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Inspector CORCORAN who is at present in charge of the Station at Shaukiwan informed me that during three months of this year (March-May) when he was in charge of the Tsimtsatsui Station, three men died from this disease at their own homes within a short time of their having left the Force.
Two of the Lukongs (Chinese Constables) said that they had cured themselves by substituting beans for rice in their diet and by eating more fish, and that they had been advised to do this by a Chinese Doctor. This fact is very interesting, as in the Japanese Navy, where the disease is common, the cases were found to improve by adopting a more nitrogenous diet, substituting beans and peas for rice, the former as is well known containing much more Nitrogen, and after this change in the diet fewer cases occurred.
On October 14th I visited the Stations of Aberdeen and Shaukiwan; at the former one man out of four stationed there showed evidence of having suffered from this disease, and he informed me that he had had an attack three months ago, and that he had been cured by some Chinese medicine which he had obtained in Hongkong.
At Shaukiwan where four of these men are stationed one had suffered from this disease eight months ago. Inspector CORCORAN also informed me that one Lukong had been attacked by this disease in September last and after being ill for a few days had left the Force and gone to his home at Stanley where he died five days after. He left the Force on September 15th and died at Stanley on September 20th; this from his account was evidently a case of "Beri-beria hydrops." When at this station, I visited the Chinese Doctor to whom the men applied for advice when attacked by this disease and he evidently was quite familiar with it. He told me that the Chinese name for this disease is Shap-Hi (Dampness rising up), and his treatment consists in giving the man as much animal food (mutton, beef, &c.) as they can eat in lieu of their usual rice, together with certain drugs. He says the disease is very common in Hongkong, and that there are several varieties of it, he has also seen cases in his own district (Tung-koon) in the interior, but there the disease is much more
rare.
The foregoing shows that out of one hundred and twenty-one (121) men examined (including one under treatment at present in the Hospital), seventeen (17) have had this disease, this being equivalent to 14.05 per cent.
With respect to the fatality of the disease, out of the eight cases I had in the Hospital one proved fatal, in addition to these, three fatal cases occurred in the Force stationed at Tsimtsatsui and one in the Force at Shaukiwan, giving five deaths this year in the entire Force of say one hundred and thirty men or a mortality of 3.84 per cent., or 17.24 per cent. of those attacked with the disease.
With regard to the infectious nature of the disease there is some difference of opinion; I have not myself in these cases coming under my treatment adopted any special precautions and have noticed no ill-effects.
In the Annual Medical Report of the Straits Settlements Civil Hospitals for the year 1886 Dr. ROWELL states page 9, section 81 :-
"As regards the contagiousness of the disease, this has been quite absent. The patients have not been placed in separate wards, but scattered among the other patients, none of whom have con- tracted the disease. Nor have the clothes conveyed the disease, for they are changed at stated periods, washed and redistributed amongst the patients, beri-beri or not, but without fresh cases occurring amongst the other sick."
On the other hand (vide British Medical Journal of December 5th, 1886) Doctors CORNELLISSEN and SUGENOYA, who have been recently investigating the disease in Acheen, conclude that:--
i. It is a contagious disease.
ii. Beri-beri patients infect certain localities, and persons in good health coming from districts free from beri-beri, and settling in those infected districts, contract the disease.
iii. That wooden structures retain the infectious product more than brick buildings. iv. That contagion through the means of wearing apparel had been observed.
I am of opinion from the observations I have made that the prevalence of the disease in Hongkong is such as to require careful investigation by the Medical Profession.
In conclusion I would express my indebtedness to Dr. MANSON for giving me the benefit of his long experience of this disease which is one peculiar to the Tropics.
J. MITFORD ATKINSON, M.B., (Lond.), Superintendent, Civil Hospital, Hongkong.
October 17th, 1888.
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