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Chapter IV.
PUBLIC HEALTH.
In the absence of some general system of registration of sickness, the only sources of information available for gauging the state of the public health in this Colony are the returns relating to deaths, the notifications of infectious diseases and the records of Government and Chinese hospitals. Judging from the death returns the health of the Colony was better than that of the previous year. The crude death rate was 22.11 per mille as compared with 24.74 for 1982.
2. Respiratory diseases accounted for 41.93 per cent of the total deaths; the percentage for 1932 was 43.05. The principal diseases causing death were broncho-pneumonia, pulmonary tuberculosis, bronchitis, pneumonia, infantile diarrhoea and diarrhoea.
3. The overcrowded houses, the expectorating habits of the people, and poverty furnish sufficient explanation for the prevalence of respiratory troubles.
4. Pulmonary Tuberculosis.-This disease continues to rank second to broncho-pneumonia as the principal cause of death. It is probable that some of the cases of the latter were of tuberculous origin.
5. The total number of deaths was 2,225; that for 1932 was 2,042. The death rate per mille was 2.71 as compared with 2.54 for the previous year.
6. There is need for more hospital or infirmary accommoda. tion for tuberculosis patients, especially for those of the poorer classes.
7. Malaria. Owing to efficient drainage methods this disease has disappeared from the greater part of the urban districts. It still persists, however, in the suburbs and in the rural areas. There are parts of the New Territories where the spleen rate exceeds 75 per cent.
8. Malaria not being a notifiable disease the incidence figures are unknown. The cases admitted to the Government Hospitals numbered 482 as compared to 334 in the previous The percentage of deaths to cases admitted was 1.63. Among the Chinese Hospitals there were 925 admissions with a case mortality rate of 22.51 per cent.
year
9. The total number of deaths attributed to this disease was 414, giving a death rate of 0.50 per mille over the whole population. The low death rate is, of course, due to the fact
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that the great bulk of the population residing in the drained urban area is not subject to risks of infection. If figures for local districts were available it would be found that in some areas the incidence and death rates were very considerable.
10. During the year the Malaria Bureau continued its investigations into the life history, habits and carrying powers of the local anophelines. The result obtained were both interesting and instructive. As in previous years there was no obstruction from the local Chinese; on the contrary they took an interest in the proceedings and showed their eagerness to be of assistance. The Chinese Inspectors have shown ability and zeal.
11. The Bureau
co-operated fully with the Military Authorities and with the Public Works Department.
INFECTIOUS DISEASES.
12. During the year there were reported 566 cases of small- pox, 191 cases of cerebro-spinal fever, 122 cases of diphtheria and 207 cases of enteric. There were no cholera cases.
18. Smallpox.-Every year in the cold season this disease manifests itself in outbreaks which are sometimes sporadic, sometimes epidemic. Whatever the prevalence there is always a tendency for the morbidity rate to decline or disappear with the advent of summer. In the year under review there were 566 cases and 438 deaths, 194 cases only were treated in hospital the remainder did not come under the notice of the authorities until after death,
14. The vaccination campaign was continued and during the year 545,850 persons were vaccinated. Valuable assistance was afforded by the St. John Ambulance Brigade and by the Chinese Public Dispensaries. Both bodies engaged in active propaganda and through their efforts many were persuaded who otherwise would have kept aloof. The various sections of the Brigade again carried out street vaccination with excellent results.
15. The Chinese have a preference for vaccination in the spring as being the auspicious season, and for a month or two after Chinese New Year the Chinese Public Dispensaries are crowded with children waiting to be done.
16. The majority of Chinese still hold the opinion that the herbalist treatment of smallpox gives better results than the methods adopted by practitioners qualified in Western medicine. An analysis of the statistics of (a) the Tung Wah Infectious Diseases Hospital where only herbalist treatment is carried out, and (b) the Government Infectious Diseases Hospital where
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