the state of Health of Hongkong is, at least coincident with the planting and growth of the trees that now adorn it, mast hate grieved at the havoc a few hours effected, and which years will nx repair-what may be the resulting loss of salubrity sustained is not easily estimated.
I shall now proceed to make a few remarks on the condition of the various lastítutious of which it is my duty to take cognizance in my Annual Report,
L-THE POLICE
Xumerically this Force is not munch above what it was last year--but both the European and Indian element have in. ereased at the expense of the Chinese. The death rate is therefore somewhat in excess of what it was in 1806, but still the average is under that of the onlinary residents. The rate of sickness is much lower than it was last year. Considering the ture of the duties to be performa: and the manner in which the men are liable to ha exposed to night air and other morlife influences, and the fact that one third of the entire mortality is due to consumption, I consider the result very favorable. The Sikk element, while it has improved the general appearance and hearing of the Force, has not added to its health. It is dif ficult to assign a correct reason for the result, but the fact remains indisputable, that men under military discipline re unhealthy in proportion as they diverge from the character of the true civilian,
Tablo I-Shews the number of admissions into, and deaths in, the Hospital, of Members of the Police Force, during every month of 1867. It will be seen that the greatest number of admissions took place in June and October. The latter nonth is always the most unhealthy, but September usually ranks next to it. It would appear that men are able to gi through the extreme heat of summer but break down with the change of the monsoon.
Tabla II-Shews the rate per cent of Sickness and Mortality of the Force during the same year.
Table II-Kindly furnished to me by Dr. Heffernan, Deputy Inspector General of Hospitals, and Principal Military Medical Officer, gives a comparative return of the Health of the Troops serving in Hongkong, from which it will be seen thi a further improvement in this rest has taken place among the Military last year, the rate of sickness being less than t thinls, and the rate of death sensibly lowered. The present Return is more interesting than usual, as the numbers refer to a body of men scarcely double that of the Police Force.
Table XV-Shows the rate per cent of Sickass and Mortality in the Police Force from the year 1945 to 1967, with th exception of the four years forn 1851 to 1837, of which there are no sañcient data. By this table the singular result is shest that in 1818, when the lowest rate of sickness was attained, the highest rate of Mortality was indicated, a rate seven uns what it was last year-bat, as nineteen of the deaths are accounted for by the typhoon of that year, the rate is reduced # 3.80 per cent or less than double that of 1867.
Table XVI-Shers the number of cases of Infectious disease occurring among the Police Juring the last seven years, with a classification of the special nature of the disease--an examination of this table reveals the important fact that a steady in provement in this respect has been going on in this body of men, that in the year 1807 the rate of sickness to the hot strength was only 11.13 per cent, against 310) per cent in 1800-and that the diminution of disease has taken pla especially under the head of Chanera and Bato, the two most dangerous forms for the general health of the Force.
I-THE GOVERNMENT CIVIL HOSPITAL.
Deficient as this Institution is in every essential for the effectual treatment of disease, it is with peculiar pleasure that am able to point to the last year's results, which are mainly attributable to the zeal and fidelity with which Dr. Cochran, Superintendent, performs his anlusus duties. It is not creditable to a Colony which was only lately considered one of wealthiest of its size, that it pressesses no Colaial Government Hospital worthy of the name, and that the only provision t the treatment of the sick is a mere make shift of an altered dwelling, without even the means of supplying hot baths sti moment's notice, and to which it is impossible to adapt any of the molern therapeutic improvements. This state of matte will not, I believe, be of long duration, as His Excellency the Governor, appreciating the necessity of supplying the prop incans for successful treatmusa', Iris, I understand, slra ly taken preliminary steps to prevent the Government Civil Hospi continuing to be pointed at by visitors as the one public Institution which is naworthy of inspection. Nor is it fair to t Police, in whose interest the Hospital was originally established, to transfer them for treatment of disease to worse quarte than are afforded by their own new Intracks.
It is gratifying to refer to Table IX, which presents a summary of the result of treatment in the Government Cis Hospital from the year 1819 to 1807, both inclusive, with the exception of an interval of five years between 1852 and 182 of which there appears to be no records. Nor are there any previous to the year 1819. By this table it may be seen that of 9,510 cases, treated in 14 years, 910 diel, thus giving on average Mortality of 9,57 per cent and that the average 1807, viz: 7.50 per cent-lias been lower than any year recorded since 1862, and only exceeds the three years 1800-6 and 02.
On reference to Table V, which gives the rate of Mortality during the last nine years, distinguishing that in the case Europeans from Colored Persons and Chinese, it will be seen that in no year registered has the rate been so low acet Europears as during the past one, when it only reached 4.70 per cent of the cases admitted, the year which approached nearest in point of success being 1802. A result almost as satisfactory is recorded in reference to Chinese.
• It may, however, be fairly diagnosed as the local affection, If, without other premonitzy symptom, an acute pain referred to the rectum saddest attacks the patient, and usually at night, a desire to empty the bowel being followed by violent spastas, producing excruciating pain and burning, ett some cases causing syncope, and followed either by a copious discharge of Hood, or of a mucous fluid—and all these symptoms without the pre existence of hæmorrhoids, we other local exuse of irritation. At året it is almost impossible to relieve the sufferior, owing to the spasmodic action of sphincter, but a sita bath as hot as the patient can submit to soon allows of the use of warm eneniata, which, in the few cases I have seen, have œ beneficially—and by rest, and maintenance of the heat Se a suflicient length of time, the disease has been arrested--but where the case hecpases ebr ~~and a greater number of such in-tances have come under my notice than of acute inflammation,—I have found the electuary of sulphur, inters with injections of reiste of lead and opium, or Gallie Acid supporítories, the most successful treatment. It is not easy to assign a cause for the diet but it in of the wlmost importance to distinguish it when met with.
130
Table IV-which gives the number of admissions into and the Mortality in this Hospital during the year 1867, explains to some extent the improvement. Among the Europeans the admissions for Remittent Fever have not been half as numerous as in 1860, and only one death is noted from this disease. Typlavid Fever has not been seen at all, whereas in 1868 two deaths were attributed to this cansa. No case of Delirium Tremens has proved fatal among the Europeans admitted: in 130% no less than 4 died. Apoplexy leaves an equal blank this year-of Disease of the Heart only one case terminated fatally, against 4 in 1863. On the other Land Small Pox, Phthisis and Hepatitis have been treated with less success in 1887 than in the preceding year.
Among the Chinese patients the great improvement may be mainly attributed to the milder form of Diarrhea and Dysentery, to the total absence of Yellow Fever, of which no less than 3) cases proved fatal in 1866, and to the smaller number of Phthisical patients admitted. Under the head of Starvation it is welancholy to find an equal number of patients
dying as in 1800, vir.": 17.
The increased Mortality among the colored people admitted may be said to be entirely owing to the reception of an unusual number of cases of Phthisis, of which no less than three of the fatal cases were from the Indian Police, or equal to one fourth of the entire Mortality of the Force.
Table VI-Kindly sent me by the Resident Surgeon, Dr. Adams, gives information in reference to the Seamen's Hospital. The admissions appear to have slightly exceeded those of 1861, as 324 to 313, the number of deaths being exactly the same in both years, viz.: 29, and the death rate consequently somewhat lower as 8.95 per cent against 9.20 per cent in 1860. In this Return no distinction is drawn between Europeans, Colonel persons, and Chinese-but as I ar led to believe that almost the whole of the patients belong to the tan firmer nationalities it would appear that the death rate has been nearly double what it has been in the Government Civil Hospital for Europeans and Colored persons, and even greater than that of the three classes together.
During the past year several chronic cases were received into the Government Civil, from the Seamen's Hospital-cases which could only terminate in one manner-it is to be regretted that such cases should be transferred at all. One was that of a man suffering from cluronic Dysentery, who had contracted Small Pox before his reception into the Government Civil Hospital, as the latter disease made its appearance within five days of his admission-and he died of it
"Although I do not propose entering on the subject of treatment of disease in general, the successful use of small doses of the Chlorate of Potash, in the treatment of Secondary Syphilitic affections, deserves to be recorded among the events of the year.
Daring 1867 the Harbor Master sent home 11 invalids from Hospital, and the Italian Consul 2 suffering from Phthisis. This is the greatest number ever sent from the Government Civil Hospital, and, as much has been said on the subject, I cannot owit to paint out the absolute necessity there exists for the Harbor Master retaining this power. I would even go farther, and, in the interests of humanity, arge the desirability of the power being extended to a greater degree. There can be no doubt that many valuable lives might be saved if the system of invaluding adopted in the Army and Navy extended to the Merchant service. At present invalids have to wait so long before a suitable vessel can be found to afford them a passage, that the chance of effecting good is often past, but that they should have the chance, although it may be a small one," of preserving their lives is not to be denied, even although the Masters or the Surgeaus of the Vessels compelled to afford them a passage complain of the trouble or annoyance. Vessels carrying such invalids should be required to supply a proper sick- herth, and afford kind and careful Hospital treatment-but, to carry out such a system it would be necessary for the Home Government to legislate, in the interest of the shipowner and sanetins an indetanification to him which would, however, prove, in the long run profitable to the country.
Table XVII--Shews the camber of dead bodies brought to the Government Civil Hospital for examination, with the cause of death in all cases where it could be ascertained. It will be observed that 12 are entered under the head of suffocation, caused by the numerous landslips which took place last year, 14 under the head of drowning, the result, to a great extent, of the two typhoons by which the Colony was visited.
JIL-THE GAOL.
Tablo VII-Shews the number of admissions into the Gaol Hospital, and deaths there, during the year 1867, with the average number of admissions and deaths during the past 10 years, as a means of comparison.
Table VIII-Shews the rate of sickness and mortality in the Gaol Hospital, as compared with the total number of prisoners, and with the number treated, during the year 1807.
The numbers imprisoned in Victoria Gaol, during the past year, were:
Europeans
Indians
Chinese
665
114
.4,128
Total,......4,907
The daily average was 427,15, of which number 14 died. In 1860 the total number of prisoners was 5,461: the daily average 5814, and the deaths 70. In 1800 the greatest number any one day in Gaol was on the 13th November, when there were:
Europeans
Chinese
85
.....707
Total,. .216
61
22
.992
Total,......475
The smallest number were imprisoned on the 10th March, when there were:
Europeans...............
Indians
Chinese ...
During the past year these extreme numbers have diminished in the same manner as the average. Thus the greatest number confiued on any one day in 1807 was on the 14th January, when there were:
Europeans
Indians
Chinese
Total,....
77 21
632
730
The smallest number in Gaol during the same year was on the 20th May, when there were:
Europeans .................................
Indians
Chinese ......................................
71
16
.949
Total,......430