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done and less painful in its doing than that of ordinary vaccination. The inocula- tion causes in a few hours fever, headache, malaise, and discomfort for about thirty- six to forty-eight hours and a painful swelling at the site of the inoculation which necessitates rest for a day or two. The discomfort and pain experienced in the inoculated arm are, however, seldom greater than those following vaccination against small-pox and only last a few days instead of a fortnight as in the case of vaccina- tion. The inoculation against plague with properly prepared material is perfectly harmless. If the inhabitants residing in a zone surrounding an infected house are. inoculated, they are rendered in a high degree immune to the plague and the risk of the spread of the disease among the inhabitants in that particular area, which is a dangerous area, is much reduced.

13. In Hongkong with its proximity and daily intercommunications with Canton and Macao which appear not to be free of plague, it is necessary to prevent, as far as possible, the importation of plague because every such importation is likely to add to the number of infected centres. This requires arrangements and medical officers for the inspection of incoming passengers from these places. Possibly in the Port as in the districts, Assistant Surgeons from India trained in plague work could be employed under supervision.

14. Connected with the removal of the sick from the healthy, I understand there are special difficulties owing to the Chinese having a dread of being taken to an European hospital.

It is believed, however, that these difficulties could be overcome to a large extent by allowing the large firms to establish private hospitals with Chinese doctors and nurses to attend the sick. If such hospitals are erected on suitable sites approved by the Medical Officer of Health, are equipped with the proper sanitary appliances requisite in an infectious hospital, and the necessary precautionary measures of dis- infection carefully carried out in order to prevent them from becoming centres of infection for the locality in which they are situated, I see no objection. For all sanitary purposes the hospitals would require to be under the supervision of the medical staff of the Sanitary Board. It would be an immense advantage to secure in this way the assistance and co-operation of the different firms in the early discovery and isolation of the sick.

I have the honour to be,

Sir,

Your most obedient Servant,

The Honourable

J. H. STEWART LOCKHART, C.M.G.,

Colonial Secretary.

W. J. SIMPSON, M.D., F.R.C.P..