The cases, as a
THE HONGKONG GOVERNMENT GAZETTE, 12тп MAY, 1866.
191
rule, did not appear before witness in an early stage when first observed-the symptoms were those of fever in the great majority. The skin was hot and dry. Tongue coated and parched. Obstinate constipation, with more or less suppression of the Urinary and other secretions. The Urine was albuminous but not to any extent, in some yellow- ness of the skin and conjunctive had already appeared. The patient complained often of severe frontal head-acle-and in some cases delirium at night appeared; no irritability of stomach until immediately before death, where in a few instances a greenish black fluid was ejected without effort appearing more to trickle from the mouth. In some cases also there were Hemorrhagic discharges from the bowels and nostrils.
Has noticed that after the vomiting of the dark fluid mentioned no recovery took place.
In a few fatal cases small patches of Ecchymosis were observed on the body somewhat larger than but resembling ordinary Petecchia. As a general rule the symptoms remitted in the morning-did not observe any lighter colored fluid ejected from the stomach previous to the discharge of the dark greenish matter.
Frequent relapses took place recurring after about a week and generally proving fatal. Deaths generally took place on the
3rd or 4th day. Intellect continued unclouded for the most part to the last.
Post-mortem appearances.
Was present at the great majority of the Post-mortem examinations. The appearances were-skin and conjunctivæ yellow Blood fluid-spleen very much enlarged. Liver much enlarged not increased in weight; friable, mottled on surface--- Gall Bladder full of a dark greenish fluid. Stomach: mucous membrane congested towards Pyloric Orifice, contained a quantity of dark fluid resembling that in gall bladder, and that vomited before death. Chocolate coloured Urine found in the bladder. Surface of kidneys vascular. Petecchial spots persistent.
Was in many instances obliged to depend more on reports made than on actual observation-believes the disease to be contagious as some of the Chinese nurses became affected who had been for some time in Gaol, and had not been out of the establishment-and also because several of the older prisoners were attacked under similar circumstances. Has been 21 years in China and never before saw this disease in an Epidemic form.
Treatment.
Quinine succeeded in but few cases; full support was found necessary from the beginning: and salivation, by small doses of
calomel and opium, given at short intervals was found to be generally successful.
The same observations refer to cases which have this year appeared in the Gaol, of which from the 30th December 1865 to this day, there have been 150 in Hospital and 60 milder cases under observation; in all 210-of this number all were Chinese except 1 European and 1 Colored man: of the 208 Chinese, 11 have died.
Has also observed that several of the men attacked last year, have had a recurrence of the disease this year.
The disease has not appeared in Stone Cutters' Island. Last year stopped the communication between the Island, and this establishment-in consequence of the presence of this disease. All prisoners sent from here to Stone Cutters' Island are first examined by me.
At the Government Civil Hospital, of which he is Medical Inspector-the same disease has been observed at the same time, 103 cases in 1865 were received, of which 12 were Europeans, 26 Colored men and 65 Chinese-40 deaths took place, of which 4 occurred in Europeans, and 4 Colored men. The symptoms and Post-mortem appearances were the same as have been described. In addition, 20 Chinese bodies were brought to the Government Civil Hospital, presenting the same appearances.
At the time he certified that there had been cases of Jaundice, not having arrived at a clear opinion as to the nature of the
disease.
With the exception of this Epidemic both Gaol and Hospital were more healthy than usual.
20th March, 1866.
Mr. DOUGLAS has been Superintendent of Victoria Gaol since November 1863-health of prisoners excellent until last year-
unhealthy last year owing to prevalence of a disease resembling that now present. Has observed the skin to be yellow in the majority of cases--remembers the 1st case attacked-observed him when he came in--was in a state of great exhaustion, skin deeply yellow-expressed his conviction that he would die-was sent as a prisoner. Ascertained that he had come from Macao that day-this on good authority-he came into the Hospital in the afternoon. Remembers several other cases, coming in subsequently--some were ill on admission and tinged yellow-and others soon after became ill and observed to be similarly affected. Several deaths occurred among the men taken ill up to the 15th Aptil. Saw the bodies after death and observed them to be discoloured. Skin of a dark hue in some cases, in others yellow-others spotted-keeps a register of deaths-3 men died of the disease on the 5th, 9th, and 13th April. The inan who died on the 5th April had been admitted into Gaol on the 21st of the previous January-the man who died on the 9th admitted on the 8th April--and the one who died on the 13th was admitted on the 4th March. All the prisoners. admitted in March were new prisoners.
*
The majority of those taken ill were new comers. I also remember they came from Taipingshan as a rule-a few old prisoners however also suffered-for the past 2 months the prisoners whether old or recently arrived at the Gaol, lived in the same corrider-worked in many instances together and eat together-using the same privies-in some instances old and new prisoners lived in the same cell.
After the first 2 months, owing to the prevalence of the discase and at the instance of the Colonial Surgeon all newly arrived prisoners were entirely separated-no communication allowed with the old prisoners. At this period several of the old prisoners had been suffering from the disease. I mean prisoners admitted prior to the 30th April-and many others suffering from this disease were admitted into Hospital after the 1st May. Selected a corrider in the European part of the Gaol for the admission of new prisoners after this date, which had never before been occupied by Chinese. The same disease appeared among those new prisoners but not to such extent as among the old. Of the 107 cases admitted in the month of May the proportion was considerably greater in the old prisoners than the new-of the 373 cases of the disease admitted between the 3rd March and 28th August, my impression is that the larger number came into the prison after the 3rd March-and of the 40 deaths-3/4ths occurred among men admitted subsequently to the 3rd March. No deaths occurred between the 28th August 1865 and 2nd January 1866. 3 cases were admitted previous to the 2nd
January 1866 and after the 28th August, viz: one on the 29th December-one on the 30th and one on the 31st.
Commissioners at Stone Cutters' Island.
DOUGLAS continued:
21st March, 1866.
22nd March, 1866.
The first was admitted into Gaol on the 28th December and came from Chuck Chew otherwise Stanley, named Young Achow a woman-- this proved a slight case. The second Wong Asing was admitted into the Gaol on the 6th June 1865, and discharged cured the 6th January. The third Lye Akit who had been admitted into Gaol on the 16th August 1865, died on the 2nd January 1800. It appears on reference to the book that a case of Bilious Remittent Fever named Lee Aming as alinitted into Gaol on the 20th September--and admitted into Hospital on the 11th December, and died on the same day--this man was worked daily in the chaingang and could have communicated when out of Gaol with his friends.
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