I
4
that the present state of affairs is scarcely less deplorable than that which existed in the earlier days of the Colony before restrictive measures had been attempted.
If, as seems to have been abundantly proved, good reasons exist why the Contagious Disease Ordinances should be re-introduced into India, the foregoing statements, amply corroborated by the medical reports to which your attention is now being directed, are conclusive that remedial measures for the protection of the community are as urgently needed in Hongkong as in India, and it is the earnest hope of the Committee that action in that direction will not be long delayed.
The gradual change in public opinion in England, apparently largely due to the startling accounts sent home in regard to the condition to which the troops in India have been reduced by disease, seems to have brought a majority to the side of those who advocate a return to restrictive measures. It appears not improbable that a good deal of the opposition emanating from persons actuated by, no doubt, conscientious scruples will be withdrawn and thus render more easy of accomplishment the self-imposed task of those who are striving for reform.
To those who deny the right of interference—the result, doubtless, of honest conviction, and for that reason worthy of respect—neither facts nor figures seem to appeal; but it is difficult to imagine that even they, however much they may consider the penalties attaching to the transgression of their code of morals only just retribution, will continue to much longer oppose a movement which has among other aims the protection of innocent women and children from the fearful consequences of contamination, the occurrence of which only strong measures can prevent.
The Committee are in entire sympathy with a movement which aims at the amelioration of the present existing state of things, and will be prepared to cordially support any steps you may deem it desirable to take towards the advancement of that object.
That the re-introduction of the Contagious Diseases Ordinances, not only in India but also in the Straits Settlements and Hongkong, is imperative, has been so abundantly proved that the Committee consider it unlikely that the suggestion will any longer meet with opposition at the hands of Her Majesty's advisers. The effectiveness of the Ordinances might be much increased if, in view of the power possessed by even a single individual of spreading infection, more stringent laws were imposed as to the examination and segregation of women; but if the principle is admitted, such details may be safely left to be dealt with by medical experts.
I may mention that the two medical gentlemen already referred to are both in England—Dr. Ivor Murray at present practising in Scarborough, and Dr. Ayres resident, I believe, in London—and would, if applied to, be only too happy to furnish you with any information it may be in their power to supply in addition to that contained in the reports herewith, and would no doubt be also willing to testify afresh as to the efficacy of the Contagious Disease Ordinances in Hongkong while under their observation.
It is intended to address the Governor asking his assistance in the endeavour to bring about the re-introduction of the above Ordinances, and a copy of the letter will be forwarded to you when written.
R. S. Gundry, Esq.,
(Signed)
F. HENDERSON,
Hon. Secretary.
COLONIAL SURGEON'S REPORT, 1861.
Table VII affords a complete answer to those who think that the Ordinance under which this institution was established has effected no good. It will be seen that during the four years it has been in force 1,089 infected women have been segregated from the localities in which they could convey infection, and that during a total of 30,072 days; for, in other words, supposing that every infected woman could only convey disease to one man during each day she was diseased, we have at least 30,072 cases of disease prevented—or, at all events, 30,072 opportunities of conveying disease have been prevented. The table shows further that the average number of days in which these diseased women have been under treatment has steadily decreased until it has almost reached the minimum we can look for. This proves the disease to be milder in type, and to have been arrested in its earlier stages.
COLONIAL SURGEON'S REPORT FOR 1862.
I must be permitted to hazard the statement (the data for arriving at which I have given in former Reports), that of the total sick, in all Hospitals in the East, fully 25 per cent. are afflicted with Venereal disease,
.5
So completely satisfied am I of the incalculable benefit that has resulted to the Colony from the Ordinance under discussion that I shall be glad to see its provisions extended to both the so-called purely Chinese houses and to that still more fertile source of infection, the boat population.
Both Military and Naval Officers concur with me in estimating very highly the advantage of the Ordinance as affecting the health of their men—of which I have received numerous proofs.
Dr. Home, the present Deputy Inspector and Principal Military Medical Officer, who had experience of the Colony prior to the introduction of the Ordinance, writes: "On behalf of the Army Medical Officers stationed here I have pleasure in expressing to you the great advantage we have derived from the excellent Sanitary arrangements in force in regard to prostitution. Venereal disease, from being, but a few years ago, one of the most common causes of unfitness for duty here, has now become of comparatively rare occurrence."
Dr. Sexton, Assistant Surgeon of H.M's. 5th Bombay Light Infantry, made the following statement last May: "Among 427 men, the total strength of the detachment at present quartered at Hongkong, only 4 cases of Venereal disease have occurred during the months of March and April, 1862; that is to say at the rate of two cases, or 0·6 per month. No less remarkable is the mild form under which the disease presents itself; that it has become extremely amenable to treatment is best evidenced by the fact that the average number of days under treatment of each case only amounted to 8·5; a result almost unprecedented in the statistical history of this disease."
COLONIAL SURGEON'S REPORT FOR 1864
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.
SIB,
(APPENDIX TO) COLONIAL SURGEON'S REPORT FOR 1868.
Royal Naval Hospital,
Hongkong, 14th February, 1869.
In compliance with your wishes I herewith send you the following information relative to the prevalence of syphilis amongst the ships of war at this Port.
Since my appointment to H.M.S. "Melville" in October last, 38 cases of primary and 20 of secondary syphilis have been treated; they were all contracted either in Japan, Shanghai, or Singapore, and not in one instance can I trace the disease to infection at Hongkong.
By referring to the Nosological Returns from 1st January till the date of my appointment (9 months), I find that 43 cases of primary and 15 of secondary syphilis were admitted into hospital, but I am unable to inform you exactly where the disease was contracted; most probably in Japan, as the majority of the patients belonged to the "Rodney," which had visited Yokohama, where the crew got leave and suffered much from syphilis subsequently.
GEO. BIRNIE HILL,
Staff Surgeon in Charge.
Dr. J. M. Murray, Colonial Surgeon,
(Signed)
COLONIAL SURGEON'S REPORT FOR 1869.
**Lately the Contagious Diseases Acts have been brought somewhat prominently before public notice, singularly enough by an association of "earnest and pertinacious ladies who are banded together with the avowed object of procuring the repeal of these Acts." It therefore behoves those who are, like myself, greatly in favour of their extension, and who possess unusual opportunities of judging of their working, to come forward and express their convictions. I need not, therefore, hesitate to record, in this Official Report, the result of about twelve years' daily supervision of the System of Inspection and Control, as carried out in this Colony.
It 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 affected but on generations unborn?
2.—Is it possible by any legislative means 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 perhaps so well known that the wide-spread scrofulous and consumptive taint of the human race is traced by some men of science to 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 climates; 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 syphilitic 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 supervision 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, and until the passing of an Ordinance, became as bad as any other garrison town in respect to contagious disease. The same result cannot be shown in Hongkong, but I shall be able presently to point out
I
4
that the present state of affairs is scarcely less deplorable than that which existed in the earlier days of the Colony before restrictive measures had been attempted.
If, as seems to have been abundantly proved, good reasons exist why the Con- tagious Disease Ordinances should be re-introduced into India, the foregoing statements, amply corroborated by the medical reports to which your attention is now being directed, are conclusive that remedial measures for the protection of the com- munity are as urgently needed in Hongkong as in India, and it is the earnest hope of the Committee that action in that direction will not be long delayed.
The gradual change in public opinion in England, apparently largely due to the startling accounts sent home in regard to the condition to which the troops in India have been reduced by disease, seems to have brought a majority to the side of those who advocate a return to restrictive measures. It appears not improbable that a good deal of the opposition emanating from persons actuated by, no doubt, conscien- tious scruples will be withdrawn and thus render more easy of accomplishment the self-imposed task of those who are striving for reform.
To those who deny the right of interference-the result, doubtless, of honest conviction, and for that reason worthy of respect-neither facts nor figures seem to appeal; but it is difficult to imagine that even they, however much they may consider the penalties attaching to the transgression of their code of morals only just retribution, will continue to much longer oppose a movement which has among other aims the protection of innocent women and children from the fearful consequences of contami- nation, the occurrence of which only strong measures can prevent.
The Committee are in entire sympathy with a movement which aims at the amelioration of the present existing state of things, and will be prepared to cordially support any steps you may deem it desirable to take towards the advancement of that object.
That the re-introduction of the Contagious Diseases Ordinances, not only in India but also in the Straits Settlements and Hongkong, is imperative, has been so abun- dantly proved that the Committee consider it unlikely that the suggestion will any longer meet with opposition at the hands of Her Majesty's advisers. The effectiveness of the Ordinances might be much increased if, in view of the power possessed by even a single individual of spreading infection, more stringent laws were imposed as to the examination and segregration of women; but if the principle is admitted, such details may be safely left to be dealt with by medical experts.
you
I may mention that the two medical gentlemen already referred to are both in England-Dr. Ivor Murray at present practising in Scarborough, and Dr. Ayres resident, I believe, in London—and would, if applied to, he only too happy to furnish with any information it may be in their power to supply in addition to that contained in the reports herewith, and would no doubt be also willing to testify afresh as to the efficacy of the Contagious Disease Ordinances in Hongkong while under their observation.
It is intended to address the Governor asking his assistance in the endeavour to bring about the re-introduction of the above Ordinances, and a copy of the letter will be forwarded to you when written,
R. S. Gundry, Esq.,
(Signed)
Hon. Sec. China Association, London.
F. HENDERSON,
Hon. Secretary.
COLONIAL SURGEON'S REPORT, 1861.
Table VII affords a complete answer to those who think that the Ordinance under which this institution was established has effected no good. It will be seen that during the four years it has been in force 1,089 in- fected women have been segregrated from the localities in which they could convey infection, and that during a total of 30,072 days; for, in other words, supposing that every infected woman could only convey disease to one man during each day she was diseased, we have at least 30,072 cases of disease prevented-or, at all events, 30,072 opportunities of conveying disease have been prevented. The table shows further that the average number of days in which these diseased women have been under treatment has steadily decreased until it has almost reached the minimum we can look for. This proves the disease to be milder in type, and to have been arrested in its earlier stages.
COLONIAL SURGEON'S REPORT FOR 1862.
I must be permitted to hazard the statement (the data for arriving at which I have given in former Reports), that of the total sick, in all Hospitals in the East, fully 25 per cent, are afflicted with Venereal disease,
.5
So completely satisfied an I of the incalculable benefit that has resulted to the Colony from the Ordinance under discussion that I shall be glad to see its provisions extended to both the so-called purely Chinese houses and to that still more fertile source of infection, the boat population.
Both Military and Naval Officers concur with me in estimating very highly the advantage of the Ordinance as affecting the health of their men-of which I have received numerous proofs.
Dr. Home, the prescut Deputy Inspector and Principal Military Medical Officer, who had experience of the Colony prior to the introduction of the Ordinance, writes: On behalf of the Army Medical Officers stationed here I have pleasure in expressing to yon the great advantage we have derived from the excellent Sanitary arrangements in force in regard to prostitution. Venereal disease, from being, but a few years ago, oue of the most common causes of unfitness for duty here, has now become of comparatively rare occurrence."
Dr. Sexton, Assistant Surgeon of H.M's. 5th Bombay Light Infantry, made the following statement last May Among 427 men, the total strength of the detachment at present quartered at Hongkong, only 4 cases of Venereal disease have occurred during the months of March and April, 1862; that is to say at the rate of two rases, or 0'6 per month. No less remarkable is the mild form under which the disease presents itself; that it has become extremely amenable to treatment is hest evidenced by the fact that the average number of days under treatment of each case only amounted to 8:5; a result almost unprecedented in the statistical history of this disease."
COLONIAL SURGEON'S REPORT FOR 1864
This table pointa out, further, that the duration of treatment has steadily diminished up to last year. The increased ratio I believe to be referable to two cansos, 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.
SIB,
(APPENDIX TO) COLONIAL SURGEON'S REPORT FOR 1868.
Royal Naval Hospital,
Hongkong, 14th February, 1869.
In compliance with your wishes I herewith send you the following information relative to the prevalence of syphilis amongst the ships of war at this Port.
Since my appointment to H.M.S. "Melville" in October last, 38 cases of primary and 20 of secondary syphilis have been treated; they were all contracted either in Japan, Shanghai, or Singapore, and not in one instance can I trace the disease to infection at Hongkong.
By referring to the Nosological Returns from 1st January till the date of my appointment (9 months), I find that 43 cases of primary and 15 of secondary syphilis were admitted into hospital, but I am unable to inform you exactly where the disease was contracter; most probably in Japan, as the majority of the patients belonged to the Rodney," which had visited Yokohama, where the crew got leave and suffered much from syphilis subsequently,
GEO. BIRNIE HILL,
Staff Surgeon in Charge.
Dr. J. 1. Murray, Colonial Surgeon,
(Signed)
COLONIAL SURGEON'S REPORT FOR 1869. ** Lately the Contagious Diseases Acts have been brought somewhat prominently before public notice, singularly enough by an association of "earnest and pertinacious ladies who are banded together with the avowed object of procuring the repeal of these Acts." It therefore behoves those who are, like myself, greatly in favour of their extension, and who possess anusaal opportunities of judging of their working, to come forward and express their convictions. I need not, therefore, hesitate to record, in this Official Report, the result of
about twelve years daily supervision of the System of Inspection and Control, as carried out in this Colony.
It 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 affected but on generations unborn?
2.--Is it possible by any legislative means 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 perhaps so well known that the wide-spread scrofulous and consumptive taint of the human race is traced by some men of science to 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 partion- arly important to the residents of tropical climates; for, could the united experience of medical practitioners in the tropios 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 syphilitic disease.
That it is possible to a great extent to reduce, if not entirely prevent, the spread of this disease by legisla tive 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 supervision 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, and until the passing of an Ordinance, became as bad as any other garrison town in respect to contagious disease. The same result cannot be shown in Hongkong, but I shall be able presently to point out
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