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upon its more intelligent members protecting themselves from this most loathsome disease by judicious re-vaccination and the adoption of such other precautions as will readily suggest themselves during periods of epidemic. I would suggest, however, that the Government might undertake to supply the Tung Wah Hospital authorities with an ample supply of vaccine lymph throughout the year and offer a small bonus of, say, 20 cents to the Chinese House Surgeons at that Hospital for every success- ful vaccination performed by them, the results to be certified by the Government Medical Officer attending that Hospital. A similar offer night be made to the Chinese House Surgeons of the Alice Memorial and Nethersole Hospitals if the Medical Superintendent would consent to certify the results. This principle of offering bonuses for successful vaccination has been in vogue in England for many years past, and would, I believe, prove a suitable method of largely increasing the number of vaccinated persons in the Colony.

While speaking of vaccination I may mention that a most interesting historical account of the Vaccine Institute at Saigon, by Drs. CALMETTE and LEPIGNAY will be found in the Archives de Médicine Navale el Coloniale (vol. 61) 1894; great stress is laid therein upon the fact that vaccine becomes rapidly attenuated in this climate on transmission from calf to calf, so much so that it was found necessary to obtain fresh supplies of lymph from Paris every fortnight for the inoculation of the calves until in 1892 young buffaloes were used experimentally in lien of calves, and the results were so excellent, th- tend ney of the lymph being, in these animals, rather to become stronger than to attenuate, that buffaloes have since that date been invariably used in the Institute in lieu of calves, The practical application of this experience of our confreres in Saigon to our own Institute will, I am sure, appeal to the Superintendent of the Vaccine Institute, for there appears to be, at present, a general consensus of opinion among medical practitioners in this Colony that the Saigon lymph is more reliable than that prepared in Hongkong, and the use of buffaloes in lieu of calves is, no doubt, the scientific explanation of this circumstance.

ENTERIC FEVER.

Sixty-five cases of Enteric Fever were reported during the year, and no less than 51 of these were Europeans, while the remainder comprise 7 Chinese, 3 Japanese, 1 Portuguese and 1 Indian. Of the 51 European cases, however, 21 are known to have contracted the infection at neighbouring Ports while 2 others probably did so, thus leaving 28 of these cases to be accounted for locally.

During the month of June six cases occurred within a few days of one another, and as they all obtained their milk from the same Dairy, it is reasonable to suppose that the infection was conveyed to them by this medium. Fortunately, however, the source of contamination appears to have been promptly, although perhaps unconsciously removed, as no further cases were traceable to this cause. Many of the cases which occurred during the earlier part of the year were of so mild a type as to occasion considerable doubt in the minds of their medical attendants as to the genuineness of their infectious nature, and it would no doubt be as well if in future the diagnosis could be checked by Widal's serum test which seems to have established a good claim to reliability. This test consists in adding to the serum of a drop of the patient's blood ten times the quantity of a 24 hour old broth culture of the bacillus typhosus, and examining a portion of this mixture under the microscope, when in genuine cases of Enteric Fever it will be found that the bacilli, which in the broth culture are exceedingly active and uniformly distributed over the field, become motionless and clumped in masses, the intervening portions of the field being quite clear. This change takes place immediately or within a few minutes in the great majority of cases, but in those doubtful cases of Enteric Fever in which the application of the test would naturally be of most value, the change is not always so pronounced, for some of the bacilli may retain for a time a sluggish movement, while again the clumping will not be so perfect as in typical cases of the disease, but yet the influence of the serum upon the bacilli will be readily apparent, while with blood serum other than that from a typhoid patient no reaction whatever takes place, Bates Black's statement that cases of Malaria react to the test having been disproved by subsequent observers. In many cases a first test, especially if applied early in the course of the disease (.e. before the tenth day), may prove negative, while a further test a week later, if the clinical symptoms continue to be suspicious, may result in producing the typical reaction.

The importance of an accurate diagnosis in all such doubtful cases cannot well be exaggerated even apart from scientific grounds, for the welfare and comfort of the patient, and of those residing under the same roof, must of necessity be largely influenced by the circumstance of the infectious or non-infectious nature of the illness, and I would venture to hope therefore that some attempt may be made by local medical practitioners to adopt this test in all doubtful cases of Enteric Fever, and I think that the Government would be wise to make use of the valuable experience of the Colonial Veterinary Surgeon in bacteriological work and instruct him to prepare the necessary cultures for such tests as that of Widal. An excellent laboratory might be fitted up at the Vaccine Institute at a comparatively small cost, and much valuable scientific work might be done there, on behalf of the Board, by its officers.