CO885-6 — Page 50

PUBLIC RECORD OFFICE

Reference :-

C.O. 882

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PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

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spite of sickness, while many told me that they had been brought, as it were, "second- hand," from Singapore, and that they were suffering from disease when they came to the State.

The aggravated state of the disease among many Chinese patients is, I think, due to the indiscriminate use of mercury among Chinese practitioners, while, on the other hand, in many cases the same drug is used by the same men with benefit. The absolute neglect of cleanliness is, of course, in all cases an aggravating influence.

To

As to whether venereal disease is or is not on the increase, any opinion of mine must be entirely founded on general impressions, and these are unreliable. I have no evidence available to show that it is either on the increase or decrease. That larger numbers are admitted to the hospitals suffering from venereal disease is to be expected from the fact that there is more accommodation available every year for the treatment of less severe forms of disease, and that, with improved efficiency of staff and improved facilities for separation of cases, correct diagnosis of cases becomes more possible. give an instance in point: "Rheumatism " used to be one of our commonest diseases; most careful enquiry into the past histories of patients shows a large proportion of these to be malarial, a still larger to be syphilitic. We seldom see a case of pure rheumatism.

In connection with the whole subject the question of transmission of leprosy along with syphilis (or other venereal disease) raises a serious question. The figures quoted above from the Leper Hospital show how prevalent a syphilitic history is among lepers. The co-prevalence of syphilis with leprosy is well known in Iceland, Scandinavia, and Northern Russia, while the measures taken in towns in both England and Scotland centuries ago show that no distinction was then made between the two diseases. The question is one, however, at present more of speculative than practical interest.

As to any measures for the amelioration of the existing state of things all I can say that these to be of any use would have to be of the most drastic description: (i.) In- creased strictness in the admission of women from Singapore and Penang. (ii.) Strict registration of brothels, with better sanitary arrangements. (iii.) Careful and regular examination of public women. (iv.) If possible, examination of all coolie bangsals and enquiry into any possible cases of sodomy. That the last are frequent I know from my experience in attending on the coolies in Mr. M. Campbell's coolie bangsals some years ago. That it not unfrequently transmits the disease I know from certain cases which have presented themselves at the Pauper Hospital.

I have, &c.,

Pauper Hospital, Selangor, April 21, 1897.

J. L. WELCH,

District Surgeon.

MEMORANDUM by the State Surgeon, Selangor.

As requested by the Resident-General, I have the honour to report upon venereal contagious disease in Selangor.

2. I propose to divide my report into three headings :- 1st. The prevalence of contagious disease in Selangor.

2nd. The condition of the brothels and their inmates, with measures taken to im- prove them from a sanitary point of view, and to diminish the misery caused by venereal disease.

3rd. Suggestions and reasons for action in the future.

3. The prevalence of infectious disease in Selangor.-The returns from all hos- pitals in the State for the last ten years give the following figures as to the annual number of venereal cases treated as in-patients:-

No. of Cases of Venereal Disease,

Year.

1886

96

1887

222

1888

267

1889

207

1890

350

1891

447

1892

545

1893

571

1894

974

1895

766

1896

921

89

5. It is necessary to point out that these figures in no way represent the actual amount of venereal disease in the State. Owing to their lack of knowledge of these diseases, the Chinese and others do not understand the vital importance of careful and continued medical treatment in the slighter forms, and never apply for assistance until they are actually unable to work. The figures given above represent, therefore, only those cases of venereal disease which have developed to such an extent as to disable the unfortunate sufferers.

6. When it is borne in mind that the subsequent results, both hereditary and other- wise, of syphilis, in no way depend on the severity of the outward manifestations, it will be seen that among a more or less unintelligent population statistics of disease of this nature are not wholly illustrative.

a careful examination of all

7. I attribute more importance to the results prisoners in the Pudu Gaol made for the purpose of this report.

A total number of 455 prisoners were examined, of whom no less than 164 bore actual scars and other signs of undoubted venereal disease; there were undoubtedly many, many others who had suffered from syphilis, but presented no outward signs of it. I made an attempt to gather some particulars from the prisoners, but found their answers so unreliable that I abandoned the attempt as misleading.

8. The condition of brothels in the past. Reporting on the brothels in Kuala "The houses occupied by Lumpor in 1892, I made use of the following description:- Chinese prostitutes are of one description, consisting of two or three storied buildings, with narrow passages running the whole length of the house; doors at intervals along the passages open into small oblong boxes, which are pitch dark even in the middle of the day, and are lighted with a small lamp. The air in the rooms is foul and stagnant. It seems incredible to a European that women can exist in such a horrible and, in many cases, fœtid atmosphere."

9. The women brought occasionally to the hospital for treatment were found to be in an advanced state of disease, and almost invariably stated that they had been forced by the brothel keepers to continue their usual method of earning their living almost up to the date of admission to hospital.

10. At this time compulsory examination and treatment in hospital of prostitutes having been forbidden, a system of registration was carried out, by which certain houses were set apart as brothels, and the inmates registered by the police, a fee of 25 cents per month being paid by each prostitute. The registration was, however, carried out by a police officer, who could not speak Chinese, and was of little value.

11. The introduction of Regulation No. XII. of 1893 gave full powers to the officer in charge of the Chinese Protectorate, as Registrar under the Regulation, to exercise all proper supervision over the brothels and their inmates. Provision was made for registration and inspection, as well as for the maintenance of cleanliness and order. The minimum size and cubic space of rooms was also laid down,

12. Armed with the powers given him under this Regulation, the Chinese Secre- tary, aided by the Health Officer, at once set himself to deal energetically with the sanitary condition of the brothels, which were a disgrace to any civilised community.

13. The houses were dealt with one by one, the ventilation and lighting of the rooms and passages was improved by gratings in the floors and glass tiles in the roofs, openings for ventilation were made in the sides of the rooms, partitions were in many cases taken down, the latrines were altered and added to, and the houses were white- washed throughout. A list of the inmates of the brothels was kept at each house, and if, when visiting the brothels, the Registrar or his representative came across any prosti- tute appearing to be sick, she was at once sent to the General Hospital for treatment.

14. These improvements were very greatly appreciated by the respectable classes of Chinese, and the Members of Council did all in their power to assist in the good work, which they fully recognised. About half the brothels in Kuala Lumpor having been dealt with, this excellent Regulation was, to the astonishment of everyone, suddenly repealed and replaced by another, which effectually stopped the progress of this good work by taking all power out of the hands of the Chinese Secretary and Health Officer. The brothels are now entirely neglected, and the worst class of brothel keepers are at liberty to keep their houses in as insanitary a condition as they please.

15. The better educated Chinese naturally ask why a good work of this nature should be abandoned, and why a Government the advantage of whose administration is everywhere apparent should utterly neglect this question, and appear to encourage and abet the brothel keepers in carrying on a condition of things which is a disgrace to the town. It is difficult to answer them.