Administrative-Report-1934_Part_025





Venereal Diseases Technical Assistant 1 Dressers (Charge) 2 1 Venereal Diseases Nurse Maternity and Child Welfare Branch. Lady Medical Officer Chinese Lady Medical Officer Infant Welfare Nurses Interpreter 1 1 3 1 School Hygiene Branch. Health Officer for Schools.. 1 Chinese Medical Officers for Schools ON LO 2 5 School Nurses Chinese Hospital and Dispensaries Branch. Visiting Medical Officer Lady Visiting Medical Officer Chinese Resident Medical Officers Chinese Lady Medical Officers. Stenographer Dispensary Nurse Midwives 1 1 3 3 1 1 4 M 20 MEDICAL DIVISION. Clinical Branch. Government Consultants Senior Medical Officer.. 3 00 - 1 Medical Officers 8 Chinese Medical Officers 3 House Officers 4 Nursing Staff (General). Principal Matron:. Matrons 3 Home Sisters 2 Tutor Sister 1 Nursing Sisters 52 Nurses (Staff)......(4 Vacant posts). 11 Nurses (Probationers) (1 Vacant post) 46 Dressers (Charge). 5 Dressers (Staff) 3 Dressers (Probationers) 20 Linen Maid 1 Nursing Staff (Mental Hospital). Head Attendant Assistant Attendant Mental Nurses 1 1 3. 2 Wardmasters Kennedy Town Hospital (Infectious Diseases). Nurses (Staff) Nurse (Probationer) Dressers (Staff) 212 Dresser (Probationer) 1 Wardmaster 1 Tsan Yuk Maternity Hospital. House Medical Officer 1 Secretary 1 Matron 1. Assistant Matron 1 Midwives 4 Pupil Midwives 12 Stewards. Steward 1 Assistant Steward 1 Apothecary M 21- Pharmacy Branch. Assistant Apothecaries Dispensers (Charge) Dispensers (Staff) Dispensers (Probationers) Radiological Branch. 3 1248 10 5 Radiologist Radiographers Masseuses. 1 2 2 X-Ray Sister 1 New Territories Branch. Medical Officer Chinese Medical Officers 1 2 Nurse (Staff). 1 Midwives Dresser (Staff), for Travelling Dispensary Driver Miscellaneous. Office Attendants, Messengers, Wardboys, Amahs, Coolies etc., (27 Vacancies) PRINCIPAL CHANGES IN PERSONNEL. 8 1 1 380 59. The following were the principal changes which took place during the year:- Mr. J. H. Gelling appointed Secretary on return from leave on 22nd February and assumed duty as Secretary and Deputy Registrar of Births and Deaths. Mr. T. G. Stokes, who acted as Secretary and Deputy Registrar of Births and Deaths until Mr. Gelling's return from leave was transferred to Police De- partment. Miss M. J. Wilson, Matron, Civil Hospital, acted as Princi- pal Matron until 13th January. Miss S. I. Summerskill, Nursing Sister, acted as Matron, Civil Hospital, until 13th January and as Principal Matron from 24th February to 17th October during the absence on leave of Miss M. J. Wilson. Mrs. B. E. Elliott, Nursing Sister, acted as Matron, Civil Hospital, from 24th February to 17th October. Miss S. F. Sutton, Home Sister, acted as Matron, Kowloon Hospital, during the absence on leave of Miss J. A. Davis from 5th May. M 22 Miss A. M. Cullinan, Nursing Sister, acted as Home Sister, Kowloon Hospital, from 5th May. Miss F. A. Cranfield, Nursing Sister, acted as Matron, Victoria Hospital from 24th September to 15th December. Dr. G. W. Pope returned from leave on 1st November and resumed duty as Medical Officer of Health. Dr. J. M. Gray acted as Medical Officer of Health during Dr. Pope's absence from 27th January to 31st October. Dr. A. V. Greaves returned from leave on 9th November and resumed duty as Bacteriologist. Dr. R. S. Begbie acted as Bacteriologist during Dr. Greaves' absence from 31st January to 8th November. Mr. L. J. Morley, Assistant Apothecary, acted as Apothe- cary from 6th April during Mr. Cable's absence on leave. Mr. A. Jackson returned from leave on 12th August and resumed duty as Assistant Analyst and acted as Analyst from 6th October during the absence on leave of Mr. V. C. Branson. APPOINTMENTS. Name of Officer. Designation. Date of assumption of duty. Miss K. N. Graveson Mr. J. I. Barnes Mr. J. G. Robertson Dr. (Miss) Fau Choi Chue Mr. J. H. Gelling Dr. G. M. Hargreaves Dr. (Mrs.) G. R. Nash Dr. (Mrs.) L. O. Hunter Dr. G. I. Shaw Assistant Apothecary Secretary, Tsan Yuk Hospital 1. 1.34 1. 1.34 Asst. Radiographer Chinese Lady Medical Officer 1. 2.34 1. 2.34 Secretary 22. 2.34 4. 4.34 1.12.34 1.12.34 13.12.34 Health Officer for Schools Lady Medical Officer Lady Visiting Medical Officer Medical Officer PROMOTION. Miss M. J. Wilson, Matron Civil Hospital, was appointed Principal Matron on 14th January. Miss S. I. Summerskill, Nursing Sister, was appointed Matron, Civil Hospital, on 14th January. - M 28 Miss S. F. Sutton, Nursing Sister, was appointed Home Sister, Kowloon Hospital, on 1st March. I Miss I. Warbrick, Nursing Sister, was appointed X-Ray Sister on 10th May. Mrs. B. E. Elliott, Nursing Sister, was appointed Matron, Victoria Hospital on 16th December. RESIGNATIONS OR RETIREMENTS. Name of Officer. Designation. Date of Resigna- tion or re- tirement. Miss C. S. Mackenzie Dr. H. L. Clift X-Ray Sister V.M.O.C.H. & D. Dr. (Mrs.) A. L. J. Dovey Lady. V.M.O.C.H. & D. Miss G. Chettle Matron, Victoria Hospital OFFICERS ON VACATION LEAVE IN EUROPE. Name of Officer. Designation. 9. 5.34 30. 9.34 30.11.34 15.12.34 Date of Date of Departure. Return. Mr. J. H. Gelling Prof. W. I. Gerrard Prof. R. E. Tottenham Dr. D. J. Valentine Dr. I. Newton Secretary Govt. Consultant do. 16. 3.34 18. 5.34 Medical Officer 22. 2.34 3.11.34 27.12.34 8. 2.34 do. 24. 2.34 Dr. G. V. A. Griffith do. 21. 4.34 do. Health Officer Dr. J. B. Mackie Dr. G. W. Pope Mr. J. Skinner Mr. R. E. Cable Mr. J. F. McGowan Miss M. J. Wilson Miss J. A. Davis Mr. L. A. Collyer Dr. K. H. Uttley Dr. A. V. Greaves Mr. V. C. Branson Mr. A. Jackson Radiographer Apothecary Asst. Steward Principal Matron Matron, Kowloon Hospital Asst. Attendant, M. Hosp. Medical Officer Bacteriologist Govt. Analyst Asst. Analyst 3. 2.34 31. 1.34 6.11.34 29. 9.34 -9.11.34 13. 8.34 2.10.34 27. 1.34 24. 2.34 .1.11.34 29.11.34 6. 4.34 10. 2.84 13.12.34 24. 2.34 18.10.34 5. 5.34 17.11.34 M 24 LIST OF ORDINANCES AFFECTING THE PUBLIC HEALTH ENACTED DURING THE YEAR. 60. The Ordinances affecting the public health which were enacted during the year were:- No. 21-Births and Deaths Registration Ordinance. No. 40-Cremation Ordinance. 61. EXPENDITURE FOR 1934 AND 1933 COMPARED. 1933. 1934. Personal Emoluments $1,008,860.62 $1,053,087.22 OTHER CHARGES. A.-Staff. Conveyance Allowances $13,219.62 $13,947.46 B.-General. Artificial Limbs $ Bedding and Clothing 30.00 12,963.08 $ 47.00 15,787.70 Board for 5 House Officers (4 in 1933) 1,460.00 1,825.00 Board and Lodging for 6 Pupil Midwives 576.00 480.00 Books 415.33 502.24 Bonuses to Dispensary Licentiates and Clerks for vaccination of Children and registration of births 4,277.20 4,549.10 .Cleansing Materials 5,537.45 6,859.30 Dental and Other Special Treat- ment 3,093.50 1.959.00 Expenses of Courses of Study and attendance at Medical Con- gresses 1,895.02 4,175.12 Fuel and Light 54,272.33 63,357.86 Grants to Protestant and Roman Catholic Chaplains for Re- ligious Services 1,800.00 1,800.00 Incidental Expenses 2,565:27 3,304.33 Maintenance of lunatics at Canton 7,722.16 -8,674.02 Medical Comforts 603.20 659.40 Medicines, Surgical Appliances and Instruments.... 72,549.17 77,691.01 Nursing Board Expenses 2,315.50 M 25 Rent of Premises for Dispensar- Provisions for patients ies, and Infant Welfare Cen- 1933. $144,370.88 1934. $116,907.34 tres 3,479.35 5,334.50 Transport 1,188.70 1,293.80 Treatment of Opium Addicts 560.50 1,968.00 Upkeep of Hospital Equipment... 12,428.42 13,251.05 Upkeep of X-Ray Apparatus........... 11,746.81 11,799.41 Upkeep of Travelling Dispensary. 2,366.31 929.65 Ventilation of Operating Theatre. Washing 419.60 445.55 17,462.03 15,836.46 C.-Port Health Officer's Office. Conveyance Allowances $ 179.03 $ 218.31 Incidental Expenses, etc. 399.81 364.26 Uniforms 166.89 103.52 Expenses in connection with Fumigation and Disinfecting of shipping 32,527.28 D.-Bacteriological Institute. Animals and Fodder $ 6,889.90 $ 5,942.35 Anti-rabic work 373.19 Apparatus and Chemicals 1,338.37 353.58 1,291.96 Books and Journals 86.20 18.32 Conveyance Allowances 343.71 212.04 Fuel and Light 1,540.28 1,575.01 Incidental Expenses 720.40 789.33 Freparation of Vaccines, Serum, etc. 1,571.10 1,709.70 Uniforms 240.83 232.44 E.-Mortuaries, Victoria and Kowloon. Conveyance Allowance for Mes- senger Fuel and Light Uniforms $ 18.00 $ 18.00 81.33 86.09 94.50 111.90 M 26 F.-Malaria Bureau. Anti-Malarial Field Work............. ..... 1933. $ 1,136.84 1934. $ 1,011.92 Conveyance Allowances 1,379.42 1,686.37 Equipment 1,392.27 827.67 Incidental Expenses 290.91 162.26 Uniforms 644.81 520.11 G.-Analytical Laboratory. Apparatus and Chemicals. $ 3,991.84 $ 3,871.15 Books and Journals 161.69 169.24 Conveyance Allowance 180.00 180.00 Fuel and Light 807.11 797.22 Incidental Expenses 381.17 296.01 Uniforms 133.25 106.00 Total Personal Emoluments and Other Charges $1,409,905.40 $1,483,969.06 SPECIAL EXPENDITURE. Electric Centrifuge 1933. $ 1,167.94 1934 Microscope for Bacteriological In- stitute Microscope for Training Asiatic Sanitary Inspectors Microscope for Venereal Diseases 689656 TO DO Clinic 702.40 Repair and Calibration of Instru- ments, Analytical Laboratory. 676.29 Equipment of Kowloon Hospital. 16,774.29 Lymph Grinding Machine for Bacteriological Institute 1.923.30 Steel Cupboards X-Ray Apparatus 650.00 1,100.00 Gestetner Duplicating Machine..... 847.40 Total Special Expenditure.... $ 4,176.19 S 21,294.99 Total Medical Department ... $1,414,081.59 $1,505,264.05 M 27 Medical Treatment REVENUE FOR 1933 AND 1934 COMPARED. 1934. 92,388.58 1933. 94,220.96 Miscellaneous 1,180.00 405.00 Bacteriological Examination 9,346.70 6,998.50 Chemical Analyses 43,107.50 32,893.75 Bills of Health 11,070.00 9,960.00 Medical Examination of Emmig- rants 89,531.70 145,208.10 Official Certificates 2,775.00 1,295.00 Births and Deaths Registration... 9,097.48 7,811.50 Consultants Fees 5,530.00 1,427.50 Fumigation and Disinfection Fees 2,512.25 Total $265,859.34 $300,900.18 62. EXPENDITURE AND REVENUE MEDICAL DEPARTMENT FOR THE PAST TEN YEARS. Personal Emoluments Year. & Other Charges. Special Expenditure. Total Expenditure. Total Revenue. 1925.. 548,703.64 75,537.46 624,241.10 194,547.75 1926 701,717.93 34,451.05 736,168.98 255,070.19 1927........ 721,623.32 16,409.47 738,032.79 307,744.48 1928......... 808,412.61 23.37 808,475.98 306,347.62 1929........ 878,058.19 17,061.08 895,119.27 299,524.51 1930....... 1931....... 1,172,791.22 1,325,353.30 51,305.06 1,224,096.28 267,887.66 52,697.76 1,378,051.06 243,256.99 1932...... 1933... 1934.. 1,316,575.34 1,409,905.40 1,483,969.06 6,689,20 1,323,264.54 260,164.87 Total 4,176.19 1,414,081.59 265,859,34 21,294.99 1,505,264,05 300,900.18 $10,367,110.01 $279,645.63 $10,646,755.64 $2,701,303.59 M 28 63. In drawing comparisons between the expenditure and revenue of different years it should not be forgotten that the Hong Kong dollar is based on silver and its value rises and falls with the price of that metal. Most of the European officers draw sterling salaries and the bulk of the drugs, dressings and instruments are obtained from England and paid for in sterling. With the exchange at a shilling, the number of dollars expended on sterling priced material is double what it would have been had the exchange been two shillings to the dollar. RATIO OF EXPENDITURE ON MEDICAL AND SANITARY SERVICES TO TOTAL REVENUE FROM ALL SOURCES. 64. The total revenue of the Colony from all sources was estimated at $31,731,625.00. 65. Because of the overlapping which occurs when a work serves both a utilitarian and a sanitary service it is impossible to assess exactly the amounts which have been spent for purely medical and sanitary purposes. Including all water works and drainage works as sanitary works, the following (which include the salaries of the P.W.D. staff concerned) shows the commit- ments as laid down in the Estimates for 1934. Expenditure by Medical Department Sanitary Department Public Works Department. " J} 11 "} Police Department Subsidies to Charities.. Total:- $1,745,589.00 1,179,394.00 2,510,730.00 6,240.00 201,041.00 $5,642,994.00 66. Ratio of expenditure on Medical and Sanitary Services to total revenue = 5,642,994.00 33,442,695.00 = 16.87 per cent. 67. If the expenditure on Water Works be not taken into account the ratio is 13.96 per cent. As explained in paragraph 65 above these figures are approximate only. M 29 SECTION II. Public Health. PART I. VITAL STATISTICS. CIVIL POPULATION. 68. The estimated civil population for the whole of the territories under British jurisdiction at the middle of the year was 944,492, of which 923,584 or 97.8 per cent was Chinese and 20,908 or 2.21 per cent non-Chinese. The distribution was as follows:- Urban area of Victoria:- Europeans and Americans Other non-Chinese races Chinese 4,162 5,704 373,199 383,065 Villages of Hong Kong:- Europeans and Americans 342 Other non-Chinese races 115 Chinese 47,059 47,516 Total for Hong Kong Island 430,581 Urban area of Kowloon including New Kowloon :-- Europeans and Americans 4,702 Other non-Chinese races 5,858 Chinese 300,550 Total for Kowloon & New Kowloon.. 311,110 Junks and Sampans:- Chinese 100,000 New Territories exclusive of New Kowloon :- Europeans and Americans Chinese Total civil population 25 102,776 102,801 944,492 69. During the year 2,275,346 persons entered and 2,318,642 left the Colony by river steamer and by railroad, making a surplus of emigrants over immigrants by these routes of 43,296. Fuller details are as follows: Arrived. Departed. River steamer Railway 1,305,961 1,317,913 969,385 1,000,729 Ocean going steamers. 513,693 492,458 Total 2,789,039 2,811,100 M 30- 70. The above does not represent the total movement between Hong Kong and the neighbouring provinces for there are many who arrive and depart by junk or sampan. It is estimated that on an average some 7,000 arrive and 7,000 depart daily. BIRTHS AND DEATHS REGISTRATION, 71. The Registration of Births and Deaths Ordinance has since 1911 applied to the whole territory under British jurisdic- tion but until 1932 no action was taken to enforce it in the New Territories where registration of both births and deaths had been the exception rather than the rule. 72. As a result of the better enforcement of the law and still more as a result of the introduction of a new Births and Deaths Registration Ordinance, which did away with certain fees and penalties, the registration of births during 1934 has increased throughout the Colony, but more particularly in the New Territories where 3,564 births were registerd (3,380 in 1933). 73. Registration of births is however still far from complete and many births, especially of females, are never recorded. 74. In view of the increased numbers of births registered in the New Territories, it was decided to calculate the birth and death rates for 1934 on the population of the whole Colony and not to exclude the New Territories as heretofore. 75. Death registration in the Colony being a necessary preliminary to a permit to bury, it may be taken for granted that practically all deaths are registered. Bodies found dumped or abandoned in the streets and open spaces, are taken to the Public Mortuaries where they are examined by the Medical Officer who fills in the necessary certificates which go through the Coroners' hands to the Registrar. All certificates of deaths are scrutinized by the Medical Officer of Health. BIRTHS. 76. The following table shows the number of births registered during the last five years:- Chinese Non-Chinese 1930. 1931. 1932. .10,756 378 1933. 1934.* 12,055 388 13,166 431 14,909 453 20,424 462 Total .11,134 12,443 13,597 15,362 20,886 *Includes those from New Territories. - M 31 DEATHS. 77. The deaths registered among the civilian poulation of the Colony (including New Kowloon and New Territories) was 19,766 giving a crude death rate of 20.93 as compared with 22.11 for the previous year (which included New Kowloon but did not include the New Territories). Death rate per Estimated Year Deaths population mille population 1933 Chinese ... Non-Chinese 17,923 233 800,921 22.38 20,421 11.39 1934 Chinese Non-Chinese 19,516 250 923,584 21.13 20,908 11.96 78. The principal diseases causing deaths were:- Disease. Percent- No. of deaths. age of total Death rate deaths. per mille population. 1933 1934 Eroncho-pneumonia 3,020 15.78 3.60 3.20 Pulmonary tuberculosis... 2,179 11.02 2.71 2.31 Pneumonia 527 2.66 0.93 0.56 Bronchitis 1,923 9.73 1.98 2.04 Diarrhoea (infantile) 1,346 6.81 1,68 1.42 Diarrhoea (over one year). 870 4.40 1.02 0.92 Dysentery 189 0.96 0.23 0.20 Nephritis 638 3.23 0.72 0.67 Heart disease heart failure 669 3.38 0.73 0.71 Beri-beri 447 2.23 0.56 0.47 Malaria 365 1.85 0.50 0.39 Notifiable Diseases :- Smallpox. 104 0.53 0.53 0.11 Enteric 65 0.33 0.08 0.07 Diphtheria 83 0.42 · 0.10 0.09 Cerebro-spinal meningitis 125 0.63 0.14 0.13 Cholera Plague.. M 32 79. Death Clock showing percentage of total deaths caused by different diseases :- 15 78% 11.02% PULMONARY TUBERCULOSIS BRONCHO. PNEUMONIA 9.73% 2.66% 6.81% 4.40% RESPIRATORY BRONCHITIS LOBER PNEUMONIA DISEASES DIARRHOEA (INFANTILE) DIARRHOEA (OVER ONE YEAR) OTHER DISEASES 37 95% HEART DISEASE NEPHRITIS BERI BERI MALARIA DYSENTERY 3.38% 3.23% 2 23%{ 185 %/096) Page 390Page 391 M 33 Infantile Mortality. 80. The numbers of deaths of infants under one year were :- Chinese Non-Chinese 7,094 23 81. If the figures for the Chinese births registered repre- sented the total births, which they do not, the infantile mortality rate for this race would be 347.34 as compared with 454.89, which was the equally incorrect rate for the previous year. Allowing that only one third of the births are registered this would still mean a very high infantile mortality figurė. 82. The mortality rate among the non-Chinese was 49.78 as compared with 88.30 in 1933. The Dumping of the Dead. 83. The following table shows the number of unknown dead bodies found by the Police in the streets and elsewhere during the last five years:- 1930 1931 1932 1933 1934 Victoria 418 366 382 357 289 Kowloon 669 738 884 881 679 Harbour 126 115 79 47 27 Elsewhere 103 76 82 62 61 1,316 1,295 1,427 1,347 1,056 98 per cent of the bodies dumped were children the majority being infants. The number of males exceeded that of females. VITAL STATISTICS OF EUROPEAN CIVILIAN POPULATION. 84. The Europeans and Americans resident in the Colony are estimated to number 9,216 of whom 7,121 were British. The majority of Europeans and Americans are treated by private practitioners when ill, and figures are not available for calculat- ing incidence rates. 85. There were 149 deaths among the 9,216 giving a death rate of 16.2 per mille. M 34 86. Vital Statistics of European Officials. Number of Europeans (excluding temporary school mistresses) Average number resident in the Colony Number invalided during 1934:- (a) when on leave at home (b) in the Colony Number died during 1934:- (a) in the Colony (b) when on leave at home PART II.-HEALTH CONDITIONS. 985 843 2 6 8 3 1 4 GENERAL REMARKS. 87. In the absence of some general system of registration of sickness, the only sources of information available for gauging the state of the public health in this Colony are the returns relating to deaths, the notifications of infectious diseases and the records of Government and Chinese hospitals. Judging from the death returns the health of the Colony was better than that of the previous year. The crude death rate was 20.93 per mille as compared with 22.11 for 1933. 88. Respiratory diseases accounted for 39.97 per cent of the total deaths; the percentage for 1933 was 41.93. The principal diseases causing death were broncho-pneumonia, pulmonary tuberculosis, bronchitis, infantile diarrhoea and diarrhoea. 89. The overcrowded houses, the expectorating habits of the people, and poverty furnish sufficient explanation for the prevalence of respiratory troubles. MALARIA. 90. Owing to efficient drainage methods this disease has disappeared from the greater part of the urban districts. It still persists, however, in the suburbs and in the rural areas. There are parts of the New Territories where the spleen rate is as high as 41.4%. 91. Malaria not being a notifiable disease the incidence figures are unknown. The cases admitted to the Government Hospitals numbered 457 as compared to 482 in the previous year. The percentage of deaths to cases admitted was 1.31. Among the Chinese Hospitals there were 839 admissions with a case mortality rate of 18.35 per cent. M 35 92. The cases admitted to the Government Hospitals during the last nine years are as follows:- 1926 1927 1928 1929 1930 1931 1932 1933 1934 970 670 485 658 535 585 465 475 457 93. The total number of deaths attributed to this disease was 365, giving a death rate of 0.39 per mille over the whole population. The low death rate is, of course, due to the fact that the great bulk of the population residing in the drained urban area is not subject to risks of infection. If figures for local districts were available it would be found that in some areas the incidence and death rates were very considerable. 94. During the year the Malaria Bureau continued its investigations into the life history, habits and carrying powers of the local anophelines. The results obtained were both interesting and instructive. and instructive. As in previous As in previous years there was no obstruction from the local Chinese; on the contrary they took an interest in the proceedings and showed their eagerness to be of assistance. The Chinese Inspectors have shown ability and zeal. 95. The Bureau co-operated fully with the Military Authorities and with the Public Works Department. A full account of the activities of the Bureau will be found in Appendix "B". OTHER INFECTIOUS DISEASES. 96. During the year there were reported 153 cases of small- pox, 246 cases of cerebro-spinal fever, 162 cases of diphtheria and 212 cases of enteric. There were no cholera cases. Pulmonary Tuberculosis. 97. This disease continues to rank second to broncho- pneumonia as the principal cause of death. It is probable that some of the cases of the latter were of tuberculous origin. 98. The total number of deaths was 2,179; that for 1933 was 2,225. The death rate per mille was 2.31 as compared with 2.71 for the previous year. 99. There is need for more hospital or infirmary accommoda- tion for tuberculosis patients, especially for those of the poorer classes. M 36 Smallpox. 100. Every year in the cold season this disease manifests itself in outbreaks which are sometimes sporadic, sometimes epidemic. Whatever the prevalence there is always a tendency for the morbidity rate to decline or disappear with the advent of summer. In the year under review there were 153 cases and 104 deaths. 53 cases only were treated in hospital the remainder did not come under the notice of the authorities until after death. 101. The vaccination campaign was continued and during the year 298,836 persons were vaccinated. Valuable assistance was afforded by the St. John Ambulance Brigade and by the Chinese Public Dispensaries. Both bodies engaged in active propaganda and through their efforts many were persuaded who otherwise would have kept aloof. The various sections of the Brigade again carried out street vaccination with excellent results. 102. The Chinese have a preference for vaccination in the spring as being the auspicious season, and for a month or two after Chinese New Year the Chinese Public Dispensaries are crowded with children waiting to be done. 103. The majority of Chinese still hold the opinion that the herbalist treatment of smallpox gives better results than the methods adopted by practitioners qualified in Western medicine. An analysis of the statistics of (a) the Tung Wah Infectious Diseases Hospital where only herbalist treatment is carried out, and (b) the Government Infectious Diseases Hospital where western treatment only is provided shows that this view is not correct. Calculating on the figures for the last 25 years the case death rate at the Tung Wah was 47.9 per cent while that at the Government institution was 15.25 per cent. Plague. 104. For the last five years no cases of plague have been reported in Hong Kong. The disappearance of this disease not only from this Colony but from the greater part of China and its decline throughout the world are due to factors which are not understood. 105. Systematic rat-catching and periodical cleansing of houses were carried out throughout the year. The total number of rats collected was 175,687 of which 21,976 were taken alive, as compared with 174,272 and 17,088 in 1933. The number collected each year shows that there is no diminution in the rat population. All the rats collected were sent to the Public Mortuary for examination. None was found infected. M 37 Cerebro-Spinal Fever. 106. The following table shows the monthly incidence of this disease for the last 5 years:- Month. 1930 1931 1932 1933 1934 January, February, March, April, May, June, July,

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