Sessional_Paper_1903 — Page 468

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13. My object was (1) to endeavour to secure the cleanliness of house and person, that must in any case be beneficial; (2) to induce the people to undertake this work themselves; (3) to put a stop to the dumping of dead bodies by re- moving the dread of disinfection by the coolies of the Sanitary Department; (4) to induce the people to give notice of sickness. Inspector GIDLEY'S report (Appendix A.) will show how far these efforts have been successful. It will be observed that in cases where death had occurred the people destroyed or disinfected bed and clothing of deceased, cleaned the house and remained. In cases of illness we at first removed the inmates, who in case of the death of the patient returned to the house as soon as it had been cleansed. In no case was there any plague developed among these "contacts" after the ordinary period of incubation; for instance in five cases occurring among the inmates of 4 Sheung Fung Lane they were all deve- loped within five days of the date of the first seizure reported. The return of cases attached to Inspector GIDLEY's report shows that in 41 cases, apart from those reported dead, 8 were reported at once,

9 after one day's illness,

7 after two days,

1 after three days,

2 after five days,

3 after six days,

1 after seven days.

Considering the reluctance of the Chinese to speak of illness, the return speaks well for the efficiency of supervision by the Kai-fong and the readiness of the people to co-operate with the efforts to assist them.

14. Having got the tanks in order the whole district was systematically taken house by house, the occupants bringing their bed boards and mats, their settles, and any furniture that could be immersed to be dipped in the boiling water for a few minutes and thoroughly scrubbed. Clothing was either taken to a wash house and washed, or sent to the Disinfecting Station at the option of the people. With 253 houses to clean, this process took some time, but apart from the thorough cleansing as above all the householders in the experimental block turned out their furniture into the streets, scrubbed it and swept the houses within a week of the taking over of the small district. With two exceptions there was no case of plague, the first invasion of which was after the date of thorough cleansing.

15. So many cases occurred in the second week in May that difficulty was found in obtaining accommodation for the occupants of the houses. I therefore took a house in Third Street as a local hospital, where the patients might be attended by their friends. Two hospital attendants were engaged, but unfortunately trained attendants could not be procured. The people showed no disinclination to go to this hospital.

16. On the 14th May I directed that the inhabitants of Sheung Fung Lane should be moved as so many cases of plague had occurred, and I wished to have the houses thoroughly explored for rat runs to see if any connection could be traced between the houses in which plague had occurred. The report (Appendix B.) shows that while rat runs were connecting respectively Numbers 1, 3 and 5, 7 and 9, 15 and 13, 6 and 8, 2 and 4, the houses in connection with 8 and 4 the only infected houses in the series namely 6 and 2 were not apparently infected.

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18. Having stated the objects of my experiment, the question remains whether, assuming that local hospitals and a minimum of disturbance will en- sure a more timely discovery of cases of plague we may hope for a material diminution in the case mortality. As affording a rough comparison I have obtained from Dr. THOMSON a return of the cases of plague in Kennedy Town Hospital during this year's epidemic. It will be found in Appendix F. Dr. THOMSON divides the cases into two divisions, the reasons for which are two- fold. About the middle of May an improved method of examination of blood for bacilli first, I believe, discovered by Dr. Ross, was adopted by Dr. BELL of the Government Civil Hospital and by this method a large number of mild cases of plague were diagnosed, especially among Europeans, which under for- mer methods would have escaped observation, and again at this time the treat- ment of patients by large doses of carbolic acid was adopted in Kennedy Town