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"In the second case, that of a strong healthy young man of temperate habits admitted from

Aberdeen, the disease ran through precisely the same stages.

"The third case was that of a young man of most robust frame, active intellect and temperate habits. In this instance the disease was of seven days duration and death was preceded by symptoms of stupor and low delirium.”

I mention these cases as they agree in their characteristics with those I will describe later on as having occurred during the past few years. It will be observed that in the last case but one, there is a note that no delirium was noticed.

There were three other fatal cases that year amongst the European Police from this disease. Seven other European Police were noted as convalescent recovering from Remittent Fever. But they were unfortunately drowned in the month of August whilst on a cruise in an armed Police boat with some other convalescent patients.

During this year the average number of Policemen employed was :---

Europeans.

50

Indians.

130

Chinese.

28

Deaths.

35

Percentage of Deaths to persons 14.28 per cent. so that altogether in the Police Force amongst fifty Europeans, we have six deaths from Remittent Fever giving a percentage of 12, in addition to the seven convalescents who were drowned during the typhoon.

The death rate this year was as follows:-

No. of Europeans.

963

No. Deaths.

125

A percentage of 12.90, (129 per 1,000.)

This is furnished by statistics from the Registrar General's Department.

In this year many deaths occurred in the 95th Regiment, concerning these Dr. GORDON, Staff Assistant Surgeon, states:

"A large majority of the cases and the most fatal came from the South or rear range of the Barracks. The disease was first observed about the first week in May slightly increasing in June, in July a considerable increase in the number and severity of the cases took place, this continued during August, but sensibly decreased during September, the average duration of the disease being about 56 hours. Death generally occurred about the third day, though in many instances it occurred a few hours after admission." The disease was called by Dr. GORDON "Febris Remittens," and described as congestive and malignant. Dr. MORRISON, the Colonial Surgeon, considers this disease as nearly identical with the "Yellow Fever" of the West Indies which is said never to occur in the East, although indeed the earliest name of the Yellow Fever received was Maladie de Siam." He states "I was always of the opinion that although the fever of last summer was probably endemic it was not peculiar to this place." In illustration of this opinion he places in juxta-position with a case and his remarks given by Dr. GORDON, a case recorded in JOHNSTONE'S work on "Tropical Climates" by Mr. SHIELDS, which occurred in Batavia in the month of August 1800, together with that gentleman's remarks.

66

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Mr. SHIELD's statement: "Never was there a disease so deceitful as this Fever. I have frequently seen instances where every symptom was so favourable that I could have almost pronounced my patient out of danger when all at once he would be seized with restlessness, black vomiting, delirium, and convulsions, which in a few hours would hurry him out of existence.”

Case.

"This was the case with Mr. BROUGHTON, Purser of the Daedalus, who died of the Batavian epidemic at the Edam Hospital. On the seventh day of his illness he took a change for the better and everything was promising. The morning before he died he expressed himself greatly relieved and called for some mutton broth and sago, both of which he ate with a good appetite spoke rationally and was in good spirits. Towards evening the delusion vanished, restlessness, black vomiting, delirium and convulsions supervened and carried him off before morning.

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Dr. GORDON, states :--" The Fever was of a very malignant and insidious character, the symptoms changing for the worse suddenly and without warning either to the medical attendant or to the patient himself. Although often visited and apparently much improved both in feeling and appearance, half-an-hour previous to his death he would suddenly became strongly convulsed, his skin intensely hot and dry, the surface asserting a livid hue, and thus the scene would close case."

"Colour Sergeant STALEY, a stout healthy young man, was admitted on the morning of the 17th June, in the cold stage of Intermittent Fever, and in about six hours had gone through all the stages of the disease. When the intermission occurred, Quinine was administered. On the 18th he declared himself as feeling quite well and was apyretic, his pulse not even indicating the slightest constitutional irritation.

“About 4 A.M. on the 19th, I was called to see him and found him comatose and convulsed, with lividity, intense heat and dryness of the skin. Death closed the scene in a few minutes.”