158
1
6
the great improvement that has resulted from legislative interference, not only in reducing the extent but also the malignity of the disease.
The great outcry 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 more 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 contagion, 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 considered to be one of the duties of the Health Officer or Officers of the Fort. The whole of the Police Force undergo a similar examination once every month, and certainly the garrison might be equally examined. (Sir H. Storks recommends that the men should be examined at least once in seven days.) Lastly, as if to meet the objections of those who consider these Acts as one-sided, it is specially 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 Harbour 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 from all interference 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, and I am glad to be able to point to some very substantial benefits.
In 1859 I wrote "Both among Naval and Military invalids the syphilitic amount to nearly 25 per cent. of the whole, and this is very nearly the same proportion in the Government 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 proportion of 23.18 per cent." Now if the Returns accompanying this Report be contrasted with that former state of matters, it is seen during the year 1860, as the result of the working of the Contagious Diseases Ordinance, that disease was greatly decreased. In the Government Civil Hospital, even in spite of the great number of cases sent by the Harbour Master, the percentage of syphilitic cases was reduced to 15.82. In the garrison, the percentage of primary disease to the total strength was only 6.83, according to a Return compiled from data furnished to me by Dr. H. Heffernan, the Deputy Inspector-General. In the Police, it was 16.66 against 31.00 per cent. in 1863 as shown in Table XV.; and in a most interesting letter addressed to me by Fleet Surgeon Dr. Maccoun, of the United States ship "Delaware," on the eve of his departure from the Colony, he says:- "Since my arrival on this Station in the Spring of 1868, I have been struck with the benefit derived from the system 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."
But the whole letter deserves to be carefully perused and I think, coming 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 24.5 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 am 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 I am confident that if all prostitutes are subject to the requirements of the Ordinance these results will be limited, for I am aware that the inmates 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 Ordinance 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 consequences. In no case, I believe, will young men be led into temptation for the first time because they can fall with impunity. As long as men are men, vice will continue, and it is clearly the duty of the legislature to protect, if not the actual transgressor, at all events the innocent, from the fearful consequences of disease.
7
REPORT OF THE COLONIAL SURGEON FOR THE YEAR 1870.
In my last Annual Report, I entered so fully into the question of the working of the Contagious Diseases Ordinance that I can do little more, on the present occasion, than refer to the statistics contained in Tables, A, B, C, and D of the Appendix. It will be seen that a great improvement has taken place during the past year. In the two Hospitals, the percentage of contagious disease contracted in Hongkong to all admissions, was 8.96, against nearly double that amount in 1869. In the Garrison, the percentage of primary disease to the total strength was reduced to 5.51, against 6.93 in 1869; and among the British ships of war which have visited this port during the past year, only 116 cases of contagious disease were contracted in Hongkong. In the Police, a similar improvement has taken place, and the percentage of infection has been reduced from 16.66 in 1869 to 13.75 in 1870. Again, in turning to Table X, we find that the type of the disease is undergoing a steady improvement, under the strict surveillance to which the women are subjected; the average number of days of treatment having further diminished from 24.8 in 1869 to 23.1 in 1870. The whole of these Tables, as well as Table XIV., convey a large amount of information, and will well repay a careful study.
I have added, in Appendices E and F, a letter addressed to me by Deputy-Inspector-General Pottinger of H.M.'s Naval Hospital, and statistics from Surgeon Ramsay of H.M.'s 71st Regiment in reference to the freedom of men of his regiment from contagious disease. The evidence of these gentlemen is extremely valuable, and gratifying to myself under whose care the medical examinations have been carried on for the past twelve years. Both gentlemen have had experience of Hongkong, and known what "Hongkong Disease" was before the introduction of the Contagious Diseases Ordinance into the Colony—and both agree as to the great contrast. Dr. Pottinger says: "Judging from my own experience, I should say that syphilis has all but disappeared from the Colony." Dr. Ramsay writes: "I may add that during an experience of 16 years as an Army Medical Officer, in all climates, I have not seen a similar immunity."
MY DEAR SIR,
H.M.'s Hospital Ship "Melville,”
Hongkong, December 28th, 1870.
As you are about to leave this Colony for a time, I would beg to address a few words to you on the subject of the working of the Contagious Diseases Ordinance carried out under your inspection. During the years 1849-50 and 1851 I was Surgeon of the Reynard Sloop of War, on the Chinese Station, and though unfortunately I am not in possession of my Journal for that vessel, I have a vivid remembrance of the sufferings of the crew from syphilitic disease in Hongkong. On every occasion when the men had leave on shore, a large proportion of them became affected with the disease. [allusion made to the severity of the type]. Secondary symptoms were also of frequent occurrence, often requiring the patients to be invalided and sent home. The altered state of things at the present time is very striking. During the year and nine months that I have had charge of this Hospital... [allusion made to decreased severity of type]. Judging from my own experience, I should say that syphilis has all but disappeared from the Colony, and I have no hesitation moreover in attributing this success... Could a similar system of examination be established in the Treaty Ports of China and Japan, a great boon would indeed be conferred on the Naval Squadron serving in these waters.
Dr. Murray, Colonial Surgeon, Hongkong.
(Signed)
ROBERT POTTINGER.
*Statistics of Disease in H.M.'s 75th Regiment From 21st December, 1863, till 21st December, 1870.
1.—Average Strength during the above-named period, 428.5.
2. Different forms of Venereal and the number of cases of each between the above-named dates:-
Primary Syphilis.
17
Gonorrhea.
Total.
Secondary Syphilis.
39
66
10
The forms of Secondaries were very mild, amenable to treatment, and left no sign of permanent injury. The above figures speak for themselves, and show the great gain which the enforcement of the Contagious Diseases Act has been to the Government in preserving the health of the men of the Regiment. I may add that during an experience of 16 years as an Army Medical Officer in all climates, I have not seen a similar immunity. To me it is the more striking as I can look back on the prevalence and terrible severity of the disease which existed in this Colony in 1857, when "Hongkong Disease" was a well-known by-word. At times for an entire month there has not been a man reported as suffering from any form of Venereal, thus attesting the thorough manner in which the duties in connection with the Contagious Diseases Act have been carried out, and the efficacy of legislation against this "Scourge of humanity" seen in a Colony like Hongkong whose ever-shifting population, native and foreign, must render success unusually difficult.
(Signed) W. RAMSAY, F.R.C.S.L.,
Surgeon, 75th Regiment.
MY DEAR DR. MURRAY.
United States Flag Ship Delaware,
Hongkong, 12th March, 1870.
Since my arrival on this Station in the Spring of 1868, I have been struck with the benefit derived from the system of Registration and Inspection of public women, so ably carried out in this Colony.
In most of the ports visited by our ships the men have suffered from syphilis, and especially in Japan where the disease exists in its most virulent form. But during our visits to Hongkong but few have been infected, and the type of the disease is very mild. In proof of this, I would mention that the crew of this ship, numbering four hundred and seventy men, have lately been granted liberty and only five cases of chancroid have been noticed.
Such a result as this proves the great benefit derived from the system; and on the eve of my departure from Victoria I deem it a duty, as well as a pleasure, to express to you my high appreciation of your labours in the cause of humanity, as well as to congratulate you upon the success with which they have been crowned.
(Signed) ROBERT L. MACCOUN
Fleet Surgeon, U. S. N.
Dr. Murray, Colonial Surgeon, Hongkong.
REPORT OF THE ACTING COLONIAL SURGEON FOR THE YEAR 1871.
Whatever may be said against the working of the "Contagious Diseases Act" at home, there can be no doubt that in Hongkong the results are most satisfactory and valuable. In Table C it will be seen that out of 460 men admitted to the Military, Naval Police, and Seamen's Hospitals, 157 contracted the disease elsewhere than in Hongkong, and out of an average monthly number of 10,901 men in Port and Garrison, only 0.34 per cent. per month were diseased.
Extracts from Special Report on Lock Hospital by Dr. R. Young.
5. A reference to Table A shows that the type of disease met with is more amenable to treatment, from the fact that the average number of days during which patients were detained in Hospital has been reduced to a shorter period than has yet been reached during the past 14 years of the Hospital's existence. In 1870 it was 23.1 days, while during 1871 it has been 18.5 days.
6. Tables B, C, D, E, and F show the amount of Venereal disease met with in the Hospitals of this Colony, and the measures taken to prevent its spread. It will be seen on reference to Table C that in two-thirds of the admissions into the Seamen's and Civil Hospitals, the disease was not contracted in Hongkong. But for the Contagious Diseases Ordinance, there would soon be abundance of Venereal disease in the Colony.
158
1
6
the great improvement that has resulted from legislative interference, not only in reducing the extent but also the malignity of the disease.
The great outery 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 more 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 contagion, 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 considered to be one of the duties of the Health Officer or Officers of the Fort. The whole of the Police Force undergo a similar examination once every month, and certainly the garrison might be equally examined. (Sir H. Storks recommends that the men should be examined at least once in seven days.) Lastly, as if to meet the objections of those who consider these Acts as one-sided, it is specially 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 Harbour 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 from all interference 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 nativo 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, and I am glad to be able to point to some very substantial benefits.
In 1859 I wrote "Both among Naval and Military invalids the syphilitic amount to nearly 25 per cent. of the whole, and this is very nearly the same proportion in the Government Civil Hospital. In one ship num- "bering in all 523 bands, of which 300 had been on the sick list doring the last quarter, 77 of these were for "cenereal diseases, being at the rate of 25.66 per cent, of the total sick, or 14.72 per cent. of the total strongth; "and that be it observed in one quarter. In the Government Civil Hospital the proportion of venereal cases wis *138 out of 591 admissions, being in the proportion of 23.18 per cent." Now if the Returns accompanying this Report be contrasted with that former state of matters, it is seen during the year 1860), as the result of the working of the Contagious Diseases Ordicance, that disease was greatly decreased. In the Government Civil Hospital, even in spite of the great number of cases sent by the Harbour Master, the percentage of syphilitic cases was reduced to 15.82. In the garrison, the percentage of primary disease to the total strength was only 6.83, according to a Retara compiled from data furnished to me by Dr. H. Heffernan, the Deputy Inspector-General. In the Police, it was 16.66 against 31.00 per cent, in 1863 as shown in Table XV.,; and in a most interesting letter addressed to me by Fleet Surgeon Dr. Maccoun, of the United States ship "Delaware," on the eve of his departure from the Colony, he says:-"Since my arrival on this Station in the Spring of 1868, I have been "struck with the benefit derived from the system 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."
But the whole letter deserves to be carefully perused and I think, coming 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 24.5 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 am 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 I am confident that antif all prostitutes are subject to the requirements of the Ordinance these results will be 3mited, for I am aware that the inmates 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 Ordinance under discussion Jus 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 consequences. In no case, I believe, will young men he led into temptation for the first time because they can fall with impunity As long as men are men, vice will continue, and it is clearly the duty of the legislature to protect, if not the actual transgressor, at all events the innocent, from the fearful consequences of disease.
7
REPORT OF THE COLONIAL SURGEON FOR THE YEAR 1870.
In my last Annual Report, I entered so fully into the question of the working of the Contagions Diseases Ordinance that I can do little more, on the present occasion, than refer to the statistics contained in Tables, A, B, C, and D of the Appendix. It will be seen that a great improvement has taken place during the past year. In the two Hospitals, the percentage of contagious disease contracted in Hongkong to all admissions, was 8-96, against nearly double that amorut in 1889. In the Garrison, the percentage of primary disease to the total strength was reduced to 5′51, against 6·93 in 1869; and among the British ships of war which have visited this port during the past pear, only 116 cases of contagious disease were contracted in Hongkong. In the Police, a similar improvement has taken place, and the percentage of infection has been reduced from 16-66 in 1869 to 13:75 in 1870. Again, in turning to Table X, we find that the type of the disease is undergoing a steady improvement, under the strict surveillance to which the women are subjected; the average number of days of treatment having further diminished from 248 in 1869 to 23-1 in 1870. The whole of these Tables, as well as Table XIV., convey a large amount of information, and will well repay a careful study.
I have added, in Appendices Eț and F*, a letter addressed to me by Deputy-Inspector-General Pottinger of H.M.'s Naval Hospital, and statistles from Surgeon Ramsay of H.M.'s 71st Regiment in reference to the freedom of men of his regiment from contagious disease. The evidence of these gentlemen is extremely valuable, and gratifying to myself under whose care the medical examinations have been carried on for the past twelve years. Both gentlemen have had experience of Hongkong, und known what Hongkong Disease" was before the introduction of the Contagious Diseases Ordinance into the Colony-and both agree as to the great contrast. Dr. Pottinger says: "Judging from my own experience, I should say that syphilis has all but disappeared from the Colony." Dr. Ramsay writes: "I may add that during an experience of 16 years as an Army Medical Officer, in all climates, 1 have not seen a similar immunity."
MY DEAR SIR,
H.M.'s Hospital Ship "Melville,”
Bougkong, December 28th, 1870.
As you are about to leave this Colony for a time, I would beg to address a few words to you on the subject of the working of the Contagions Diseases Ordinance carried out under your inspection. During the years 1849-50 and 1851 1 was Surgeon of the Reynard Bloop of War, on the Chinese Station, and though anfortunately I am not in possession of my Journal for that vessel, I have a vivid remembrance of the sufferings of the crew from syphilitio disease in Hongkong. On every occasion when the men had leave on shore, a large proportion of them became affected with the disease. [allusion made to the severity of the type]. Secondary symptoms were also of frequent occurrence, often requiring the patients to be invalided and sent home. The altered state of things at the present time is very striking. During the year and nine months that I have had charge of this Hospital. .[allusion made to decreased severity of type]. Judging from my own experience, I should say that examination (?), which I have repeatedly witnessed.
Could a similar system of examination be established
Oxy
syphilis has all bit disappeared from the Colony, and I have no hesitation moreover in attributing this success of Car ..
in the Treaty Ports of China and Japan, a great boon would indeed be conferred on the Naval Squadron serving in these waters.
Dr. Murray, Colonial Surgeon, Hongkong.
(Signed)
ROBERT POTTINGER.
*Statistics of Discaso in H.Mf's 75th Regiment From 21st December, 1863, till 21st December, 1870. 1-Average Strength during the above-named period, 428.5.
2. Different forms of Venereal sad the number of cases of each between the above-named dates:-
Primary Syphilis.
17
Gonorrhea.
Total.
Secondary Syphilis.
39
66
10
The forms of Secondaries were very mild, amenable to treatment, and left no sign of permanent injury. The above figures speak for themselves, and show the great gain which the enforcement of the Contagions Diseases Act has been to the Government in preserving the health of the men of the Regiment. I may add that during an experience of 16 years as an Army Medical Officer in all climates. I have not secu a similar immunity. To me it is the more striking as I can look back on the prevalence and terrible severity of the disease which existed in this Colony in 1857, when "Hongkong Disease" was a well-known bye-worâ. times for an entire month there has not been a man reported as suffering from any form of Venereal, thus attesting the thorough manner in which the duties in connection with the Contagious Diseases Act have been carried out, and the efficacy of legislation against this "Scourge of humanity" seen in a Colony like Hongkong whose ever shifting population, native and foreign, minst render success unusually difficult.
(Signed) W. RAMSAY, F.R.C.S.L.,
Surgeon, 75th Regiment.
At
MY DEAR DR. MURRAY.
United States Flag Ship Delaware,
Hongkong, 12th March, 1870.
Since my arrival on this Station in the Spring of 1868, I have been struck with the benefit derived from the system of Registration and Inspection of public women, so ably carried out in this Colony.
In most of the ports visited by our ships the wen have suffered from syphilis, and especially in Japan where the disease exists in its innst virulent form. Bulduring our visita to Hongkong but few have been infected, and the type of the disease is very mibt. In proof of this, I would mention that the crew of this ship, nuruberiug four hundred and seventy men, have lately been granted liberty and only five cases of chaucre (chaneroid) have been noticed.
Such a result as this proves the great benefit derived from the system; and on the eve of my departure from Victoria I deem it a duty, as well as a pleasure, to express to you my bigh appreciation of your labours in the cause of humanity, as well as to congratulate you upon the success with which they have been crowned.
(Signed) ROBERT L. MACCOUN
Fleet Surgeon, U. S. N.
Dr. Murray, Colonial Surgeon, Hongkong.
REPORT OF THE ACTING COLONIAL SURGEON FOR THE YEAR 1871. Whatever may be said against the working of the "Contagious Diseases Act" at home, there can be no doubt that in Hongkong the results are most satisfactory and valuable. In Table C it will be seen that out of 460 men admitted to the Military, Naval Police, and Seamen's Hospitals, 157 contracted the disease elsewhere than in Hongkong, and out of an average monthly number of 10,901 men in Port and Garrison, only 034 per cent. per month were discusert.
Extracts from Special Report on Lock Hospital by Dr. R. Young.
5.A reference to Table A shows that the type of disease met with is more amenable to treatment, from the fact that the average number of days during which patients were detained in Hospital has been reduced to a shorter period than has yet been reached during the past 14 years of the Hospital's existence. In 1870 it was 23-1 days, while during 1871 is bas been 185 days.
G-Tables B, C, D, E, and F show the amount of Venereal disease met with in the llospitals of this Colony, and the measures taken to provent its spread. It will be seen on reference to Table C that in two- thirds of the admissions into the Seamen's and Civil Hospitals, the disease was not contracted in Hongkong. But for the Contagious Diseases Ordinance, there would soon be abundance of Venereal disease in the Colony. I
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