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page 38 of Dr. Lowson's Report, for he had two inoculation wounds, one on the left third finger and, the other on the right thumb; both of these wounds became so inflamed and intensely painful that they had to be freely incised, while severe lymphangitis occurred in both arms, and buboes formed in each axilla; it is worthy of note that the first bubo formed in the left axilla while the lymphangitis appeared first in the right arm. Case X., Chinese, also illustrates this point, and in my opinion serves to accentuate the rarity of infection by inoculation under ordinary circumstances.

As I have said, the infective material will breed in premises which are filthy, ill-ventilated, overcrowded and dark, and the disease is contracted by prolonged breathing of such atmosphere as is found under these conditions, and the attention of the Board should therefore be directed not to the substitution of other methods of conservancy for that at present in vogue, but to the speedy improve- ment of the general sanitary condition of the Colony, the prohibition of back-to-back houses, the opening out of narrow lanes and passages, at present occluded by filthy hoardings, awnings and other coverings, the provision of an abundant supply of pure water, and the prevention of that over- crowding which has unhappily been permitted to continue unchecked for so many years past.

It is a significant fact that only about 26 per cent. of the cases occur on the ground floors of houses, although nearly half the tenement houses of the Colony are still but two-story buildings, and the proportion of occupied ground floor rooms to upper floor rooms is as 65 to 100. This is, I think, another argument in favour of the theory that overcrowding and want of ventilation are the more potent factors in the spread of the disease, for the ground floor rooms of most Chinese houses are open throughout their entire frontage, during the day-time, being closed at night by wide doors, while the upper floor rooms have no such efficient means of ventilation.

The course to be pursued appears undoubtedly to take steps at an early date, in the direction indicated by the provisions of the Crown Lands Resumption Ordinance, No. 23 of 1889, which is much on the lines of the Imperial Housing of the Working Classes Act of 1890, and to resume certain insanitary areas, demolish the premises upon them, and then having laid out the land, either re-sell the building lots, or build model dwellings thereon; there are a number of insanitary areas in the city which urgently need resumption, and when the clearing and laying out of Taipingshan has been completed others could be taken in hand without producing further congestion of the remaining portions of the city.

The number of cases of Bubonic Fever reported during the year was 45, of whom 14 were women and 31 were men; 14 of these were taken to Hospital after death. Thirty-six deaths were registered during the year; the first case occurred on April 29th, and the disease continued to recur sporadically during the remainder of the year. No less than twelve of the cases originated in No. 7 Health District where the houses are in a very dirty and insanitary condition, and many of the inhabitants of which are said to have come from the resumed area of Taipingshan. Four cases were clearly imported from the mainland, while eight came from two houses in a small lane in No. 6 Health District (Heung Lane), but the origin of these cases was unexplained.

The distribution of the cases was as follows:-

April May June

July

August September November December

.....

3

2

13

2

4

6 12

The steps adopted upon the report of each case have been to at once remove the patient to the Kennedy Town Hospital, to place a Police guard upon the premises to prevent persons leaving, to disinfect all clothing, bedding and other fomites found upon the premises (including the clothing actually worn by these persons, suits of Government clothing being lent to them, in the meantime), and then to give these persons the option of leaving the Colony for a period of not less than ten days, or of remaining isolated upon a quarantine boat, for a like period, at the Government expense. The great majority elected to leave the Colony, and they were accordingly escorted to the boats by a Police Officer, and their return fares to Canton paid by the Captain Superintendent of Police. In all cases the premises recently occupied by the patient have been stripped, disinfected, scrubbed and limewashed.

2 CHOLERA.

Four deaths from cholera are recorded for the year 1895, two being in Europeans belonging to the Army (cet. 22 and 30 respectively), one an Asiatic at Kowloon (ct. 21) and one a Portuguese (æt. 19); it will be noted that the victims were all young adults. In no case did the disease spread, and I think we may take it that the cause of death was not, in any of these cases, genuine Asiatic cholera, but rather some form of non-infectious cholera nostras, such as is met with in Egypt and elsewhere, or an acute choleraie diarrhoea induced by indiscretions of diet or exposure to chill.

I