Sessional_Paper_1904 — Page 373

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PATHOLOGICAL INVESTIGATION.

Small-pox.

A small epidemic occurred during the early part of the year. Twenty-two cases of the disease were examined at the Mortuary. Four cases were received in January; eight in February; five in March; three in April; and one in May and in August.

All the cases occurred in infants.

The type of the disease was severe.

The majority of the cases examined showed the hæmorrhagic and confluent type of the disease.

Enteric Fever.

It

Only one case of this disease has been met with during the past year. occurred in a Chinese female aged about one year. The post-mortern lesions were severe with diffuse ulceration in the ileum. The Bacillus Typhosus was isolated in pure culture from the spleen. It is rather remarkable that in Hongkong so few cases of this disease are found post-mortem and further that such cases as are met with, cecur mostly in children. A case of Enteric Fever in an adult has only been found by me once during the past two years.

From mere post-mortem statistics alone one would be obliged to conclude that Typhoid Fever was a rare disease amongst the Chinese. My statistics for the past two years show a total of 5,142 post-mortem examinations performed, and amongst these only 8 cases of Enteric Fever. To explain this insusceptibility to Typhoid Fever amongst the Chinese, it has been suggested that the majority of the population contract the malady in infancy.

Whether this is based upon clinical, pathological or bacteriological evidence, or upon all three, I cannot say, but in making such a diagnosis in infancy and childhood, clinical and pathological factors should always be supplemented by the determination of the presence the causal agent-the Bacillus Typhosus-owing to the frequent great variation met with clinically and pathologically in Enteric Fever amongst children-this variation being the result of the state of development of various elements in the small intestine in young children.

of

If the disease occurred amongst the Chinese more particularly during infancy, then a much greater percentage of deaths from Enteric Fever in children, would be met with in the post-mortem room. As a matter of fact only 1 case of Enteric Fever in children has been found out of 812 post-mortem examinations performed on children under 5 years of age. In regard to the prevalence of Typhoid Fever amongst the Chinese in Hongkong, one fact must be borne in mind that Enteric Fever is a disease, insiduous in onset, and one which would allow the Chinese po- pulation, should they feel themselves gradually becoming a prey to some malady. to migrate to their own homes.

Cholera.

Three cases were brought to post-mortem examination during the past year. The characteristic micro-organism was isolated in each case, establishing the diagnosis.

Dysentery.

One case was met was during the year. Bacteriological attempts were made to isolate a causal agent, but the results were negative. From my own investiga- tions, coupled with the conclusions of other local medical gentlemen, it would appear that the bacteriology of Dysentery so called is by no means settled.

Sloughing Phagedæna.

This pathological condition was met with in an adult Chinese male aged about 30. The penis, scrotum, and adjacent parts of the thigh were covered with ulcers. These varied much in size, shape and depth. Many of them had apparently run together producing large areas of broken surface.

The ulcers on the penis had penetrated the corpus cavernosum deeply while those on the scrotum were more superficial. The inner side of the thigh and groin was covered with deep ulcers extending into the muscular tissue. The floor of the ulcers was covered with bluish unhealthy looking granulations which were bathed in foul smelling pus, and capped with a considerable quantity of necrotic tissue. The edges of the ulcers were irregular and undermined.

The