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No. 41.

THE HONGKONG GOVERNMENT GAZETTE, 17TH MARCH, 1866.

GOVERNMENT NOTIFICATION.

The Colonial Surgeon's Report, with Returns on the Sanitary Condition of the Colony for the Year 1865, is published for general information.

By Order,

Colonial Secretary's Office, Hongkong, 13th March, 1866.

W. T. MERCER,

Colonial Secretary.

VICTORIA, HONGKONG, 3rd March, 1866.

A very general impression having prevailed that the year 1865, the subject of my Seventh Annual Report, has been marked by an extraordinary amount of Sickness and Mortality, it becomes my duty to point out how far this impression has been well founded in regard to certain classes of the population, and at the same time to show that amid some startling instances of sudden death, the general average Mortality of the Resident European and American population, has actually been below that of the two years immediately preceding. This I shall do very briefly by reference to the instructive tables, which I have been enabled, with the kind cooperation of my professional brethren, to draw up, and which will, in some measure, enable me to explain the reasons of the enormous increase in the general Mortality, which has prevailed amongst the Residents of Hongkong in the year 1865:-reasons which, it will in part appear, are not necessarily connected with a greatly increased amount of insalubrity.

An observation of the Meteorological currents for many years past had induced the belief that, unless the temperature be kept down by an abundant fall of rain, the summer of 1860 would prove to. be the point at which the Thermometrical wave would attain its highest altitude, and the greatest amount of insalubrity would, based upon somewhat similar calculations, have nearly coincided with this maximum temperature. Unfortunately the rainfall throughout the year proved to be much below the average-and possibly to this cause may be attributed in no slight degree the appearance of an epidemic, happily as yet almost entirely restricted to the Chinese population, but which has not, as far as I am aware, been hitherto described as occurring in China, if indeed in the Eastern hemisphere.

Small pox appeared as usual in the months of January, February and March, but the mortality did not exceed that of previous years, nor was the number of admissions into Hospital for this disease above the average.

Cholera may be said to have been absent in its epidemic form-although several sudden cases have occurred among the community. The admission of one patient only suffering under this disease is recorded in the Returns of the Government Civil Hospital and two in those of the Seaman's Hospitel.

An epidemic however of quite as startling a character was first recognized in Victoria Gaol upon the 3rd of March, when a prisoner, who was said to have cone directly from Macao, was seized with symptoms closely resembling those of Yellow fever. No new case occurred until the 15th of the same month, and during the whole of March there had been 5 cases only, but of these three had terminated fatally. The disease increased rapidly until it attained its acmú on the 2nd of May, on which day there were 46 cases in Hospital, inclusive of 15 admissions on that day. From that period it commenced to decline, but did not entirely disappear until there had been 373 admissions and 40 deaths.

The disease as it exhibited itself was of the nature of a bilious fever, occurring in the form of the continued, remittent or intermittent type, rapidly passing in all fatal cases into the typhoid, and frequently terminating by hemorrhage from the bowels and in some cases by black vomit. The skin became yellow with an orange tinge, passing into olive, and all the fluids of the body were of a marked yellow. In fatal cases spots of cechymosis over the body were not unfrequent. A detailed account of the pathological changes, as collected by Dr. O'Brien, from the examination of several bodies, I have added in the form of an appendix. As far as I could ascertain the fact the disease proved to be contagious but not infectious and the period of incubation about 10 days. It was undoubtedly a form of Yellow fever,

but

The disease was not however limited to Victoria Gaol, but prevailed throughout the Town, among the lower classes principally. There are 103 cases recorded as admitted into the Government Civil Hospital, of which no less than 40 died; it is a little doubtful whether these were all ascertained cases of the epidemic and not in some simply a severe form of bilious fever. Many of the men admitted were nearly or quite moribund when sent to Hospital, and 20 dead bodies were sent there for examination after death, in which the same epidemic had been the active agent.

of 10.79

I notice that two cases of Bilious fever were admitted into the Seaman's Hospital, both of which proved fatal. Possibly they may have been cases of the epidemic.

The disease was most easily studied in the Gaol and upon the observation of it, as it there presented itself, I have based these remarks. As I have already said the number of admissions were 373 and the deaths 40, giving a per centage deaths, which after all is not very high for any epidemic, and nothing in comparison to the usual mortality in Cholera. Very few Europeans were attacked, a comparatively small number of Indians and no females were brought under its influence.

It is a curious fact that the British Ship Tricolor left this port for Dutch Guiana on the 2nd of May, when this epidemic was at its worst, with 480 coolies on board, and that upwards of 200 died on the voyage, as far as can be ascertained, from the effects of a somewhat similar epidemic.

Poverty and destitution appeared to be one of the most marked predisposing causes of the disease, and the long drough

In this belief the diet of the prisoners, more

especially of and great heat were probably in some measure the exciting causes. the wretched and most emaciated, was greatly improved by the addition of strong soup made from bullocks' heads; the prisoners were carefully examined every day and at once segregated from their fellows when showing any sign of disease. I foun! obstinate constipation generally preceded the outbreak of the fever, a constipation extending from 5 to 15 days and yet it was almost impossible to get the prisoners to admit its existence until brought into Hospital with unmistakeable symptoms of fever upon them.

The treatment which I found most successful was the immediate administration of an emetic, followed by a calomel purgi and either quinine or calomel and opium according to the circumstances of the particular case, a hot bath was given when the fever ran high, and blisters to the head and sinapisms to the stomach and feet had frequently to be resorted to. Duria. convalescence quinine and beef tea and wine were freely administered. I believe that scarcely a single case terminated fatally

With these preliminary remarks I sh where there had been sufficient time to get the gums slightly affected by the mercury." now proceed to consider the result of the past year's treatment of disease in the various Institutions which come officially unbe my cognizance.

*

* As this disease has shown itself again this year and we have already had 105 admissions although only 6 deaths, it may be advisable to request heads of the Medical Department in the Ariny and Navy to consult with inc as to its probable cause and possible means of staying its ravages.