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Certain of the Ko Fong wards still remain, and the use of these for the accommodation of the female patients is in every respect unsatisfactory. This question would probably have been dealt with in 1898 but for the disturbance in the financial calculations of the late Board of Directors that resulted from the Plague Epidemic, and the consequent necessity of maintaining for a time a special Plague Hospital. It is to be hoped that the new Directors will move vigorously towards the removal of this ground of complaint, under the stimulus of the generous offer male by His Excellency at his recent meeting with them on 10th January to grant a site for the necessary eulargement of the Hospital on part of the adjoining resumed area on Taipingshan.

THE WARDS AND THE WARD WORK.

A uniform has been provided for the use of the ward-coolies.

During the summer over 250 small blankets were purchased, and were in use in all the wards. The Directors of the previous year had refused to sanction the use of blankets. As the cold weather advanced, the cotton quilts ("ineen-tois") were issued again, to a large extent new, however, and all of them clean and in good order, but the use of blankets during the autumn indicates the beginning of the disappearance of the opposition that formerly existed to all forms of bedding except these quilts. I make a weekly inspection of all "meen-tois" in use with their covers removed.

Clothing and bedding are now kept clean, and the regulations which I made regarding them are carried out to my satisfaction. The clean clothing is laid out on the beds for my personal inspection before use every Wednesday and Saturday in ruing, and the soiled clothing is changed and removed from the Hospital immediately after my visit. In former times all the washing was done within the Hospital, but under new conditions this soon became impossible, and now nearly all of it is done by outside laundrymen.

A temperature chart is now kept in all cases of Diarrhoea as well as in all cases of Fever, whether under native or Western treatment, to obviate the probability of obscure cases of Enteric Fever being classed as simple Diarrhoea, with the consequent risks of infection.

Quinine is now systematically used, though under protest on the part of some of the native doctors, in all cases diagnosed malarial, whether under native or Western treatment. In the more virulent types and in cases brought in comatose, it is administered by Dr. CHUNG subcutaneously. By this means the mortality in malarial fevers has been reduced from 33 per cent. (191 deaths in 571 cases) in 1897 to 23 per cent. (122 deaths in 521 cases) in 1898. It is still abnormally high, and would no doubt be further reduced were all cases treated properly, but it is to some extent at least due to the large number of cases of Pernicious Remittent Fever brought in advanced stages from out-lying districts such as Aberdeen and Quarry Bay.

It is necessary throughout the Table showing the proportion of deaths to admissions to have in mind the fact that the Tung Wah Hospital is largely used as a sort of dying house by the lower orders of the Chinese community, many cases in extremis" being brought in from the coolie houses, &c., and many others being in perfectly hopeless stages of Pulmonary Tuberculosis, Heart Disease, Malarial Cachexia, &c.

OPERATIONS.

Almost from the beginning of his connection with the Tung Wah Hospital Dr. CHUNG has performed surgical operations of a minor character, but only lately has he felt himself at liberty to attempt there anything at all serious, though he had previously had considerable operative experience. During the latter part of the year he has successfully performed the following :—

Amputation through the thigh,

Lateral Lithotomy for Vesical Calculus (3 cases), Reduction of Dislocation of Hip Joint,

Removal of Necrosis of Lower Jaw,

Operations for Cataract, Entropion, Pterygium, Fistula in Ano, Cysts, &c.

This is specially worthy of note as marking the introduction of European Surgery under the influence of Chloroform into the Tung Wah Hospital. In all cases where a general anesthetic was used, it was administered by Dr. Was Tux Mo, House-Surgeon of the Alice Memorial Hospital, who is an experienced anesthetist. All the patients have done well, and there has been no case of death following operation,

THE PLAGUE EPIDEMIC.

During the Plague Epidemic of 1898 the Tung Wah Hospital was used as a convenient centre for the inspection and diagnosis of suspicious cases found alive by the search parties, and from the beginning of May all Chinese patients were first conveyed thither. Dr. CHUNG at once forwarded those found to be suffering from Bubonic Plague to Kennedy Town, and less pronounced cases were detained in the Receiving Ward for further examination by myself.

The Captain Superintendent of Police appointed Chinese constables to superintend the transfer of Plague cases to the Plague Hospitals, and these were on duty at the Tung Wah Hospital day and night while the epidemic lasted.