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tially one of the lymphatic system generally, and that, as can be seen at any post-mortem examination, most of the lymphatic glands of the body are in a more or less inflamed and irritable condition, while the special enlargement of any particular group of superficial glands (which does not by any means always occur) is due to purely accidental circumstances, such as by the carrying of heavy weights upon one's shoulder (as is invariably done by Asiatics) during the initial period of the disease, great strain being thus thrown upon one leg, by climbing up and down narrow flights of stairs as was done by the Europeans employed in house to house visitation and cleansing (most of the arduous manual labour was performed by coolies acting under the direction of these Europeans) or in fact by any of the ordi- nary daily avocations of life which happen to be of a laborious nature.

Murchison's opinion, although not perhaps scientifically accurate in the light of modern bacteriological research, yet indicates the close resemblance of Typhus Fever and Bubonic Fever, for he wrote: Plague is perhaps the Typhus of warm climates, the two diseases being generated from similar causes and differing only in intensity from the effects of climate and other collateral circumstances."

The marked recurrence of cases in houses previously infected, even after an interval of more than twelve mouths, has convinced me that only the most thorough disinfection, and even in some cases the removal of all existing unsound woodwork, will eradicate the disease from an infected dwelling, and I have decided to abolish the processes of disinfection by burning sulphur and by wash- ing the floors with some coal tar preparation, which have hitherto been in vogue in this Colony, and to adopt the system of disinfection which has proved so successful in Paris of spraying floors, walls, etc. with a 1 in 1,000 solution of Perchloride of Mercury; the rooms will subsequently be exposed as far as it is practicable in the ill-ventilated and mostly back to back dwellings in which these cases occur, to a free current of air by opening all doors, windows and ventilators as fully as possible, and keeping the premises unoccupied for a few days. There is, however, but one course for the Govern- ment to adopt, if this Colony is to be kept free from this and other filth diseases, and that is the absolute prohibition of back to back houses, and the compulsory provision of an adequate amount of light and ventilation in all the Chinese dwellings in the Colony.

SMALL-POX.

No less than 293 cases of this disease were reported during the year, of these 200 occurred during the first quarter. The number of imported cases was 37, of which 35 were imported during the first quarter of the year, and I certainly consider that the extensive outbreak of Small-pox during that quarter was largely attributable to the importation of these 35 cases, many of which would have been prevented from landing, if there had been a systematic medical inspection of all persons entering the Colony. The number of cases among the Chinese was 234, while 49 cases occurred among Europeans, 6 were Japanese, 2 Portuguese and 2 Indian. The European cases occurred mostly in groups-thus there was an outbreak of eight cases on board H.M.S. Grafton, which was clearly traceable to infection introduced to the ship by certain Chinese day-labourers who were working at the time in the stoke- hole; there were also four cases on board H.M.S. Æolus, two cases on board H.M.S. Centurion, two cases on board H.M.S. Humber and one case on board H.M.S. Hart, while the sick berth attendant on board the hospital ship H.M.S. Midge, where these naval cases were treated, also developed the disease. I have already ventured to suggest to the Commodore that a daily medical inspection of all day-labourers employed in the Naval Yard, during the prevalence of Small-pox in the Colony, coupled with the re-vaccination of the crews whenever necessary would probably be the best means of protecting the Fleet from such outbreaks as that which occurred on board H.M.S. Grafton, and arrangements have been made to supply the Commodore with a weekly return of all cases of infectious disease notified to this Department, while a similar return is forwarded each week to the Principal Medical Officer of the Army Medical Staff on this station. It seems strange, however, in the light of the statistics furnished by Germany as to the efficacy of re-vaccination in protecting the community from Small-pox, that the Naval Authorities are not able to confer sufficient immunity on their men by careful vaccination and re-vaccination to protect them from this disease, even when it exists among the Chinese community of this Colony.

I

Reference has already been made to a group of cases (seven in all) occurring in the Willison Circus Troupe in the month of February, on their arrival from Saigon, while, of the remaining Euro- pean cases, two developed the disease in the Garrison Female Hospital and one was an officer of the Royal Artillery whose death has already been commented on in this Report.

It may

be added that the vaccination of infants has been compulsory in this Colony since 1890; but as it appears from the Report on the recent census that only 7 per 1,000 of the Chinese population are born in the Colony, it is evident that the protection afforded to the public health by this enactment is infinitesimal, and one is thus compelled to consider whether the compulsory vac cination or re-vaccination of adults, which has been no successfully carried out in Germany since 1874, is yet within the range of practical politics in this Colony. I must confess, however, that I am unable to suggest any scheme whereby this most desirable object could be attained without considerable interference with the liberty and comfort of the community, and we must therefore be content to rely