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113. The number of cases treated in the Government In- fectious Diseases Hospital where Western methods only are prac- tised was 8 with 2 deaths. The case death rate was 25 per cent. The number of cases treated in the Tung Wah Infectious Dis- eases Hospital by Chinese methods was 77 with 44 deaths. The ease death rate was 57 per cent,
114. During the last 21 years 288 cases were treated at the Government Infectious Diseases Hospital by western treatment with a death rate of 14.2 per cent. During the same period at the Tung Wah Infectious Diseases Hospital 1.249 cases were treated by Chinese herbalists methods with a death rate of 46.8 per cent.
These figures should convince any open minded person that the supposed superiority of Chinese treatment over Western treatment is a myth.
115. During the year immune calf serum was given to a number of patients at the Government Infectious Diseases Hospital in the hope that it would favourably influence the course of the disease. In two severe cases the result appeared to be beneficial but the number of cases was not sufficient to draw definite conclusions.
116. The fear expressed by some of the Chinese that the withdrawal by the Sanitary Board of the privilege granted to the people of keeping the sick in their houses would result in increas- ed concealment has not been realized. On the contrary, the figures show a decrease.
Plague.
117. For the last three years no case of plague, human or rudent, has been reported in the Colony. The disease has dis- appeared from Hong Kong and the same may be said of South China. The rat population is much the same as it was and so far as we know there is no change in quantity or quality in the flea population. The sanitary conditions in Hong Kong are generally better than they were but in the majority of Chinese towns there is little change. We must accept the fact that the rise and fall in plague figures has not been satisfactorily explained. We know that plague is primarily a disease of rats communicated to man through the rat flea, but we have to admit that we know little of the reason for the rise and fall in the incidence of disease among rodents.
118. Many attempts have been made to show a relation be- tween meteorological conditions and plague prevalence. Otten of Java records that his findings with reference to meteorological conditions are just the opposite to the findings of observers in British India. The truth appears to be that though meteorologi- al conditions do have a distinct bearing on the life histories of rats and fleas, the most important factor in the plague problem
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is the relation between the tissues of the rat and the bacillus pestis. Where the former offers a favourable inedium for the growth of the latter and for enhancement of its virulence there plague flourishes: where the conditions are reversed there is a liminution in virulence and a corresponding decline in both in- cidence and death rates. But concerning the natural causes which have an influence on the resistance of the rat or the virulence of the plague organism little is known,
119. The value of a continuous anti-rat campaign lies in the carly information it affords of an epidemic and because of this rats are being regularly caught and examined.
120. In spite of the continuous campaign against them, owing to the rapidity with which they multiply and the ease with which they enter and leave the Colony, there still is and probably always will be a sufficiency of rats and rat fleas in the Colony to light up and maintain an epidemic if the Gods so will it.
Cerebro-Spinal Fever.
121. The disease appeared in the neighbouring Portuguese Colony of Macao early in March. It is supposed to have been introduced by refugees from North China. It soon assumed epidemic form there and during the two months the outbreak lasted there were 600 cases with a mortality of 58 per cent.
There were only 11 instances where two cases occurred in the same house and only one instance where there were four cases. Schools, hotels, colleges, and barracks were almost en- tirely unaffected and there was no case where infection spreadi from patient to those in attendance.
122. On 26th March news was received from Canton of a serious epidemic there.
123. Considering the extent of communication between Macao, Canton and Hong Kong and the overcrowded condition of the working class area here, fears were entertained of the possi- bility of widespread and serious epidemic. The Government infectious Diseases Hospital was, therefore, opened and arrange- ments made to meet any emergency.
124. There was no epidemic properly speaking. On 31st March two cases were reported. and thereafter daily until about the middle of May cases were reported.
125. All cases were lumbar punctured and all received in- tradural injection of immune serum prepared from local strains of the meningococcus.
126. Altogether there were 61 cases and 26 deaths.
127. No house had more than one case and the disease never spread from cases to those in attendance.
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