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260.
appears to me that the questions of most importance to be answered are:---
1. Does Syphilitic disease left unchecked inflict serious injury not only on the individual infected, but on generations unborn?
2. Is it possible by any legislative incans to check the spread of this fearful scourge?
3. How far can legislative interference be applied to the male as well as to the female sex? 4. What has been in this Colony the sanitary result of such interference?
It will not be necessary to dilate on the first point. It is unfortunately too well known how the victims of this loathsome disease are lowered in their moral and physical condition, how from symptom to symptom they may, after years of misery, sink finally into a premature grave. But it is not per haps so well known that the wide spread scrofulous and consumptive taint of the human race is traced by some men of science to a syphilitic poison. Nor is it sufficiently recognized how such a poison coursing through the system, renders the infected person immeasurably more liable to and less able to resist the inroad of other diseases. This is a subject particularly important to the Residents of tropical clinates; for could the united experience of medical practitioners in the tropics be reduced to a statistical form, it would prove not a little startling, to find how large a proportion of the mortality and invaliding could be traced directly, or remotely, to syphilitie disease.
That it is possible to a great extent to reduce, if not entirely prevent, the spread of this disease by legislative measures is a fact generally admitted by all unprejudiced persons. A most notable instance of this power was seen some years ago in Malta, where up to 1859 a strict system of super- vision and personal inspection was maintained and the disease was in consequence almost unknown. The system was then abandoned as it was found to be a "traditional abuse of power," which at last was resisted by the peculiar class of persons concerned, and Malta, for a time aid until the passing of an Ordinance, became as bad as any other garrison town in respect to contagions disease. The sim result cannot be shown in Hongkong, but I shall be able presently to point out the great improvement that has resulted from legislative interference, not only in reducing the extent, but also the malignity of the disease.
The great ontery against the Contagious Diseases Acts now (for the old plea of the immorality of licensing vice has been partly abandoned) is that they deal unfairly in the case of the two sexes and as the present opponents of these Acts say, punish the comparatively innocent female and let her nore guilty partner in iniquity go free. This is a great mistake on their part, for these Acts are not introduced for the purpose of punishment, but with the sole object of restricting the extent of con tagion and curing the disease. Moreover, in this Colony at least, the Acts are as far as practicable applied to the male sex equally. Thus before leave is granted to seamen of the Royal Navy they all undergo medical inspection and are detained on board if found diseased. By a very slight outlay a similar inspection might be made of all merchant seamen, and I hope still to see that this will be con- sidered to be one of the duties of the Health Officer or Officers of the Port. The whole of the Police Force undergo a similar examination once every month, and certainly the soldiers of the garrison might be equally examined. * Lastly, as if to meet the objections of those who consider these Acts as one sided, it is especially provided in our local Ordinance, that all seamen known to be diseased, residing in any boarding house, must under a heavy penalty be reported to the Harbor Master for the purpose of transference to Hospital. There only remain therefore the higher class of transgressors against whom it is more difficult to proceed, and as if to balance this, the numerous Portuguese and European prostitutes who now frequent the Colony appear to be equally exempted froin all interfer- ence on the part of the Executive. And here a very important question presents itself, viz: whether disease has increased among the class of young men who formerly frequented the native establishments. For
my
own part I am inclined to the opinion that it has so increased, but I am not prepared with statistics on this subject.
Lastly, I come to consider the question of the sanitary result of legislative interference in this Colony-und I am glad to be able to point to some very substantial benefits.
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In 1859 I wrote: "Both among Naval and Military invalids the syphilitic amount to nearly 23 per cent of the whole, and this is very nearly the same proportion in the Goverment Civil Hospital. In one ship numbering in all 523 hands, of which 300 had been on the sick list, during the last "quarter, 77 of these were for venereal diseases, being at the rate of 25.66 per cent of the total sick "or 14.72 per cent of the total strength, and that be it observed in one quarter. In the Government "Civil Hospital the proportion of venereal cases was 138 out of 591 admissions, being in the propor “tion of 23.18 per cent.” Now if the Returns accompanying this Report be contrasted with that former state of inatters, it is seen that during the year 1869, as the result of the working of the Con tagions Diseases Ordinance, that disease has greatly decreased. In the Government Civil Hospital, even in spite of the great number of cases sent by the Harbor Master, the per centage of syphilitie cases was reduced to 15.82. In the garrison, the per centage of primary disease to the total strength' was only 6.83, according to a Return compiled from data furnished to me by Dr. Heffeman, the Deputy Inspector General. † In the Police, it was 16.66 against 31.00 per cent in 1862 as shown in Table XV., and in a most interesting letter ‡ addressed to ine by Fleet Surgeon, Dr. Maccoun of the United
• Sir II. Storks recorurnends that the meu should be examined at least once in seven days.
↑ Sec Appendix A. See Appendis B.
if
281.
142
States ship Delaware, on the eve of his departure from the Colony, he says: "Sinco my arrival on this "Station in the Spring of 1868, I have been struck with the benefit derived from the systern of "Registration and Inspection of public women, so ably carried out in this Colony ". "During our "visits to Hongkong, but few have been infected, and the type of the disease is very mild "..............“ Out of a crew of 470 men, only five cases of Chancre have been noticed." But the whole letter deserves to be carefully perused and I think, coming as it does from a perfectly independent source, it is one of the most valuable testimonies that could be adduced in support of the good results of the system. And if we turn to Table X., we find that the type of the disease must have equally improved; at least the average duration of treatment, which may be considered to be a fair test of the severity of a case, has diminished from 43.8 days in 1868 to 24.8 in 1869. I admit that the working of the Ordinance is by no means perfect, and I am still of opinion that all prostitutes, whether in so called purely Chinese houses, or others, should be examined. In this opinion I aun not supported by some of those who are supposed to be peculiarly conversant with the habits of the natives, and in deference to their opinion those houses are exempted from the action of the Ordinance. But, independently of the question whether the Chinese are not equally entitled to share in its beneficial action, if its operation is really for good, I am confident that until all prostitutes are subject to the requirements of the Ordinance, this result will be limited-for I am aware that the inunates of the so called purely Chinese brothels will visit the houses of Europeans, although they may not admit them into the brothels, under the dread of losing their license.
The only question that remains to be referred to, and that very cursorily, is whether the Ordi- nance under discussion has had any effect in withdrawing the fear of syphilitic infection from those upon whom it has had a deterrent effect. Such an idea will not bear investigation. The frequenters of brothels are either under the influence of drink at the time, or have lost all dread of the conse they can fall with impunity. As long as men ure inen, vice will continue, and it is clearly the duty quences-and in no case I believe will young men be led into temptation for the first time because of the legislature to protect, if not the actual transgressor, at all events the innocent, from the fearful consequences of discase.
Table XI. shows the usual approximative estimate of the mortality among the Foreign Residents in Hongkong during the past twelve years. But as I have already stated at the commencement of this Report, the data from which this table is compiled are extremely defective. It does not include deaths among soldiers, sailors whether of the Navy or Merchant Service, nor those buried from the Hospitals, who are usually non-residents. No time should be lost in making some arrangement, by which every body for burial shall be accompanied by the certificate, of a properly qualified medical practitioner, as to the cause of death, &c., which certificate shall be duly registered-and until this is done all statistical Returns can only be approximative to say the most for them.
Table XII. gives the usual information regarding the work performed by the Inspector of Nui. sances attached to this Department.
Table XIII. shows the annual mean state of the atmosphere during the year 1869, as recorded at the Government Civil Hospital.
J. I. MURRAY, M.D., Colonial SurgeOR.
The Honorable J. GARDINER AUSTIN,
Colonial Secretary.
Appendix A
TABLE shewing the Number of CASES of PRIMARY VENEREAL DISEASE in the Gabbison during the undermentioned Years.
1867.
1808.
1869.
DISEASES.
Per
Per
Euro- Asia-
tics, peans.
Total
Centage Euro-| Asia-
Total.
of
peans.
tics.
Strength.
Centage Euro- Asia-
of
tice. Strength
Total.
Per Contage
[peans.
of
Strength.
4
4
A 0.00
10 0.78
2
0.13
21
18
39 3.40
31
38 2.78
19
3
1.50
Gonorrhoea,
29
19
48 4.18
57
60
5.00 62
4.10
Orchitis,
4
4
8
0.60
1.00
l'hymosis and other,.
4
$
0.34
Total,.
€2
45
107
9.32
100
195 0.17
88
Bubo,.. Syphilis Primary,
**
c,
882.18
0.20 15
4 0.29
12 100 6.63