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PLAGUE IN HONGKONG.
(Daily Press; 16th May.)
Wo have received from the COLONIAL SECRETARY a copy of Report on the causes and continuance of Plague in Hong- kong, and suggestions as to Remedial Mea sures, by W. J. SIMPSON, M.D., F.R.C.P.' who was rent
it out to the Colony last year by the Secretary of State for the Colonies to investigate and report on the subject. The Report, including maps, diagrams and appendices, occupies 125 foolscap folio pages, and is divided into four parts. The first part deals with plague in China (a) before the outbreak in Canton in the spring of 1894, nud (b) during and after the out- break in Canton in 1894.Part II treats of plague in Hongkong; Part III recorde the results of the investigation into plague in animals; and Part TV suggests remedial
measures.
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It is an eminently readable report, but we can hardly say of it that it adds much to local knowledge "either as to the causes of the constantly recurring epidemics or the measures necessary to keep the Colony as free of the pert as possible. But Dr. SIMPSON has collected together an immense amount of information on the subject which is of permanent value as a basis
on which remedial measures must
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THE HONGKONG WEEKLY PRESS AND
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[May 23, 1903. and alimentary canal, causes Dr. SIMPSON | lowest or even absent in the autumn and to attach great importance to the food winter, and reaches its maximum in the question. While he admits that he is summer months, especially in May and unaware of any recorded instances of plague June. With a present total of 656 we in man being caused by infecte food, have the worst six weeks of the plague he thinks this may be due to enquiry in season before us,280 that it would appear in this direction not being pursued owing that all the expenditure to which the to the preponderating influence of assigning Colony has been committed in the attempt most of the cases to inoculation. More atten to rid us of the pest has failed apparently tion than hus hitherto been considered neces sary, he says, will require to be paid by the mortality returns from plague, though, of to make any appreciable reduction in the local authority in times of plague epidemics, course, it is impossible to say how much to the examination and inspection of the heavier those returns would appear but food supply, and by private individuals to for the work accomplished. It is note. the cooking and storage of food. It is worthy that the first half of the year highly probable that the dissemination of has usually to be debited with over "the disease by plague rats is due, in a ninety per cent. of the cases of plague treasure at least, to their infecting food occurring in this Colony. In 1896 there "which has been lying about or to which
were no fewer than 1,116 in the first half they have gained access." These conclu- of the year out of a total of 1,204 for the sions contrast sharply with those of the twelve months. In 1898 the figures were Indian Plague Commission which found no 1,312 out of 1,825; in 1899, 1,072 out of evidenco " to show that plague ever effects 1,462; in 1900, 764 out of 1,036; in 1901, an entrance through the channel of the 1,487 out of 1,651; in 1902, 387 out of 582. "stomach or intestinal canal." The ex- Plague wherever it occurs is a seasonal periments conducted in Hongkong show disease, but the experts are unable to dis conclusively that animals die of the plague cover the explanation of this. Dr. SIMPSON, after eating infected food. In connection however, says there is little doubt that its with these experiments and what they seasonal prevalence in Hongkong is favour show, Dr. SIMPSON says it is instructive to ed in the early part of the Spring by the note that in nearly every description of an pilgrimages made to ancestral tombs, his eademic centre of plague the people live idea being that if plague is prevalent in the crowded together in dark and badly venti-part visited there is risk of infection, which lated huts along with their cattle, pigs and
is brought back on their return to this poultry.
Colony. The extra notivity of the emigra- tion business at this time of the year is also a favouring circumstance, as some of the coolies doubtless come to the Colony from infected districts. But Dr. SIMPSON adds that "the influenca of these two "factors is of secondary rather than "of primary_importance as matters now "stand in Hongkong, for though, re- "infection of the Colony from China plays a part in the annual recrudesence, more or less according to the extent of the plague prevalence and to the accessibility "of the area affected in the Kwangtung Province, yet the main source of plagu "in Hongkong since 1898 is in the Colony itself, where it is endemic and where it "would appear annually even if it were "not materially assisted by reinfection from “the mainland.”
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ceed. Besides visiting various places in China where plague pievailed. Dr. SIMPSON addressed a circular letter making certain questions on the subject to the medical
As to the remedial measures recommended men and medical missionaries in Chiun, by Dr. SIMPSON, they were, as he says, and in his Report he gives summary of cousidered and generally accepted in prin. the answers supplied by thirty-four medical ciple by the Hongkong Government before he practitioners in Kwangtung, Fukien and left the Colony, the suggested measures being other neighbouring provinces. While these mostly concerned with the administration answers; so far as concerns the main causes
and with the legal powers necessary to of plague, illustrate the proverbial dif. combat the plague and improve the sanitary ference of opinion among the doctors, it condition of the Colony, such as notification is, as Dr. SIMPSON says, worthy of note of plague from China by weekly bulletins that of 37 correspondents with experience from Consuls, &c. ; the inclusion of special of plague epidemics, dirty had found the plague organisation in the sanitary adminis- plague outbreak preceded by a mortality tration, a re-organisation of the sanitary do- anong ats four were of Tiiu tlat lepartment to include the medical inspection rt mortality was simultane us with the of shipping and junks and the appointment pingue outbreaks, two did not answer the of a Sanitary Commissioner for the Colony; question, and one stated it was unknown, and finally the amendment and consolida though of opinion that rodents introduced tion the Public Health Ordinances. Dr. the disease. "The concensus of opinion
SIMPSON, however, affirms that "under the "that the rat mortality is a precursor of
present condition of Hongkong and with plague in man is practically unanimous,
"Southern China infected extensively with "not only among dical men in China
plague, it is almost hopeless to expect experienced in plague, but among the
Hongkong to remain long entirely free "Chinese people whose villages an I towns
of plague, but it is not impossible, with a “have been attacked with plague." The
"trained and special organisation to keep antecedence of the rat plague. Dr. SIMPSON
"the disease in check and under control, s0 says, points to a channel of infection which as to prevent it reaching those dimensions is capable of giving the disease to the
"which alarm the population, prove dis- rat, but which at first has no influence
"astrous to the Colony, and render Hong- on man, and that the dissemination of the kong a source of anxiety to those who infection by the rat is needed to bring it
"have trade relations with it." into those channels by which man can becon.e infected. A large number of experi-
(Daily Press, 18th May.) ments were carried out under Dr. SIMPSON'S
The gratifying decline shown last year in advice on pigs, calves, hens, ducks, geese, the plague returns for the Colony naturally rats and sheep, and Dr. SIMPSON says the encouraged the hope that the efforts of the results prove that man with plague can Sanitary Authorities to cope with and stamp infect the domestic animals, and they, in out the epidemic were meeting with a success turn can infect one another. More than likely to prove permanent It is exceed *this, the infective material of a plague ratingly disappointing to find that this, un-
can cause plague in monkeys and the "infective material of a monkey with plague can give rats plague. What is "here proved to be the case with ex. periments in monkeys, amely that at plague is communicable to them by E.eding, inceculation, contact and without contact with rat plague material, "is likely also to apply to man. The fact that animals and birds experi- mented on took the infection by the mouth
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fortunately, is not the case, and that this year is likely to witness a return to the figures with which residents grew familiar ia previous epidemics. By the end of June last year the number of cas's notified in the Colony was only 387. We are now but in the middle of May, and we have for the present year a total up to noon on Saturday last of 656. Plague in Hongkong, as Dr. SIMPSON observes in his report, possesses distinct seasons for its prevalence. It is
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Dr. SIMPSON does not find any special con- nection betwee the plague and the rainfall. Whatever may be the cause of plague epidemics, there is abundant proof that in- fection adheres to old, dark, damp and rat- ridden houses. He strongly condemns the subdivision of a single room into a number- of rooms called cubicles which he describes an ingenious device for crowding together a large number of people into a "small space and securing a correspon- dingly large rental, but it is an arrange- " ment which ergenders disease and "favours its spread." This afternoon a meeting of property owners is convened to consider the sections in the new Public Health and Building Ordinance relating to overcrowding and the requirements to be observed with regard to cubicles or rooms in existing buildings, and it is to be hoped that the outcome will be some arrangement to remedy the state of things to which Dr. SIMPSON alludes in this con- nection, as promptly and effectually as possible.
(Daily Press, 22nd May.)
We have felt it to be our duty on more than one occasion to draw attention to the dumping of bodies, dead of the plague, in the streets of the Colony, and we have sug gested what is practically a certain means
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