Sessional_Paper_1892 — Page 427

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The second case was that of a seaman from the S.S. Bellerophon, this was on her homeward journey from Japan.

He was admitted at 12 o'clock on the 29th October, having evidently contracted the disease in Japan. He died some thirty hours after admission.

The Post Mortem appearances were very similar to those in the previous case, there being well marked congestion of the stomach, duodenum and jejunum.

year.

(viii.) DYSENTERY.-There were 69 cases under treatment as compared with 106 in the previous

During the year four deaths occurred.

This marked diminution in the number of cases coincident with a reduction in the number of Malarial fever cases (see paragraph IX) under treatment is to me a clear sign of the more general healthiness of last year.

An extended series of trials in the treatment of this disease by the administration of Arsenite of Copper has proved somewhat disappointing, and although in some cases it has been useful it is still on Ipecacuanha that we mainly depend for the successful treatment of this disease.

(ix.) MALARIAL FEVER.--The total number of cases under treatment was 339 as compared with 374 in 1890.

With reference to the Diagram Vd., instead of taking the whole number of cases under consideration I have limited the figures in this table to those occurring amongst the members of the Police Force. A great many of the cases admitted suffering from these fevers are sailors and others who have contracted the disease elsewhere, and, as this table is given with the idea of, if possible, ascertaining at which periods of the year this fever is most prevalent in the Colony, we cannot do better than confine ourselves to a fixed body of inen like the Police, who are of necessity residents in the Colony, and from the nature of their occupation are constantly exposed to this disease.

During the past year note has been kept of the hours of duty of these men on their admission to the Hospital. The result of these observations is given in Table VIIc. From this it will be seen that 138 out of 173, or a ratio of 79.7 per cent., evidently contracted Malarial fever during the night. There is no doubt that the hours between sunset and sunrise are those in which the Malarial poison is most rife.

As any information with reference to this class of fevers is of great importance and interest, I give in the appendix a paper on the Remittent Fevers of Hongkong read by myself before the Hongkong and China Branch of the British Medical Association. This gives the result of our experience at this Hospital during the past four years.

(x.) BERI-BERI.-There were eleven cases under treatment all of whom recovered.

(xi) VENEREAL DISEASES.--Although there is a diminution in the total number of cases under treatment during 1891 as compared with 1890, viz., 230 as against 266, on examining Table Vf., it will be seen that there has been a great increase in the number of cases of Primary and Secondary Syphilis, the numbers being 94 as against 43 in 1890, an increase of 118 per cent.

The one death was that of delicate German sailor who was under treatment for Secondary Syphilis. He developed Pneumonia in the course of this disease, and his constitution was so undermined that he could not withstand this complication.

(xii.) INJURIES.-There is a considerable diminution in this class of cases, there being only 214 as against 363 in the previous year.

SURGICAL OPERATIONS.

(xiii.) HEPATIC ABSCESS.-There were two cases operated on during the year, one being a Marine Officer in the Post Office, and the other a Turnkey at the Gaol. They both died. In only one were we enabled to have a post mortem examination, and in this case the abscess in the right lobe of the liver, which had been opened, had almost healed; there were numerous other abscesses in the right lobe, and one large one in the left lobe.

In one of these cases there was a previous history of Dysentery.

TREPHINING.-The result of the trephining was perfectly successful, the cause of death being the subsequent formation of an abscess in the opposite half of the brain.

TRACHEOTOMY.-The object of this was simply palliative, the patient suffering from advanced tubercular perichondritis.

AMPUTATIONS.-Herewith notes of the two fatal amputations:-

(1.) Fracture of upper end of Tibia and dislocation of Fibula in a man æt. 64.

From the first it was evident that the popliteal artery was either pressed on or injured by one of the pieces of bone, and, anastomotic circulation not being established, gangrene set in. Amputation at the knee joint was performed.