748
INFECTIOUS DISEASES HOSPITAL,
KENNEDY TOWN, HONGKONG, 21st February, 1902.
Sir, I have the honour to report for the information of His Excellency the Officer Administering the Government regarding the Infectious Diseases Hospital at Kennedy Town for the year 1901.
I enclose a Return of Diseases and Deaths in the Hospital during 1901.
Small-pox.-There were 42 cases, with 12 deaths. Many of the fatal cases were Chinese suffering from the confluent form of the disease, and at an advanced stage of the illness at the time of admission..
I find Salol of great value in the treatment of Small-pox, when its use is commenced early. It allays irritation of the skin, aborts the eruption, causing it to die away for the most part without sup- puration, usually prevents the secondary fever entirely, and hastens the general course of the disease. It is less useful if not given until after suppuration of the vesicles has become established. I give ten grains every
three hours at first, but find it desirable to rapidly diminish and discontiuue the drug when the disease is under control, as, if long continued, it tends to produce a warty condition of the skin of the face.
Cholera. All the cases of Cholera occurred at the end of February, and came from the S.S. "Cheung Chew." Most of the fifteen patients were in a state of collapse at the time of arrival, and of the ten fatal cases eight died within a few hours after admission.
Plague.-204 Plague patients were under treatment, and of these 156 died. This gives a mortality of 76.5 per cent., a little less than that of the previous year-77.5 per cent. As in former epidemics, the mortality was very heavy among Chinese and much lower among Europeans. The comparative racial mortality was as follows:---
Cases.
Deaths.
Europeans,
24
8
Mortality. 33.3 %
Portuguese, Chinese,
16
12
75
""
136
121
89
Other races,
28
15
53.6
"
204
156
76.5 %
The following table shows the distribution of the buboes:--
Cases.
Deaths.
Femoral,
95
65
Inguinal,
18
16
Axillary,
24
21
Cervical,
6
5
Parotid,
3
2
Multiple,
20
13
No apparent bubo,
38
34
204
156
There was only one case of pneumonic plague properly so called, but pneumonic symptoms supervened in three other cases which had also buboes.
After very careful observation of the effects of the administration of Carbolic Acid throughout the whole of last year's epidemic, I am of opinion that it does not in any way modify the course of Plague, and is useless as a method of treatment.
To test the diagnostic value of microscopic examination of the blood in Plague, apart from the question of the exclusion of Malaria, I examined a single stained film from each of 278 consecutive cases, partly from the Plague Branch of the Tung Wah Hospital Plague bacilli were present in only 30, and were absent in 241. In many of the latter, especially when going on to a fatal issue, bacilli were present in the blood at later stages of the disease; but the figures above given show that the value of blood examination is more important for purposes of prognosis than for diagnosis.
The Staff Mr. E. ABBOTT, the Wardmaster in charge at the beginning of the year, died of Phthisis in the Civil Hospital on 21st April. Corporal T. NEWLING, R.A.M.C., lent by the Military Authorities, reported for duty on 1st April, and acted as Wardmaster throughout the Plague epidemic until he was recalled on 27th July. Private B. P. LAKE, R.A.M.C., assisted him from 28th May to 24th July; and Mr. LI YIN SZE, a student of the College of Medicine for Chinese, was also employed as Assistant Wardmaster from 22nd April till the end of August. Mr. C. F. O'BRIEN arrived from England, and assumed duty as Wardmaster on 27th August.
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