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the Pyramids, and other notable instances, still baffles the expert pathologist and bacte- riologist. All that is known is that the disease is an infectious, chronic, granulomatous affection of the conjunctiva. Its bacteriology is still in a state of chaos. Several cases have been examined by me but so far nothing definite has been obtained. Cocci of various kinds, Koch-Weeks bacillus, Gonococci, etc., have been found present in trachomatons eyes, but none of these micro-organisms, can, in my opinion, be brought into causal relationship with the disease. The idea, that trachoma is a chronic inflammatory process to be traced to acute gonorrheal blenorrhoea has but little to support it. Indeed, in the light of our modern knowledge of the M. gonorrhoeae, such a pathological condition would appear to be out of the question. The causal significance of Raehlmanu's bacteria is still a matter of considerable dispute. It has often been my intention to avail myself of the excellent opportunities afforded for a thorough study of the disease which is so prevalent in Hong- kong, but up to the present, circumstances have prevented me froni investigating the subject thoroughly. I trust, however, to have better chances of examining the disease after the starting of the Bacteriological Institute.

The Vaccine Institute.

During the year 1905, the preparation and distribution of small-pox vaccine was efficiently maintained. Apart from the regular supply of vaccine lymph to Government Medical Departments and Chinese Hospitals and Public Vaccinators, a very considerable number of tubes has been sold to the outside public. Indeed the number of such tubes sold to the general public during the past year, amounts to 4,393, a figure exceeding by thousands the number of tubes issued during any previous year since the establishment of the Institute. Such a result speaks well for the popularity of the lymph, and with the future as assuredness of a constant and potent supply of vaccine in Hongkong, a consider- able revenue ought to be forthcoming. During the past year, nearly $1,500 were paid into the Bank.

It is anticipated that in the near future, with the establishment of the Bacteriological Institute, this figure will duplicate on triplicate itself.

The following figures show the extent of the work done during the past year-

1.-Number of Calves inoculated,

2. Expenditure in Calves,

3.-Number of Tubes prepared,

4.-Value of 1905 Lymph...

5. Number of Tubes issued,

6.-Value of Tubes issued,

7.-Tubes issued free of charge,

8.-Value of Tubes issued free of charge,

9.-Tubes paid for,

10.-Value of Tubes paid for,

21

$150.00

6,703 $3,351.50

*

7,638

$2,708.00 3,245

$1,223.00 4,393 $1,485.00

These figures show the following increase in the value of the work done during the

year 1905 :-

(1.) An increase in the number of Tubes prepared by (2.) An increase in the value of the Lymph by (3.) An increase in the number of Tubes issued by (4.) An enormous increase in the number of Tubes paid for by (5.) An increase of Revenue paid into the Bank by

1,419 $709.00

750

2,209 $711.50

The cause of death

Out of 21 calves inoculated, two died, and three failed to react. of the two calves was a form of septicemia, which developed within twenty-four hours after the admission of the animals to the Institute.

Up to the present time, it has always been the custom to manufacture the lymph during the colder seasons of the year. Such a practice was necessitated owing to the difficulties experienced in the production of the vaccine during the warm weather.

It is hoped, however, that with the establishment of the Bacteriological Institute, that it will be possible to maintain an efficient supply of potent lymph throughout the whole year, a state- of preparedness which will enable us to deal at once with any unforeseen outbreak of small- pox. During the last quarter of the past year, considerable difficulty was experienced in. maintaining the supply of buffalo calves for inoculation purposes. On investigation, this was found to be due, not to a dearth of animals within the bounds of the Colony, but to the reluctance on the part of the Chinese owner to part with his animal until he was paid