1903-05-18 — Page 6

a thorough knowledge of Chinese and speak and understand English, more early and relia- ble information is likely to he gathered by thein than is possible at present. -

ሳ

THE HONGKONG TELEGRAPH, MONDAY, MAY 18, 1903.

This year a Chinese medical man who had heen trained in America was engaged to atten! the Chinese in the plagué hospital, and it was entry in the chronicles, because loss of life. found il at several that objected to be removed | from disease in China, unless on an enormous to Cospital no longer obiected when they un-scale, is not likely to attract attention and derstood they would be amended by a country. becaine the subject of record. man of their new

13. In addition to the foregning special or- ganization for plaque work under the direction of the merlied officer of health, the sanitary administration of the Calony requires to he placed on a wider basis in order that the com- plicated and urgent health problems which always arise in a thriving aud expanding com- mercial centre shall be economically and successfully dealt with.

In 146, Southern China seems to have been free of plague in its large centres, otherwise the disease is likely to have been referred to by Ibn Batuta, the great Moorish traveller, who was there in that year, and who on his voyage home met with the plague in Damascus and describes its great mortality in that city.

3. As regards the source of the existing pan- demic of plague, there is not the same uncer- 'tainty. The disease sprang from Southern

From Pakhoi to Nanningfe the journey has to be accomplished overland, from Nanningfu to Pose by the West River, and from Pose to Yunnanfu again overland. Cotton goods are the principal staple article taken from the Port of Pakhei to Yunnanfu, and there they are exchanged for tin and opium which are brough to the coast.

(5) AFTER THE OUTBREAK IN CANTON IN 1894.

most direct connection with Yunnan is to be'] the "French" possession of Kwanshan-wan; seen on the map appended. The route is long From a niedical mistionary I learn that a and difficult, partly by land and partly by severe sickness which is believed to have been

Canton is the chief port, as well as the plague prevailed at Méniluk in 1890, and from largest and most important city in South China. | Dr. Swan of Canton that early in 1893 a severe It is the capital of the Kwangtung province, epidemic which was ascertained to be plague, and contains a population variously estim and which destroyed several hundreds of the 'ed at 18 to millions. Situated in 193 inhabitants, attacked the locality, Mouiluk of latitude N., and 113 14 longitude on is about 300 miles south-west of Canton. It is the banks of the Pearl River, it is some 70 evident that in the three years from 1890 to miles from the coast, and in the centre of a 1893 plogue was every now and then reported district traversed and intersected with water- as prevailing in different places in the south-ways, formed by the convergence of several western portions of the two provinces of rivers from the north, cast, and west. By this network of waterways. Canton is connected Kwangsi and Kwangtung

with the chief towns and districts in Kwangsi and Kwangtung. At the month of the Pearl River les Macao on one side, and the Colony of Hongdong on the other.

During the Mahommedan rebellion trade was much disturbed, and under the peculiar conditions it is less likely that plogue was imported from Yunnan, by the ordinary district and the island of Hainan, than by the limited intercourse of traders, into the Paklio

movement of Chinese troops, many of which, as previously stated, were drawn from the island

doubt there would be many traders with the Kwangsi and Kwangsang close to Yonnas. No troops for the purpose of supply. This latter view of the manner in which plague spread from

eace to furnish an answer. Chinese records: ] the infection of which was of en carried by the so far as is known, are silent on the subject. | rival armies from village to village and town to From Chinese authorities I gather there is no town. What proportion of the depopulation al allusion to any great plague at that time either Yunnan 'was due to fighting, and what propar-water. in Northern or Southern China. Not that any tion, to massacres,' famine, and pestilence, is importance can be attache 1 to the absence of unknown; but their combined effect was to convert a populous and thriving province into a country with a few inhabitants, and one which had to be re-peopled by jmmigrats.

7. That the pestilence was plague there can be no doubt. M. Rocher's description of the disease, and its association with swellings in the armpit, groin, and neck, allow of no other conclusion. His account of the disease is given in the Appendix, with a chart on-the Map of Southern China showing the course of the epidemic from town to town in the Fmvince of Yunnan. An earlier but similar account by M. Emile Bacher was translated by Dr. Man-- son, medical adviser to the Colonial Office, and

half-year ended 31st March, 1878, published half-yearly by the Inspector-General of the Chinese Customs Service. It will be noted that the first sign of the disease in an epidemic form was a sickness and mortality among rats. unknown. It evidently existed there before that which is known concerning the rapid the Mahsinmedan rebellion, and it was only the conditions of warfare which brought it spread of epidemics from one distant locality markedly into prominence. There are tradi- to another, namely, that these epidemics of a tions of the infection baving being imported sudden and rapid growth are usually associated front the western frontier of Yunnan, and M. with large movements of population. Rocher thinks that it may have been intraepidemic of plague occurs in Yunnanfu in 1866 duced from Burma. Possibly Mahommedan which decimates the population while they are pilgrims returning from Mecca in the early attacked, one of the bomes of returning troops in the midst of war, and in 1867 Pakhoi is part of the 19th century, when plague was pre- valent in Egypt and Arabia, may have intro- duced it into Yunnan. That this journey was accasionally undertaken is evidenced by the

13. If we now go back to the Yunnan Pro- vinces we shall find that as soon as the Cus- toms opened a station at Mengtze, one of the vince, plague is immediately reported as. principal towns in the south-cast of the pro-

epidemic there. It is the usual history of

a particular Incality until that locality is visited by a European. The disease prevailed in Menguze for many years prior to the advent of the Customs officers, but it was not discovered and described by a European medical man

The island wider communications of Calton extend westword in t. e boilers of Yunnan and

Though the trade and population of Hong-China, where it has prevailed in an endemic appears in the "Medical Reports" for the of Hainan and from the western prefectures of plague in China. Nothing is heard of it in Kweichow. The Sikiang, or West River, or

kong have grown marvellously during the past

form for sixty years or more. It is possible to few decades, yet those who are in a position be definite on this point in consequence of a to form a just opinion are unanimous in believ- better knowledge of Southern China which is ing that the Colony is only in its infancy as contemporaneous with the freer admission of regards growth and importance, Merchant, sol- foreigners into the interior, first brought about dier, and sailor, cach looking at the future pro by the influence of the British. Since the low and when plague first came to Yunnin is Yunnan to Pakhoi appears to be held by the until 1804. By the time Dr. Michoud's report between the two towns, spects of Hongkong from his own point of acquisition of Hongkong in 1841, and the

view, have confidence in its rising greatness,

It is evident from the condition of Hongkong that the sanitary administration has not been able successfully to cope with the forces which

make for deterioration and disease. Since the advent of plague in 1894. much has been done to improve it, but a good deal still remains to make it efficient.

The most noticeable feature in regard to sanitary matters in Hongkong is that no one is responsible. Independence of action by differ- ent officers and absence of co-ordination tend

to spasmodic action and inefficiency. There is a Sanitary Board and a President, who meet at

stated times and discuss public health matters, but their functions are advisory. There is the medical officer of health and assistant medical officer of health for the Colony, whose duties are executive, but there is no administrative head who is responsible to the Government for the conduct of health matters in the Colony and for the maintenance of a continuous and pro- gressive policy.

subsequent opening of the treaty ports to cor- merce in 1860, a vast change has occurred in the relationship of China and Europe. In addition to increased trade at the commercial ports a host of missionaries, explorers, and merchants have penetrated into the interior of the country and reached parts which no foreigner had previously visited. They have given accounts of their experience, with the result that, though the interior of China as a whole and its internal affairs are still veiled from foreigners, yet much more is known con- cerning important events occurring there than ever before. A favourite province for explora tion was Yunnan, because of its proximity to Burma, Siam, and French Annam, its reputed richness in minerals, and its possibility of be- coming a highway to Western and Central Chion. The sixties and seventies of the 19th century were remarkable for the number of intrepid travellers who traversed Yunnan and other parts of China, Lagrèe, Granier, Cooper, Sprye, Sladden, Dapois, Rocher, Richth, Mar gary, Grosvenor, Baker, Gill, and later Colqu.portation of plague by pilgrims in the 19th houn and Bourne, all distinguished themselves having occurred among rats and human beings century there is evidence of a fatal sickness as modern pioneers.

in Yunnan, as far back as the last decade of the 18th century, which tends to indicate that some portion of Yunnan has been an endemic centre for over 100 years at least,

It is advisable that all municipal health matters be brought more or less under one department, controlled by a sanitary or health. commissioner who would be the administrative officer. The is more than ample work to occupy the whole time of such an officer. In addition to being President of the Sanitary Board he would administer the several branches of the Public Health Department, dealing with the health questions relating to water supply, sewerage, and drainve; alignment and laying out of streets and back lanes; the prevention of the crowding ingether of new houses, or the formation of new unhealthy areas; the scrutiny of plans of new houses, and the enforcement of compliance with the requirements of health, the preparations-of-schemes for the considera-respectively 62100_and_6,pofectin-height tion of Government in connection with the demolition of insanitary areas, and the re- construction on sanitary lines; the provision of markets, public latrines, urinals, balb-houses, &c.; and the general enforcement of the Public Health Laws. Lastly, he would be responsible to Government for the efficient working of the Department, and, like the Director of Public Works, should have a seat on the Legislative Council. Mr. Osbert Chadwick, C.M.G., is also strongly of opinion that a Sanitary Commis. sioner is required.

14. At the request in Council of Sir William Gascoigne, K.C.M.G., the officer administering the Government of Hongkong, Mr. Chadwick and I, assisted by Dr. Clark, the Medical Officer of Health for the Colony, drafied a Public Health Bill which amends and conso- lidates the Public Health Ordinances of Hong- kong. It gives more control over buildings and the laying out of streets, and greater power with reference to the prevention of over- crowding. The principles of the Bill have been in the main accepted by Government and doubtless will soon become an Ordinance.

With this Act in force, and a Public Health Department organized on the basis recom-

4. It was during one of there explorations, that M. Rocher in 1871, L., over thirty years ago, came across. plague in the Province of Yunnan. This province is situated at the eastern confines of Durma and Thiber, has Tonking on the south, the province of Sechuan on the north, and the p ovinces of Kwichow

It is very mountain. and Kwangsi on the east ous, with high and fertile plateaux, which rise towards the central purtion of the province to between 6,000 and 7,000 feet. Talifu and Yunnanfu, two of its chief cities are situated on the shores finland lakes and on plateaux,

5. The prov nce of Yunnan, isolated by its position and its physical features, has only a limited intercourse with its neighbours and with the treaty ports. There are trade routes connecting Talifu and Yunnanfu with Burma. Thibet, and the Province of Sechuan, but the mountainous character of the country which has to be traversed and the cost and difficulties of transport, which has to be effected by pack animals, cause them to be little used. Cara- vans from Thibet pass Li Chiangfu on their way to Ssumno for tea.

The trend of intercourse and trade, so far as it is developed, is towards Tonking and the Province of Kweichow, Kwangsi, and Kwang tung, where, following the course of the Red River in Tonking and the West River in Kwangsi and Kwangtung, the journey can be undertaken in boats for at least some part of the way. Both the Red River and West River rise within the boundary of Yunnan, and form

Even

Chinese, and it is more in accordance with

from Yunnan.

•

An

This distance between Yunnanfu and Pakkoi is about 3,000 lis and it takes about forty-eight

day stages to travel from one to another. What intervening localities were attacked is unknown, but it is unlikely they escaped.

had appeared in an epidemic form in Canton, on plague in Mangtze was issued the disease Hongkong and Macao.

Mengtze is situated in the south-eastern part of Yunnan, in latitude 23° 34' N., and longitude of Yunnan, it is in the middle of a large plateau elevated 4,500 feet above sea-level and sur- 0,000 feet above the sea-level. The town is rounded by mountains rising from 6,000 10

the centre of a large traffic between Yunnan and Tonking.

103 36 E. Like most of the principal towns

The Imperial Chinese Customs opened a fact that Ma Te-hsing, the high priest of the

station at Mengtze in 1899, and the European Mahemmedans of Yunnan, and leader of the

officers on their arrival found plague prevailing, rebellion, visited Mecca in 1893, travelling

It had recurred every year in Mengtze since from Yunnan to Bhamo by the caravan routes

Once the disease was established in Pakhoi 1885, and first appeared there in 1874. There and then by boat to Rangoon, where he em-

it seems to have become endemic for eighteen barked in a pilgrims' ship. Having spent some Every year it recrudesced and prevailed more

was a severe epidemic in 1892. but according years. There was a severe epidemic in 1877.

to native reports, the epidemic of 1893, which time in the Sacred City, Ma Te-hsing visited

continued during the months of June, July. Egpyt and Constantinople, and returned in from the reports of the Medical Officer of the epidemics, not

or less from March to June until 1854, when and August, was, compared with previous

West River. But against this view of the im-infected in 1894. This spontaneous cessation 1846 to Yunnan, by the river of Canton of Customs it seems to have ceased until re Michoud, in describing the epidemic, remarks particularly severe, Dr.

that "however, out of an estimated population of the plague is a phenomenon which has not

of 10,000 or 12,000, a thousand people died. occasionally in large cities, and rarely in complague lay dead or dying unheeded in the infrequently manifested itself in small towns, Carried outside the dwellings, the victims of mercial town, such as Smyrna and other busy entrepots of trade in close communication with infected centres.

one.

10. Although Pakhoi seems to have enjoyed For the purposes of this report, the question a freedom from laque for ten years, from 1884 as in whether Yunnan has been an endemic to 1894, the disease was far from being ex'inct; centre for over two years is not an important not only continued in preval in the For It is sufficient to know that plagae has vince of Yunnan and 1 varying intervals existed in Yunnan since 1871. Baker met within the neighbouring towns of the Kweichow, the disease in his travels through Yanan in 1877 Mongr Fencullett, Bishop of Yunnan states that, in 1366 a large portion of the popu. Intion of Yunnanfa succumbed to plague, and M. Rocher, in a second visit to Yunnan, found that plague began to be known in 1840, hat long before that time it had existed in the western part of the province without prevailing epidemically.

8. The first medical account of plague in Southern China is given by Dr. Lowry, of Pakhai, in 1882, the year he was first stationed there as Medical Officer to the Customs. His "Notes on an Epidemic Disease observed in Pakhoi in 1882" are reproduced in Appendix C, and are extremely valuable because of the very careful and accurate manner in which the disease is described, and becouse of the com- parisons made between it and the plague of Yunnan and. of Northern India. Dr. Lowry also observed the mortality in rats which accompanies the disṇare,

He remarks that "in nearly every house where the disease brothe rats had been coming out of their holes and dying on the doors." The disease was not new to Pakhoi, nor to Lieschow, a city about 12 miles distant In 1871, Mr. T. E. Cocker, the present Deputy Commissioner of Customs at Hongkong, visited Pakhoi, and at the time of his visit there was a severe outbreak of the disease, accompanied by a mortality, not only among rats, but also

At the

Gauton River it is.soctimes called, is na- vigable for small steamer as far as Wachowiu. From there is Nanningfu the passage is more difficult on account of some dangemus rapids, but native boats ninke it successfully, and ply

boats, which are busily engaged in canving From Nanningfa to Pord the river is suitable for light-draught

is

produce to and fro. Pose is on the barde:s of Yunnan, and the produce teaching it by boat taken by pack animats overland to Venstre. West of Nanningfu a branch of the river leads to Taipinght and Lungchow. It will be seen from the map that Mengize and Lung- lines of direct communication with Canton. chow, both infected centres of plague, are on

The West River is the natural and most con- venient trade route for pmduce and traffic from Yunnan, Lungchow and the greater portion of the Kwaggai province, but, as previously stated, notwithstanding the advant ages of this route, it used not to be favoured by Chinese merchants, who preferred- to take their merchandise from Nanaingia overland to Pakhoi, rather than direct to Canton. The reason of this was partly because it was a shorter route to the coast but mainly Nanningfa and Canton, there being no fewer because of the numerous.likin charges between

than sixteen likin stations. This was altered in 159t, and the system of transit

West River for the conveyance of produce and duced, which resulted in a greater use of the passes intro-

passengers both to and from Canton.

streets, or set in rows leaning against the city wall, We saw, on some roads, dogs and

Whether plague reached Cantos from the pigs feeding undisturbed on corpses which infected towns and villages of the south- no one cared to bury. These animals fell victims to their voracity and succumbed to the Yunnan and Kwangsi by the West River is western part of Kwangtung or direct from scourge. Dr. Michoud continues: "In some plates whole families disappear.

immaterial Probably the infection arrived by beginning of the last epidemic, we were called original scarce was Yunnan. Fatshan, a town both channels; but, whichever was the first, the

to the young son of the Chen-tai Chinese situated on the delta of the West River and a Kwangsi, and Kwangtung Provinces, but it was general) of Mengize. The poor boy had just few miles frein Canton, is sail by sore Chinese also present in the adjoining prefectures to

ben given over by the native sectors, wi o, gentlemen to have been infected in 1893. It that in which Pathpi is situated. They are probably from fear of displeasing the father laralities away from European contac', and would not declare the nature of the disease.

is the custom of the Chinese to send their dead it is only incidentally that plague is dis. As we were aware of a one of pan the infection at Faishan is attributed by them to be buried in their native village ortown, and covered to prevail in them. Distant from the ping having already occurred in the Cheng-tai's coast ports, from the customs stations, or yamen-considering, too, the rapid evelation

to hodies of persons who died of plague at from missionary outposts, news becomes and extreme gravity of every symptom exhibited

Menghre having been sent to Fatshan for burial ́* exceedingly scanty, infrequent, and unreliable, by the little patient--disregarding, at the same shan occurred in families who were connected in badly fitting coffins. The first cases in Fat- and occurrences, however important or disast me, the hypothesis of heat-stroke or pernicions with Mengtze. trous they may be in the localities affected, but intermittent fever, we had no hesitation in spite

It has already been noted that both at Mengize and Lungchow, plague rarely come to the ears of Europeans. It is

of the absence of any external adenítis (and to occurred among the military stationed at each certain that from 1990s gradually extending

the great displeasure of the father) in diagnos-place, and it is a curious fact that the first case area of the western parts of Kwangsi anding yang-tzu-ping. Although ready to do pur Kwangtung was becoming affected with plague, best we insisted on the probable failure of any

in Canton seen by a European physician was but it is only in fragments of news that this

in the family of a soldier. treatment, and urged the necessity for immedi- fact is gathered,

ale and energetic disinfection in order to ward of further diffusion of the disease. The boy died shortly afterwards. Nane ofthe measure- advised were taken, because the native quacks denied the accuracy of the diagnosis. Doubt. less the failure of our treatment had discounted the value of our advice. However that may be, the Chen-tai, an old warrior who had spent his whole life in Yunnan, and had passed unscath

In Dr. Sharpe's report on the health of Pak. hai for 1893 plauge is thus referred to as oc- curring in some of the Kwangsi towns-By a letter lately received from Lungchow we learn that bubonic plague (yang-tzu-cheag) or as it is known at Pakhoi, li-tzu-cheng, made its appearance there during the latter part of March this year. Having originated in Yunnan, it passed through the town of Post and the pre-ed fectural cities of Nanning and Taiping in Kwangsi, and thence to Iungchow, also in Kwangai. Considering that a certain amount of merchandise passes regularly between Nan- ning and Pakhoi it might be supposed the plague might find its way here, but up to the date of this report no cases have occurred since

through the previous epidemic: which decimated the country, was, in a few days after the denth of his son. attacked by vang-tzu-ping and speedily. perished. Some of his wives many of his relations and servants, were in

succession attacked, all the cases ending fa'ally, The people that die from yang-tzu-ping in that yamen before the end of that epidemic numbered at least 25"

mended, with a Sanitary Commissioner as its gable from Post, a small town' situated on the among pigs and cattle. Mr. Scott, the preseal the spring of 1884." administrative head, the Government will be able, not only to cope with plague, but will be gradually able to improve the sanitary condi- tions of the Colony and to prevent in the future those conditions arising which have in the past West River as far as Nanningfu have, at that his memorandum on the progress of Levantine break, Dr. Simmonds, who was at Lungchow in Lungchow and in many towns of the proved detrimental to its health.

more or less natural trade outlets for the pro- vince. The Red River is navigable from Manhao in Yunnan, and passes through Ton- king to Haiphong in the Gulf of Tonking. This route, notwithstanding its advantages, has not been a favourite. The West River is navi. borders of Yunnan and Kwangsi away down to Nanningfu, Wachowiu, and Canton. this route has been seldom used further east than Nanninglu. recent years, Yunnan goods brought down the Almost invariably, until

point, been taken from the boats and carried across country on pack animals to Pakhoi and W. J. SIMPSON, M.D., F.R.C.P. More recently to Muiluk. Similarly, goods intended for Yunnan have entered Pakhoi, been conveyed overland to Nanningfu, been thens transferred to boats, taken up the river to Posé, and then overland again to the towns of Yunnan,

I have the honour to be, Sir,

Your obedient Servant,

December 22nd, 1901.

PART i.

+

PLAGUE. IN CHINA. (a) BEFORE THE OUTBREAK IN CANTON IN THE SPRING OF. 1894.

As soldiers were the first victims of the out-

at the time, was of opinion that the disease was imported into the garrison of Lungchow from Liencheng, a frontier town on the borders of Yunnan, There was another epidemic in Lungchow in 1891, which was evidently' a recrudescence of the outbreak of the previous

Consul-General of Canton, saw cases of plague in Pakhoi in 1879. It was then called the The epidemic at Lungchow disappeared in "Yunnan sickness" by the Chinese. Mr. April, 1830, after a heavy' fall of rain. The

the Local Government Board of England, in Netten Radcliffe, of the medical department of next outbreak at Lungchow is heard of in 1893.

Plague in 1878 and 1879 records some import ant information regarding plague at Pakhor, derived from Surgeon A. R. Lynch's journal for H. M.S. "Mosquito," an the Chinese Station, 1879. It is accompanied by a map showing the presumed route taken by the plague from Pabhoi to Yunoan; and though the map is doubtless correct in showing the localities affected, It is incorrect as to the direction of the route by which plague spread, which, was originally from Yunnan to Pabhoi, and not from Pahhol to Yunnan.

year.

411. Notwithstanding that the plague did not reach Pakhoi from Lungchow, Taiping, or Nanning, we find that in 1891 Kaochao, which is on one of the main trade routes from Taiping to Canton, and nearly 200 miles east of Pakboi and nearer Canton, is, affected by an epidemic

14. The epidemic described at Mengtze, following as it did a severe epidemic in 1891 occurred in May, June, and July of 1893. Two months later the disease is stated to be epidemic

Kwangsi Province, such as Nanningfu and Kwain, the latter of which is not more than

200 miles from Wuchowiu

2. China possesses an unfortunate reputation for being the source of many epidemic diseases which have invaded the West, but it must be

Dr. Lowry states in his notes that "the of plague. Nor was the prefecture in which inhabitants of Mangbao, on the banks of the admitted that this evil reputation is based on

epidemic which I have observed in this district Pakhoi is situated free from plague even wlien very slender grounds, as most of the recounts tion from Yunnan to Kingiwon in Kwangui does not seem to be an old ditcase, as it occur Pakhoi enjoyed an immunity, fur is recorded appearance, and

red for the first time about fifteen years ago,

soon afterwards the same

2. The first recorded case of plague in Can.

Mary Niles was called in to see General ton occurred on January 16th, 1894, when Dr.

be suffering from a "boil," and who, when Wong's daughter-in-law, who was reported to

Scen, was found to have a very painful swelling with a pulse of 150, and a petechial eruption, in the inguinal region, a temperature of 104-8

The patient recovered, but the bubo, owing to sinuses forming, took a very long time to heal.""· Out of seven cases seen by Dr. Mary Niles up to May 2nd, in no fewer than four purpuric spot appeared before death. In a number of cases met with the illness was of a light. character, for instance, Dr. Niles recorde 3 case In which "a lady came in a chair but walked into the office. She looked perfectly well,

temperature, pulse, and digestion normal. She

said she had fever six days before, and the following day when taking a bath discovered a swelling in the inguinal region, of which the had not previously been aware, and which caused her no pain. I examined the bubo and saw for myselt" This case is suggestive of other similarly mild cases and the likelihood of these occurring at an early stage of the out break without attracting any special attention, Dr. Niles further states, "It has been notice. able to the people that rats in infected houses have died in the house where the child from the school was visiting when she took the disease thirteen dead rats were swe; t out one morning,

One of the officials, I am fold, offered in cash for every dead sat brought to him. He had collected 35,000 in one month; 2,050 were brought to him in one day,”

15. In connection with the prevalence of plague in Yunnan and its spread to Southern China. the following remarks of M. E. Rocher are interesting: "As it it was to be feared that either the Canton River by Paice, or the Red There is yet another trade route from Yunnan through the Kwangi Province. It is more

River by Mangbao and Lackay, would become northerly than that by Ford, Nanningfu, and

infected by the disease, 1 reported the matter to the (French) Colonial authorities. I do not the West River, which it, however, joins before this waterway enters the Province of Kwangtung.

know what steps were taken, but in 189: the The route is overland, and in an easterly direc

Red River, reported that plague had made its

It was only towards the end of March that the disease, began to attract attention. Dr... concerning infectious and contagious diseases it here meets the River Lieau Kinng, and

Alexander Rennie reports that "a few stray" having originated therein are based more or becomes a water route to Lauchaufu, which is and since that time has occurred at certain that plague prevailed in Match and April of news came from Paise. from which place it

cases occurred in the beginning of March, but it defcended to Pakhol and Canton." (Appendix was not until the end of the month that attention less on ramour or conjecture. It could not be

a great distributing centre, goods from the west intervals, the last severe outbreak being in 1891 in a district near Ampu. Thus

E.). otherwise, for the immensity and isolation of being sent to the Yunnan and Kwelchow Pro 1877. I am told, however, that a few cases "The native population in the imme siate

was awakened on account of its fatal prevalence China have always rendered it a terra incognita, vinces, and vice verd. At Lauchaufu the occur every year, but my short .sidence hastighbourhood has not been visited by plague

16. It is clear that plague was extensively in a poor neighbourhood near the south gate of 2. The plague of the 14th century, called in ropte branches into two, one going overland in not given me an opportunity of verifying this or any epidemic since influenza was prevalent diffused at this time. It was epidemic in the city, and also in Nan-sheng-11, a quarter oc subsequent history the Black Death, which ra- a north-easterly direction to Kweilia, the capi- statement" Dr. Lowry further states, in reply during February of last year, but in a district Mengire in 1893, and the several years pre-cupied by Mahummedans, among whom the vage Europe and which was the most destructal of Kwangel, and thence by water dus south to some questions on the subject, that plague near Ampu, about 100 miles to the cast of this viously. It was also epidemic in some of the martality was very high. At this time the typo tive pandemic known in history, was set down to Wuchawfu. The other branch is by river, first appeared in, l'abhoi, in 1867. It is to be her af people during March and April. I am these situated on the West or Canton River, attacked quite 80 per cent, dying. Towards the port, bubonic plagus carried off a large num south western towns of Kwangsi, especially of the disease was exceedingly severe of those by the inhabitants of the West of that pested via Tsamchaufu to Wachowfu.

6 The Province of Yunnan, at the time of medan rebellion in Yussan was in full force who has resided for many years in the neigh-western districts of Kwangtung... as coming from Cathay. In those days, when

noted that this was at a time when the Mahom informed by ons of the French missionaries and it was more or less prevalent in the south middle of April the cases we saw were of a most of the trade from the East was overland; M. E. Becher's visit, was to a state of rebellion and troops raised jo Hajuan and the Pakur bourhood of Ampu that bubonic plague: is

milder type but the disease subsequently be the caravans were one of the means of trans. The inhabitants, chiefly Mahomedans, had district were engaged at the seat of war,

The existence of plague in these places came more severe, and extended its boundaries' porting disease from place to place, and it is risen against the Imperial Government, and

endemic in a small district near that place, and excited no interest beyond the localities affected, to other pins of the city and also to Honam, the 9. Pakboi is not a large town nor an old one, that isolated dupposed that the infection of plague was such was their power that it took some twenty

will be found there and it was not until the disease reached the || maximum mortality being reached about the brought in the caravans conveying the mer years to subdue them. The traveller found The population today is about 20,000, and it at any time of the year, but that during Delta of the West River and attacked Cantón, middle of

May

Rain felt copiously chandise from Northern China along the great large tracts of the country devastated or desert-dites hack only to 1853, when some Cantonese the early spring of some years the disease northern trades rog between the East and ed, and everywhere sigue of depopulation and merchants settled there. It seems to have occurs as an epidemic, and then the only the West Whether the pandemic of the 4th of the ravages of warfare, great numbers of the thriven fairly well for it was one of the treaty chance of escape is to leave the distici until century began in Cling and extended thus to inhabitants having been killed in bars or ports agreed to be opened to foreign trade to heavy rain has fallen.

did not take 12. Still further eitt than Pakhai or Ampu is the West, or whether it began to India or same afterwards massacred. To the miseries of was 1860, though the actual open adjacent country, thera is at present no ovid- and of fgmine were added those of pestilence place for some year later. lis principal and Moulluk, which is south of Kaochao and near

the capital of Kwanglung, and an epidemic of during the month of May and beginning of june, exceptional proportions begin to devastate the so that many streets were under water; the city in the spring of 1894, that the fact that temperature reniained comparatively low. But plagos in 'a dangerous form existed in China boh these factors seemed to favour the pro became generally known to the Europeaus pagation of the disease, as by the beginning of living in that country.

june it was vile in the westem geburku as well-