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No less that 44 of these cases are known to have been imported into the Colony, while it was in addition impossible to discover whence many of the cases of Bubonic Fever and Small-pox had come, as they were not discovered until the patients had died and the bodies been deserted by the other occu- pants of the house; of these 44 cases, 16 were Small-pox, 22 Bubonic Fever, 5 Enteric Fever, and 1 Diphtheria. The question of the medical inspection of the shipping of the Port, urged by me during the past three years, and dealt with in detail in my Report for 1897, is still, I regret to say, in abeyance, with the result that persons suffering from infectious disease may land in the Colony, with impunity, provided that they are unaware (or refuse to admit that they are aware) of the infectious nature of the disease from which they are suffering. For mail steamers and others that carry a Surgeon, the present regulations may no doubt be admirable, but as it is the vessels which do not carry Surgeous, and espe- cially the native craft that are most likely to foist cases of infectious disease upon the Colony, I must adhere to my previously expressed opinion that we have only ourselves to blame when grave epidemics are originated, as unquestionably they are in many instances, by the unrecognized importation of the initial cases.

BUBONIC FEVER.

A serious epidemic of this disease occurred during the spring of the year, no less than 1,320 cases being reported, of which 1,175 died, which is equal to a mortality of 88.1 per cent. As this outbreak has formed the subject of a special report which was presented to the Board by me in August of last year, it will be unnecessary to enter here into any further details.

SMALL-POX.

The epidemic of Bubonic Fever was preceded by a smaller outbreak of Small-pox, the total number of cases reported being 199 while the deaths numbered 110, which represents a mortality of 55.2 per cent. Sixteen of these were imported into the Colony while in many others the origin could not be traced as the disease was not discovered until after the death of the patients. The nationalities of the patients were as follows:-Chinese 130, European 51, Indian 7, Japanese 4, Philipino 4, Negroes 3. Of the European cases, one came from H.M.S. Powerful, one from H.M.S. Edgar, one from H.M.S. Centurion, and one from H.M.S. Tamar. There were no cases of Small-pox among the troops stationed ashore, whom one would expect to be brought into more intimate contact with the natives, during the epidemic, than the sailors; the most probable explanation is therefore that the troops are better vaccinated than are the sailors.

The recommendation contained in my Report for 1897, that a small bonus should be offered to the Chinese House Surgeons at the Native Hospitals (Tung Wah, Alice Memorial and Nethersole) for all successful vaccinations, the vaccine to be supplied free by the Government, with a view to increasing the number of vaccinated persons in the Colony, has not yet, I regret to say, been adopted, although it was

Ι specially recommended by the Board, by resolution, in August of last year.

The total number of vaccinations recorded last year was 7,051, the great majority of them being prisoners in the Gaol.

ENTERIC FEVER.

Fifty-two cases of Enteric Fever were reported during the year, of which fourteen were imported into the Colony. The nationalities of these cases were as follows:-European 37, Chinese 10, Japanese 3, Indian 2. Four of the European cases occurred on board H.MS. Edgar, three on H.M.S. Tamar, one on H.M.S. Powerful, one on H.M.S. Immortalité, two on U.S.S. Boston and one on S.M.S. Gefion. There were also two cases in the Military Barracks and one in the Police Barracks. The large number of cases of this disease among the Fleet compares somewhat unfavourably with the two cases among the troops, but I think one of the most probable explanations is that, while the soldier has practically no temptation to take meals away from his Mess the sailor, especially on first arrival in the Port, eagerly samples the fresh salads, the mineral waters of Chinese manufacture and other like delicacies doubtful origin and thus contracts the disease. In any case the discrepancy between the figures in the two services rather discounts the theory that sewer emanations have much to do with the causation of the disease in this Colony.

The total deaths from this disease was 23, which is equal to a case mortality of 44.2 per cent. The mortality among the European cases was 35.1 per cent.

Two of the ten Chinese cases were imported and three of the remaining eight were in children under ten years

of age. Since my Report was issued last year, in which reference was made to the apparent immunity of the Chinese to this disease, and the explanation offered that it is probably due to an attack during infancy or early childhood, a more careful search has, I believe, been made, at the Govern- ment Mortuary, for deaths from this cause among Chinese infants, with the result that several of such bodies have been found to present typical typhoid ulcers of the intestine.