Sessional_Paper_1897 — Page 362

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Among these 635 deaths we discovered 69 that had died from Plague and 3 that had died from Small-pox, making a total of 72 or rather more than eleven per cent of the bodies examined.

No attempt was made, except in a few instances, to rectify the registered cause of death of the remaining cases, as that would have involved the devotion of considerably more time than could have possibly been spared from our more pressing sanitary duties; it is possible therefore that in some of these others, death may really have resulted from such an infectious disease as Enteric Fever, which could only have been recognised after post-mortem examination, while there can be very little doubt that in a large proportion of these cases the registered cause of death has been purely a matter of conjecture and for this reason such uncertified deaths considerably impair the accuracy of any deduc- tions which one may wish to draw from our mortality statistics, The careful investigation of the actual cause of death, in all those cases in which such has not been certified by a registered medical practitioner, could well be conducted by a well trained licentiate of the Hongkong College of Medicine attached to the Sanitary staff, and I would strongly recommend that some such course should be adopted with a view to rendering our mortality statistics less misleading than they are at present.

AGE DISTRIBUTION OF DEATHS.

The most noticeable feature in connection with the age distribution of the deaths is still the great mortality among infants under one year of age, although a marked improvement has already occurred, for these deaths now represent 20 per cent of the total deaths registered during the year, whereas in 1895 they comprised 28 per cent of the total deaths. This affords a striking illustration of the beneficial effects of improved sanitation upon the general health and upon the death-rate, for, as I pointed out in my Report for 1895, the great majority of these deaths among infants are due to diseases of a convulsive type, induced in most cases, by the foul atmosphere which they are compelled to breathe in the dark and ill-ventilated dwellings of the poor. The "infant death-rate among the non-Chinese inhabitants of this Colony does not exceed the rate in England, having been only 147 per 1,000, whereas among the Chinese population this rate was 745 per 1,000 in 1896, as compared however with 759 per 1,000 during 1895. (The rate was incorrectly given in my Report for that year at 680 per 1,000.)

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Such a great difference between the infant mortality of the native and of the foreign popu lation can only be dependent, to a very large extent, upon remediable causes, and calls for prompt action on the part of those who are responsible for the sanitary welfare of the Colony.

The following is a table of the age periods at which the several deaths occurred.

Chinese, Non-Chinese,

Totals,

Percentages,

Under

1-12

1-5

1 month. months.

years.

5-15 15-45

years. years.

45 years

Un-

and over. known.

584

545

544

448

1,942

1,507

37

14

26

17

16

112

66

2

598

571

561

464

2,054

1,573

39

10.2

9.8

9.6

7.9

35.0

26.8

0.7

* By “infant death-räte" is meant the number of deaths at ages under 1 year, per 1,000 births registered during the year.

DEATHS AMONG THE CHINESE COMMUNITY.

CHEST DISEASES.

The total number of deaths among the Chinese from respiratory diseases was 1,185; this represents a death-rate of 5.2 per 1,000.

These diseases appear to be more fatal among the boat population than among the land popula- tion, as the death-rate from this cause among the former alone amounts to 6.3 per 1,000.

More than 50 per cent of these deaths are attributed to Consumption, and the causes are doubt- less those which are invariably associated with a high death-rate from this cause, namely overcrowding, back to back houses; inefficient ventilation and poverty.

It is noteworthy that although the death-rate from diseases of the chest is higher among the boat population than among the land population, the proportion of cases of Consumption to other diseases of the chest is only 45 per cent in the former, as compared with 52 per cent in the latter.

NERVOUS DISEASES.

A very large number of deaths are recorded yearly from Convulsions and Trismus, in infants, although a marked improvement is noticeable in the returns for the past year; these deaths number 711 as compared with 1,107 during 1895, the total number of deaths from diseases of the nervous system having been 785. Further reference to this subject will be found under the heading of age distribution of deaths—(ante).