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I have tried antipyrin injected subcutaneously, aconite and large doses of quinine all without avail and now when such rise has taken place our sheet anchor is "ice-packing." by this I mean that, the patient is placed on a mackintosh sheet covered with a sheet dipped in ice cold water and exposed to any breeze that may be present, ice being placed all over the patient and an ice bag to the head.

Generally in less than half an hour the temperature will fall as much as nine or ten degrees. The patient has to be carefully watched as collapse may set in, if it does this is combatted by enemata of brandy and beef tea or injections (hypodermic) of brandy.

When the temperature has fallen the patient is placed in a fresh bed and hot baths applied to the feet, the hypodermic solution of the neutral hydrobromate of quinine in 10-grain doses is then in- jected this is repeated in an hour and again in another hour. In many cases such energetic treatment will only be once necessary as the temperature does not rise so high at the next paroxysm and the patient gradually improves. In the interval champagne and soda water, Brand's essence of beef, ice and iced milk are administered in small doses repeated frequently. No ill results in the way of pneumonia, &c. have followed such treatment and by its means many of the severer cases have recovered. See Appendix (medical cases).

In some of the worst cases the temperature notwithstanding this will rise again as high as in the initial paroxysm then nothing appears to be of any avail death rapidly ensuing the patient's temper- ature frequently rising as high as 110° F. or 1104° F.

The Table of malarial fever cases shews plainly the rise which occurs during the hot rainy season (June-September), the rise in November was probably caused by the fact that the hot weather con- tinued later on in October this year than is usual, the first spell of cold weather brought about a recrudescence of the disease in those who had been previously attacked the greater majority of these cases giving a history of a previous attack of malarial fever.

(8.) There were 32 cases of beri-beri under treatment, with 2 deaths as against 16 in the pre- vious year. Two of these were of the acute variety (Beri-beri hydrops) one recovering, the remainder were of the chronic variety (Beri-beri atrophia) one death occurring.

(9.) Venereal DISEASES.-There has been a marked increase in this class of diseases the numbers being 206 as against 118 in the previous year. Although many of these cases have been introduced into the Colony from other ports, I have no reason to believe that this has been more so than in the previous year. It therefore appears evident that the propagation of this class of disease within the limits of the Colony has increased, the greater majority are those suffering from Chancres Molles and Gonorrhoea; the resulting buboes have been of a particularly indolent type many taking weeks to heal and then only after incision and the free use of Volkmann's spoon, this is no doubt accounted for by the fact that many of these cases occur in patients debilitated by previous attacks of malaria and alcholism.

(10.) There was one case of hydrophobia during the year, a Chinese boy at. 16 who had been bitten by a mad dog in Canton two months before his adinission who was violently convulsed when admitted, hypodermic injections of Curari (-grain doses) were administered every half hour for three hours and although the paroxysms were lessened the improvement was only temporary. form was then administered for some hours, during its influence the paroxysms again abated, but it had to be discontinued owing to weakness of the pulse. The paroxysms again recurred and he died nine hours after admission.

(11.) Surgical OPERATIONS.-During the year there have been 109 operations performed.

There were five cases of gun-shot wounds admitted during the year the notes of three of which are given in the Appendix as being of some surgical interest.

HEPATIC ABSCESS.-There were three cases during the year all of which were operated on; two of which died. Post Mortem Examination shewed that these were post dysenteric and multilocular, in one case as many as fourteen abscesses were present. Although a large abscess had been opened in each case causing a temporary improvement, during treatment lasting in one for some weeks, an exacerbation set in and a fatal result ensued.

The third case was operated on in December last and improved very much after operation so much so that the fever entirely subsided and the patient was able to get up and walk about. The improvement continued the patient increasing in weight so that we had great hopes that this was a unilocular abscess, unfortunately the temperature arose on 23rd January he became much worse and died on 29th of that month. Post mortem examination shewed that the cause of this was the formation of three more abscesses, one about the size of an orange situated in the posterior part of the right lobe, the others being smaller. The original abscess which had been opened in November had healed up.

There is no doubt that dysentery was the cause of these abscesses as in each case there were well marked signs of previous ulceration in the colon.

MAJOR AMPUTATIONS.-There were four cases during the year, one of the arm and one of the thigh for extensive disease of the elbow and knee joint respectively, and one of the fore-arm and one of the leg for severe injury, all of these were attended with satisfactory results.