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is wet.

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cleaning out houses the furniture &c. should be well washed with carbolic solution, by means of a haud hydrant, and cleaning should proceed whilst the furniture etc. After removal another good wash with carbolic or quicklime should take place. Chlorine will prove an efficient disinfectant if used in good quantity within a building, the doors and windows being carefully closed. Dirt and rubbish removed should be at once burned. The removal of the healthy from infected houses should be insisted on. They should be transferred at once to some outside encampinent. When it is realized that the floating population of Hongkong practically escaped scot free it is a matter for regret that a suggestion made by Surgeon-Major JAMES and myself (on May 31st) to form water camps for the inhabitants of Taipingshan was not acted upon. To keep the people in Taipingshan separate from those in "the as yet unaffected districts we recommend very strongly as a suggestion that a water camp be formel, separate from those on the land proposed for the "unaffected districts (whilst a thorough scavenging of the other parts of the town was going on). Things look so serious that these measures appear to us to be absolutely necessary to prevent a rapid increase of the disease throughout the "city and in Taipingshan especially and we beg your most serious consideration "of our proposals." In spite of the remarks made by the special correspondent of the British Medical Journal in its issue of 1st September (Dr. JAMES CANTLIE), I am convinced that an epidemic of plague in Hongkong could be tackled and got under rapidly if men in sufficient number could be got to do the work. Isolated Feople should be medically inspected every day and fresh cases would soon cease to occur if the camps were looked after in a proper manner.

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As regards treatment of the sick, a certain routine of treatment was carried out in most cases. Towards the end of the epidemic a true "survival of the fittest" of the medicines at our disposal occurred.

A ten-grain dose of calomel throughout the epidemic was the usual purgative to commence with; compound jalap powder grains XL was added sometimes, but as a rule the calomel proved efficient, a seidlitz powder six or eight hours afterwards being occasionally indicated. We began feeding with the most easily assimilable nutrient food that could be got; egg flip and strong beef tea, being the most easily procured and the cheapest, formed the most considerable part of the Chinese diet during the acute stage. Brand's Essence and other patent preparations were also given but did not give so good a return for the money expended; they are expensive without being any improvement upon the egg flip and strong beef tea. Moreover the Brand's Essence is generally disliked by the Chinese. Brandy is not so much disliked. Within ordinary limits any nourishment that a plague patient fancied he had, and we were glad to see him take as much as possible during the first two days of illness before he became delirious, as afterwards the difficulty of getting him to take anything at all was very great. So long as the pulse was good we did not stimulate, but began when dicrotism was evident. Ammonia and cinchona we generally started with (half a drachm each of Sp. Ammon. Co. and Tinct. Cinchon. Co. with an ounce of chloroform water being given as a rule every 4 hours). Digitalis generally required to be added early. Sometimes the infusion was used, sometimes the tincture. Different mixtures were kept in stock and according to the

patient's condition either ammonia and cinchona were given alone, or with varying doses of digitalis or with strophanthus added. Strychnia was also given, prescribed alone, as the carbonate of ainmonia precipitates the alkaloid if used with the mixture. One would have expected that digitalis would markedly improve the pulse if the dilatation of vessels were solely due to vasomotor nervous conditions, but it did not. From experience I found strophanthus better, as it never caused the pulse to get worse as digitalis sometimes undoubtedly did. Far better than either, however, is strychnia which we began to use liberally towards the end of the epidemic, and I think that in future cases the routine use of strychnia should be begun early. The dose, of course, varied with the case, but from 5-10 m. of the liquor strychnia by stomach every four hours did not seem at all too large a dose, and I should be inclined to give considerably larger doses than this some- times. Digitalis in theoretical medicine ought to be the best of the drugs above named, but undoubtedly strychnia impressed me as the better drug for the vascular condition. Although it would be scarcely fair to blame digitalis for making all intermittent pulses worse, when intermittency was already evident, yet it certainly did so sometimes. Liq. Ammon. Fort applied to the nostrils was of great use some- times in the heart failures which often took place, whilst hypodermic injections of ether at this stage were occasionally a necessity. Whilst the majority of heart failure cases proved rapidly fatal, yet in some cases where treatment was energetic it was wonderful to see how some practically moribund sufferers would rally and sometimes get better. We did not despair even when the pulse could not be felt