C.O.133
Reference: 21
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Table XIII gives the rate of mortality in the Civil Hospital during the past seven years, distinguishing the rate in the case of Europeans from Colored persons and Chinese.
Table VI, kindly sent to me by the Resident Surgeon, Dr. Adams, gives information in reference to the Seaman's Hospital similar to what may be gathered from Table V in regard to the Civil Hospital.
Table VII I have constructed on the same plan as Table IV, so as to give the number of admissions into the Seaman's Hospital during the last seven years, with the result of the treatment in each case.
It cannot be denied that the result is not so satisfactory as might be desired; I can only repeat, however, what I have already mentioned in these Reports, that no fair rate can be looked for until the building and appliances for treatment are placed upon a very different footing from that which they now present; at the same time, it must not be forgotten that among the number of admissions there are not dozens of moribund destitutes brought within the walls only to die, as constantly occurs in the Civil Hospital.
In the Civil Hospital the result of treatment has been more satisfactory than it was in 1863, but is still above the average, and much above what it was in 1860–61 and 62: this high rate has been maintained by the epidemic of smallpox already referred to — by a great increase in the number of admissions of cases of Diarrhea — by an altogether unusual number of severe cases of wounds, more especially of the abdomen, a most formidable class to treat; and, lastly, by the smaller but still large number of cases of starvation and destitution, many of which are admitted almost dead, but go to swell the rate of mortality.
Still the death rate in the Civil Hospital of this Colony is not so high but that it will bear favorable comparison with that in European Hospitals, as may be gathered from an examination of Table XIII with the following data.
Rate of mortality in the following Hospitals in the year 1862
| Hospital | Mortality Rate |
|---|---|
| St. George's | 8.3 per cent. |
| Charing Cross | 8.2 per cent. |
| Great Northern | 11.2 per cent. |
| University College | 10.7 per cent. |
| St. Bartholomew's | 17.0 per cent. |
| King's College | 12.06 per cent. |
| Hôpital Cochin (Paris) | 12.01 per cent. |
| Hôtel-Dieu (Paris) | 14.4 per cent. |
Our average for seven years is only 8.79 per cent, and last year was 9.63 per cent — a rate for which there is great reason to be thankful.
It remains a matter for serious consideration, however, that there were no less than four admissions resulting from starvation among Europeans, and that two of that number died.
Many improvements have taken place during the past year in the establishment itself. Among these the most important are the introduction of proper latrines and baths; increased pay to the wardmasters, who are consequently more attentive to the patients; monthly Reports from the Superintendent, forwarded to His Excellency the Governor, pointing out repairs and alterations required; and, lastly, regular visitation by the Justices of the Peace. With the present system in force, I look confidently for even better results than we have yet obtained — results which would appear almost incredible when compared with those of 1858, but not more marked than the contrast between the present condition of the Institution and that which it presented in 1858.
Table VIII shows the number of admissions into the Gaol Hospital, and deaths there during the seven years ending 31st December 1864.
Table IX shows the rate of admissions into the Gaol Hospital, and the rate of mortality there during the same seven years.
The death rate, although somewhat higher in 1864 than in the previous year, was not equal to the average of seven years, nor much above that of several of our English Prisons. There occurred no disease in an epidemic form, and the deaths of the two Europeans who died, one a soldier, were such as could in no way be attributed to the system of incarceration. The soldier was from disease of the heart, which proved fatal from excitement at the moment when he was about to be sent on board ship for removal to England; he fell dead in the Court Yard, in presence of his escort — the second died of serous apoplexy, the result of prolonged intoxication prior to admission.
The building is clean and well ventilated, and under its present able management should maintain the satisfactory sanitary condition for which it has been long known.
The numbers confined in Victoria Gaol during the year were:
The daily average was 447, of which number only 18 died.
The following is a curious table showing how far Europeans are affected in health by long imprisonment as proved by their weight.
| Name | Sentence | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C. W. | Life | 155 | 150 | 154 | 153 | 153 | 150 | 151 | 150 | 148 | 147 | 145 | 145 |
| J. P. | 7 years | 110 | 119 | 122 | 117 | 118 | 114 | 113 | — | — | — | — | — |
| W. M. | Life | 114 | 110 | 146 | 147 | 152 | 148 | 140 | 145 | 140 | 147 | 147 | 150 |
| R. L. | 7 years | 147 | 129 | 135 | 133 | 139 | 180 | 197 | 130 | 134 | 197 | 128 | 131 |
| W. S. | 7 years | 128 | 130 | 152 | 150 | 146 | 142 | 150 | 104 | 154 | — | — | — |
| W. D. | 7 years | 145 | 147 | 145 | 146 | 146 | 140 | 152 | 153 | 154 | 148 | 161 | 150 |
| W. H. | Life | 102 | 107 | 103 | 162 | 160 | 147 | 140 | 138 | 141 | — | — | — |
| C. A. | Life | 120 | 120 | 128 | 120 | 129 | 131 | 131 | 191 | 130 | 180 | — | — |
| J. D. | 7 years | 142 | 142 | 143 | 143 | 149 | 145 | 154 | 155 | 166 | 157 | 157 | — |
| G. B. | 7 years | 150 | 148 | 162 | 160 | 140 | 144 | 149 | — | — | — | — | — |
| W. H. (2) | 7 years | 154 | 155 | 166 | 157 | 157 | 150 | 148 | 162 | 160 | 140 | 144 | 149 |
These men were removed to Stone Cutters' Island.
It will be seen that, as a rule, the men lose weight in the summer, which they generally regain in winter. The table also points out the fact of two prisoners, out of the four named in the table as condemned for life, who have gone on steadily gaining weight, contrary to what might be expected to occur to men who have lost all hope of freedom.
The table is only the commencement of a series of observations I propose to make on this subject.
Table X shows the rate of sickness and mortality in the Convict Hulk at Stone Cutters' Island during the past year. The result shown here is very satisfactory. The total number of prisoners was 412 against 384 in 1863 — giving a daily average of about 240 against 250 in 1863, and the rate of both sickness and mortality markedly diminished.
In 1863 the rate of mortality to the total number of prisoners was 10.67 per cent and to the average 36.40 per cent, while in 1864 it was only 1.69 per cent to the total, and 2.00 to the average number of prisoners.
The Hulk was visited daily by the Surgeon appointed to perform that duty and was inspected by me from time to time. During these inspections, some of which were made in the middle of the night, I directed my attention especially to the temperature between decks and to the state of ventilation. The latter appeared to me very good, and the following Table will show what the temperature was:
| Month | Maximum (°F) | Minimum (°F) |
|---|---|---|
| January | 65 | 60 |
| February | 65 | 60 |
| March | 72 | 63 |
| April | 83 | 71 |
| May | 88 | 78 |
| June | 88 | 80 |
| July | 90 | 82 |
| August | 90 | 83 |
| September | 86 | 78 |
| October | 83 | 75 |
| November | 78 | 70 |
| December | 74 | 58 |
I think this result very satisfactory, and the fact of an increased number of Convicts on board the vessel presenting such a marked degree of health shows how unfounded was the notion that the Royal Saxon had been overcrowded in 1863.
I have to report the continual good derived from this Institution and the working of Ordinance No. 12 of 1857, by which it was established.
Table XI affords instructive information on this subject.
It points out how, during the seven years the Ordinance has been in force, 2,430 infected women have been segregated from the localities in which they could convey infection, and that during a total of 65,916 days — in other words, supposing that every infected woman would only convey the disease to one man during each day she was so diseased — we have 65,018 cases of disease prevented, or at least that number of opportunities of conveying the disease prevented. But this must be greatly below the amount of good done, for without the present system the women would probably continue infected for a much longer time, and it is certainly a very low estimate to say that each one would only infect one man a day. This table points out further that the duration of treatment has steadily diminished up to last year. The increased ratio I believe to be referable to two causes, viz: the return from Shanghai and the North of many badly diseased women, and some imperfections in the Ordinance which the women have discovered and by which they are enabled to evade the Inspector of Brothels. I believe that it will be necessary to revise this Ordinance and amend it so as to meet the changes in the Town and the defects in its working, for it behooves us to maintain the reputation we have gained for a station, once notoriously infected, having nearly purged itself of the foul disease.
In the year 1862 the enormous prevalence of Venereal disease in the Army and Navy caused a Royal Commission to be issued for the purpose of devising measures to check in some manner its spread. In the "Confidential Report" issued thereon, the good work begun in this Colony is thus acknowledged: "Too much credit cannot be given to those who have been concerned in the framing and working of the enactments which have produced such good effects at Malta and Hong Kong." But it will require unremitting attention to deserve a continuance of such commendation.
Table XII gives fuller details as to the character of the disease and average duration of treatment during every month of the year 1864.
Table XIV is an approximative estimate of the mortality among Foreign Residents in Hongkong during the last seven years. The data from which it is compiled are furnished to me by the Registrar General as regards the number of Residents, and by the Sextons of the two cemeteries as regards the deaths, excluding in both cases military and naval and merchant seamen, as well as burials from the Hospitals. A further deduction of no less than 42 out of the 151 deaths recorded must be made for the wives and children of soldiers, a class of the community peculiarly sickly. In this manner of compiling the table it appears, as there were good grounds to expect, that the past year has been more healthy than 1863 and the mortality among the actual Residents smaller. But there are many difficulties in the way of obtaining accurate information for statistical purposes. Among these must not be forgotten the peculiarly migratory character of our Foreign population, and the reputation Hongkong has attained as a sanitarium in China, thus bringing many sick here for change. Should it ever be found advisable to appoint a registrar of births, deaths and marriages, and make the registration compulsory, many of the difficulties now existing would disappear.
Table XV gives the usual information regarding the work performed by the Inspector of Nuisances attached to this Department.
Table XVI shows the annual mean state of the atmosphere during the year 1864 as recorded at the Government Civil Hospital. It points out the great increase in the fall of rain, and the lower range of the Thermometer and Barometer.
J. I. MURRAY, M.D., Colonial Surgeon
122
C.O.133
Reference :--
21
COPYRIGHT PHOTOGRAPH-NOT TO
BE
REPRODUCED PHOTOGRAPHIC- ALLY WITHOUT PERMISSION OF THE
PUBLIC RECORD OFFICE, LONDON
EP1440 anosa
Table XIII. gives the rate of mortality in the Civil Hospital, during the past seven years, distinguishing the rate in the case of Europeans from Colored persons and Chinese.
Table VI., kindly sent to me by the Resident Surgeon, Dr. Adams, gives information in reference to the Seaman's Bos- pital similar to what may be gathered from Table V. in regard to the Civil Hospital.
Table VII. I have constructed on the same plan as Table IV., so as to give the number of admissions into the Seaman's Hospital, during the last seven years, with the result of the treatment in each esse.
It cannot be denied, that the result is not so satisfactory as might be desired; I can only repeat, however, what I have already mentioned in these Reports, that no fair rate can be looked for, until the building and appliances for treatment are placed upon a very different footing from that which they now present; at the sometime, it must not be forgotten, that, Among the number of admissions, there are not dozens of moribund destitutes brought within the walls only to die, as cons- tantly occurs in the Civil Hospital.
In the Civil Hospital the result of treatment has been more satisfactory than it was in 1863, but is still above the average, and much above what it was in 1860-61 and 62: this high rate has been maintained by the epidemic of entall
ΧΙΟΣ,
already referred to—by a great increase in the number of admissions of cases of Diarrhea-by an altogether unusual number of sovere cases of wounds, more especially of the abdomen, a most formidable class to treat; and, lastly, by the smaller but still large, number of cases of starvation and destitution, many of which are admitted almost dead, but go to swell the rate of mortality.
Still the death rate in the Civil Hospital of this Colony, is not so high hut that it will bear favorable comparison with that in European Hospitals, as may be gathered from an examination of Tuble XIII, with the following data.
Rate of mortality in the following Hospitals in the year 1662.
St. George's
Charing Cross
Great Northern .....................
University College.. St. Bartholomew's
King's College... Hopital Coolin
Hotel Dira
}(Paris)
8.3 per cent.
8.2 11.2
n
"
"
107 17 "
12.06 12.01
"
n
1
44
Our average for seven years is only 8.79 per cent, and last year was 9.63 per cent--a rate for which there is great reason to be thankful.
It remains a matter for serious consideration, however, that there were no less than four admissions resulting from stur- vution among Europeans, and that two of that number die.
Many improvements bave taken place during the past year in the establishment itself. Among these the most important are the introduction of proper latrines and haths; increased pay to the wardmasters, who are consequently more attentive to the patients; monthly Reports from the Superintendent, forwarded to His Excellency the Governor, pointing out repairs and alterations required; and, lastly, regular visitation by the Justices of the Peace. With the present system in force, I look confidently for even better results than we have yet obtained-results which would appear almost incredible when compared with those of 1858, but not more marked than the contrast between the present condition of the Institution, and that which it presented in 1858.
III. THE GAOL
Table VIII, shews the number of admissions into the Gaol Hospital, and deaths there during the seven years ending 31st December, 1864.
Table IX shews the rate of admissions into the Gaol Hospital, and the rate of mortality there during the same seven years.
The death rate, although somewhat higher in 1864 than in the previous year, was not equal to the average of seven years, nor much above that of several of our English Prisons. There occurred no disease in an epidemic form, and the deatlis Of the two Europeans who died, one, a generally were such as could in no way be attributed to the system of incarceration. soldier, was from disease of the heart, which proved fatal from excitement at the moment when he was about to be sent on board ship, for removal to England; he fell dead in the Court Yard, in presence of his escort-the second died of serous apoplexy, the result of prolonged intoxication prior to admission.
The building is clean and well ventilated, and under its present able management should maintain the satisfactory sanitary condition for which it has been long known.
The numbers confined in Victoria Gaol during the year were:—
Chinese,....
Total,.
800 176
.3,478
The daily average was 447, of which number only 18 died.
The following is a curious table, shewing how far Europeans are affected in health by long imprisonment as proved by their weight.
NAXE
SENTENCE.
*ANYANYA
FEBRUARY.
MARCH.
APRIL,
MAY.
JUNK.
JULY.
AUGUST.
SEPTEMBER.
OCTOBER.
NOVEMBER
DECEMBER.
C. W.
.Life,
155
150 154
153 153 150 151
150
148 147 145 145
J. P.
7 years,
110
119 122
117
118
114
113
·
W. M.
R. L.
Life,
years,
114
110
146
147
152
148
140
145
140
147
147
150
147 145 146 144 143 134 138
135
W.8.
years,
129
W.D....
years,
W. H.
Life,
C. A.
Life
J. D.
G. B.
years, years,
W.H.
H years,
147
129 135 133 139 180 197 130 134 197 128 131
128 130 152 150 146 142 150 104 154
145 147 145 146 346 140 152 153 154 148 161 150 165
102 107
103 162 160 147 140
138 141
120
120
128
120
129
131 131 191 130 180
142 142
143 143 149
145
154
155
166
157
157
150
148
162
160
140 144
149
It will be seen that, as a rule, the men lose weight is the summer, which they generally regain in winter. The talla also points out the fact of two prisoners, out of the four named in the table as condemned for life, who have gone on stendily gaining weight, contrary to what might be expected to occur to men who have lost all hope of freedom.
The table is only the commencement of a series of observations I propose to make on this subject.
IV. THE CONVICT HULE.
Table X. shews the rate of sickness and mortality, in the Convict Hulk at Stone Cutters' island, during the past year. The result shewn here is very satisfactory. The total number of prisoners was 412 against 384 in 1863—giving a daily sverage of about 24 ugainst 250 în 1863, and the rate of both sickness and mortality markedly diminished.
In 1863 the rate of mutality, to the total number of prisoners, was 10.67 per cent and to the average 36.40 per cent, while in 1964 it was only 1.69 per cent to the total, and 2.00 to the average number of prisoners,
The Hulk was visited daily by the Surgeon appointed to perforta that duty and was inspected by me from time to time. During these inspections, some of which were made in the middle of the night, I directed my attention especially to the tem- perature between decks and to the state of ventilation. The latter appeared to me very good and the following Table will show what the temperature wAIZ
Month. January,.
Maximum. .05
Minimum.
60
February,
.65).
00
March,
72
83
April,
.83
.71
May,
80
.78
June,
.88
.80
July,
80
.82
August,
.90
.83
September,.
.26
.78
October,
23
.75
November,. December,.
.78 .74
.70
.58
I think this result very satisfactory, and the fact of as increased number of Convicts, on board the vessel, presenting suck a marked degree of health, shows how unfounded was the notion that the Royal Sazon had been overcrowded in 1803.”
Y. THE LOCK HOSPITAL.
I have to report the continuel good derived from this Institution and the working of Ordinance No. 12 of 1867, by which it was established.
Table XI, affords instructive information on this abject.
It points out how, during the seven years the Ordinance has been in force, 2,430 infected women hare been segregated from the localities in which they could convey infection, and that during a total of 65.916 days-in other words, supposing that every infected wonun would only convey the disease to one man, during each day she was so diseased, we have dö,018 cases of disease preventeil, or at least that number of opportunities of conveying the disease prevented. But this must be greatly below the amount of good done, for without the present system the women would probably continge infected for a much longer time, and it is certainly a very low estimate to say that each one would only infect one man a day. This table points out further, that the duration of treatment has steadily diminished up to Inst year. The increased ratio I believe to be referable to two causes, viz; the return from Shanghai and the North of wany badly diseased women, and some imperfections in the Ordinance, which the women have discovered and by which they are enabled to evade the Inspector of Brothels. I beliers that it will be nécessary to revise this Ordinance, and amend it so as to meet the changes in the Town and the defects in its working, for it behores us to maintain the reputation we have gained for a station, once notoriously infected, having nearly purged itself of the foul disease.
In the year 1802 the enormous prevalence of Venereal disease in the Army and Navy, caused a Royal Commission to be issued, for the purpose of derising measures to check, in some manner, its spread. In the "Confidential Report” issued thereon, the good work begun in this Colony is thus ocknowledged: “Too much celit cannot be given to those who hare "been concerned in the framing and working of the enactments" which have produced such good effects at Malta and Hong- “kong." But it will require unremitting attention to deserve a continuance of such commendation.
Table XII. gives fuller details as to the character of the disease, and average duration of treatment during every month of the year 1804.
Table XIV. is an approximative estimate of the mortality among Foreign Residents in Hongkong, during the last seven years. The data from which it is compiled are furnished to me by the Registrar General as regards the number of Residents, and by the Sextons of the two cemeteries as regands the deaths, excluding in both cases military, and naval and merchant seamen, as well as burials from the Hospitals. A further deduction of no less than 42 out of the 151 deaths recorded must be made for the wives and children of soldiers, a class of the commanity peculiarly sickly. In this manner of compiling the table it appears, as there were good grounds to expect, that the past year has been more healthy than 1863 and the mortality among the actual Residents swaller. But there are many difficulties in the way of obtaining sccurate information for statis- tical purposes. Among these must not be forgotten, the peculiarly migratory character of our Foreign population, and the reputation Hongkong has attained as a sansturium in Chine thus bringing many sick here for change." Should it ever be found advisable to appoint a registrar of births, deaths and marriages, and make the registration compulsory many of the difficulties now existing would disappear.
Table XV. gives the usual information regarding the work performed by the Inspector of Xuisancen attached to this Department.
Table XVI. shows the annual mean state of the atmosphere during the year 1804, as recorded at the Government Civil Dospital. It points out the great increase in the full of rain, and the lower range of the Thermometer and Barometer.
J. I. MURRAY, M.D., Colonial Burgw2.
122
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