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 Indian Service, 1871-75.

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 strengthfor 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 ab sorbent 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.

2 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.

CHAPTER V.

SERVICE ON BOARD SHIP.'

SERVICE on board ship must be divided into three sections, corresponding to three different kinds of service.

1. Transport ships, for the conveyance of healthy soldiers, their wives and children, from place to place, or for conveying small parties of troops in charge of convicts.

2. Transports for conveyance of sick from an army in the field to an hospital in rear, or from a foreign station to a sanitarium, or home. Although the term is a little odd, it is convenient to call these ships SickTransports.

3. Hospital ships, intended for the reception and treatment of the sick.

SECTION I

TRANSPORTS FOR HEALTHY TROOPS.'

The use of Government transports has very much altered the duty of medical officers on board. The transports are really men-of-war, i.e., officered by the Royal Navy and under naval regulations. The medical officer of troops has therefore nothing to do with the vessel and its arrangements. If hired transports are used, the "Queen's Regulations" (1881) (section 17, Movement of Troops by Sea), and the "Medical Regulations" (Part I., section iii., sub-section iii.; Part II., section vi., sub-section x.; Part V., section vii.), have to be carried out.

SECTION II.

TRANSPORTS FOR SICK TROOPS.

No specific regulations are laid down with respect to these hired ships, but it would be very desirable to have some set rules with respect to space, diet, and fittings. Invalids are now carried from India and the Colonies in Government transports; occasionally hired transports are used. At

See Rattray's paper read to the Medico-Chirurgical Society in 1872; also the last edition of this work; and Naval Hygiene, by Professor Macdonald, R. N., M.D., F.R.S. (Smith, Elder & Co.), 1881.

The following note is given in the Queen's Regulations. 1881, p. 372: "A TroopShip is one of Her Majesty's ships commissioned as a troop-ship. A Transport is a ship wholly engaged for the Government service on monthly hire, or a ship wholly engaged by the Government to execute a special troop service, though not hired by the month. A Troop Freight Ship is a ship in which conveyance is engaged by Government for troops, but which is not wholly at the disposal of the Government."