80 were as great as in 1828-52. In Bengal there is a diminution, but it is very slight. In the early period, however, there may have been less invaliding. In the absence of reliable statistics, the question of the relative amount of phthisis now and formerly seems impossible to be answered.

With respect to the cure and prevention of phthisis, it seems a great pity to send phthisical invalids to England, where they die at Netley, or are cast out to die miserably among the civil population, when in the Himalayas there are elevated localities which must be particularly adapted for the successful treatment of consumption. When means of communica tion are improved, it is possible that we may see phthisical invalids going from Europe to the high peaks of the Himalayas, and why should not the European soldier, who is actually in India, benefit by the mountain ranges? A phthisical sanitarium, at an altitude of 10,000 feet, would be likely to cure the disease in many cases, if it were diagnosed early, and then if the men were afterward kept on the lower hill stations, they would probably become perfectly strong. To send these men home to England, is condemning them to almost certain death. Formerly the distance in India would have been fatal to such a plan, but now, by proper arrangements, even weakly men could be brought from all parts of India. Dr. Hermann Weber, who has paid great attention to the effect of altitude on phthisis, holds very decided views as to the beneficial effect of such an arrangement, and has already urged this point on the attention of the authorities.

The other diseases of the lungs are not unknown in India. Pneumonia gives a mortality in Bengal of about 0.5 per 1,000 of strength, or a little less than at home (= 0.571); while in the other two presidencies it is not half this amount. Acute bronchitis also causes in all the presidencies a mortality almost precisely the same as at home (0.27 and 0.285 per 1,000).

Loss of Service-European Troops.

The admissions and mean daily sick have been already given.

As compared with home service, a larger number of admissions, a greater daily number of sick, and a shorter duration of cases and a larger mortality, indicate not only more sickness, but the presence of very rapid mortal diseases, which shorten the mean duration of all cases.

The chief causes of admissions are "paroxysmal and continued fevers,” venereal disease, dysentery, rheumatism, integumentary diseases, and digestive affections (not hepatitis). Hepatitis and cholera cause few admissions, but a large mortality.

It is most satisfactory to find that the sickness and mortality are both rapidly falling, owing to the energetic means now being adopted by the Government, and to the increased sanitary powers and improved curative means of the medical officers.

The prevalence of venereal disease demands as much attention in India as in England, but the preventive measures will be much easier. Police regulations and proper surveillance are now being enforced, and Lock hospitals are established in many places.

Invaliding of European Troops.

For some years back the invaliding statistics of Bengal have been given with great care by the late Dr. Bryden.' The invaliding ratio, from all

1 Vital Statistics of the Bengal Presidency, 1870 and 1878; and Reports of the Sanitary Commissioner (Dr. Cuningham) with the Government of India. Reference must be made to these elaborate reports for the full details.

causes, in the Bengal European army, varied in ten years (1861-70) from 28.09 to 53.98 per 1,000 of strength, the mean being 38.9; and in the next ten years (1871-80) from 29.88 to 47.14, the mean being 40.6. In the Bengal army the ratios were per 1,000 strength

Bryden remarks that there is but little change in the invaliding rate from 25 to 34 years of age, and he therefore puts the ten years in one class.

The invaliding is high during the early years of service, as shown by the following table:

Invaliding per cent. of the total Invaliding at the different Periods of

The chief causes of invaliding are phthisis, heart affections, hepatitis, and general debility, and the following table, calculated from Bryden, shows the ratio of these classes (1871-75):

The total invaliding is made up of those sent home for discharge and for change of air. From about 30 to 60 per cent. of all invalids are in the latter category. In the ten years, 1870-79, the mean number of invalids sent home was 42.44, and those finally discharged were 16.08 per 1,000 of strength. Those sent home for change were thus 62 per cent. of the whole. In 1880, 29.88 per 1,000 were sent home and 21.40 discharged, the percentage sent home for change being thus only 28.

Mortality of Native Troops.

Colonel Sykes gives the mortality for 1825-44 as 18 per 1,000 of strength for all India; and for Bengal, 17.9; Bombay, 12.9; Madras, 20.95.

In Madras, from 1842 to 1858, the average was 18 per 1,000 (Macpherson), of which 6 per 1,000 each year were deaths from cholera.

Ewart gives the following numbers per 1,000 of strength-Bengal (1826-1852), 13.9; Bombay (1803–1854), 15.8; Madras (1827–1852), 17.5. Taking successive quinquennial periods, there has been a slight progressive decrease in mortality, but this is less marked than in Europeans. The excess of mortality is chiefly due to cholera, dysentery, and fever. In Bengal, in the years 1861-67, the annual mortality per 1,000 of men present with the regiments was 14.57. In Madras the average mortality in six years, 1860-66, was 12.6.

The following table gives the mortality of native troops per 1,000 of strength for the period 1867-76, from Bryden's tables :

Mortality of Sepoys (1867–76) per 1,000 of Strength.

Although the English have occupied Canton, Tientsin in the north, and several other places, yet, as their occupation has been only temporary, it seems unnecessary to describe any other station than Hong-Kong.

Garrison of Hong-Kong about 1,000, but differing considerably accord

ing to the state of affairs in China.

The island is 27 miles in circumference, 10 long, and 8 broad at its widest part.

Geology.-The hills are for the most part of granite and syenite, more or less weathered. In some parts it is disintegrated to a great extent, and clayey beds (laterite) are formed, in which granite boulders may be embedded. Victoria, the chief town, stands on this disintegrated granite. As in all other cases, this weathered and clayey granite is said to be very absorbent of water, and, especially in the wet season, is considered very unhealthy.

Climate.-Mean annual temperature, 73° Fahr.; hottest month (July), 86.25°; coldest month (January), 52.75°; amplitude of the yearly fluctuations, 33.5°.

The humidity is considerable-about 80 per cent. of saturation, as an

average.

The N.E. monsoon blows from November to April; it is cold, dry, and is usually considered healthy and bracing; but if persons who have suffered from malaria are much exposed to it, it reinduces the paroxysm. The S.W. monsoon blows from May to October; it is hot and damp, and is considered enervating and relaxing. The difference in the thermometer between the two monsoons has been said to be as much as 46°, but this seems excessive.

The rainfall is about 90 to 100 inches with the S.W. monsoon.

In addition to Victoria, there are two or three other stations which have been occupied as sanitaria, viz., Stanley, seated on a peninsula on the south end of the island, and about 100 feet above the sea; and Sarivan, 5 miles east of Victoria. Neither station seems to have answered; the barracks are very bad at Stanley, and are exposed too much to the N.E. monsoon, which, at certain times, is cold and wintry; during the S. W. monsoon it is healthy. Sarivan has always been unhealthy, probably from the neighborhood of rice-fields. Since the close of the last war a portion of the mainland, Cowloon, opposite Victoria, has been ceded, and has been occupied by troops. It is said not to be, however, even so healthy as Hong-Kong,' but there are differences of opinion on this point.

Hong-Kong has never, it is said, been considered healthy by the Chinese. The chief causes of unhealthiness appear to be the moist laterite and weathered granite, and the numerous rice-fields. Indeed, to the latter cause is ascribed by some (Smart) the great unhealthiness, especially when the rice-fields are drying in October, November, and December.

2

Local causes of unhealthiness existed till very lately in Victoria. In building the barracks the felspar clay was too much cut into, and, in addition, the access of air was impeded by the proximity of the hills. The S.W. monsoon was entirely shut out. Till lately sewerage was very defective.

Owing probably to these climatic and local causes, for many years after its occupation in 1842, Hong-Kong was excessively unhealthy. Malarious. fevers were extremely common, and not only so, but it is now known that typhoid fever has always prevailed there (Becher and Smart). Dysentery has been extremely severe, and has assumed the peculiar form of lientery. This was noticed in the first China war, and appears, more or less, to have

1 See Report of Surgeon Snell, Army Medical Report, vol. v., p. 360, for the causes of the unhealthiness of Cowloon.

* Transactions of the Epid. Soc., vol. i., p. 191. This paper should be consulted for an excellent account of Hong-Kong, and of the diseases among sailors especially.

continued since. In addition to these diseases, phthisis appears to have been frequent.

For some years there were such frequent wars in China, that the exact amount of sickness and mortality, due to the climate of Hong-Kong, could not be well determined. But it is becoming much healthier than in former years, owing to the gradual improvement in sanitary matters which goes on from year to year. In 1865 there was, however, much sickness, owing apparently to overcrowding and to bad accommodation.

In the "Statistical Reports," the troops serving in Hong-Kong, Cowloon, Canton, Shanghai, and the Straits settlements, are classed together, so that the influence of Hong-Kong per se can only be partially known.

In the years 1859-66, which include years of war, the admissions in South China averaged 2,131, and the deaths 56.25, or, exclusive of violent deaths, 52.63 per 1,000 of strength, and there was in addition a large invaliding. Paroxysmal fevers gave 609 admissions and 7.77 deaths; continued fevers, 25.25 admissions and 4.17 deaths; and dysentery and diarrhoea, 249 admissions and 16.3 deaths per 1,000. In later years the mortality was less; in 1869-70, it was 16.02, and in 1871 only 5.82 per 1,000 of strength, and of these only 3.88 was from disease. In the five years, 1871-75, it was 11.73; and in 1876-80 it was 8.61, giving for the ten years a mean of 10.17. This contrasts very favorably with the mean of the previous ten years (1861-70), which was 39.84, or nearly four times as great. It is evident that the causes of sickness and mortality are now being brought under control.'

1 Australia and New Zealand -The withdrawal of the troops from these colonies renders it unnecessary to give any statistical details.