China.

While there has been a decrease in the proportion of admissions by every class of diseases except diathetic, the most marked difference has been in miasmatic diseases. These, when subdivided into groups, give the following results: :

There has been a very great reduction both in the admissions and deaths by paroxysmal fevers. The admissions by dysentery, diarrhoea, and cholera were also much below the average, but without any corresponding decrease in the deaths, which were rather higher than the average, and considerably above the proportion in 1360, when they amounted to 7.88 per 1,000 of the strength.

ENTHETIC DISEASES (Venereal) have undergone a considerable reduction, and their prevalence among the native as compared with the European troops, has been in proportion of only one to seven.

DISEASES OF NUTRITION have occasioned relatively a high rate of mortality, the deaths having amounted to 4:15 per 1,000 of the strength. They have not been the subject of special remark by the medical officers. They were probably, for the most part, cases of atrophy following repeated attacks of fever; but, in the absence of specific information, this must be considered a mere conjecture.

NORTH CHINA.

In the middle of November 1860, upon the removal of the Expeditionary Force from the North of China, a large garrison was left at Tien-tsin with a detachment at the Taku Forts. In October 1861 it was reduced by the withdrawal of a battery of Artillery, the 2nd Battalion 60th Regiment, and Fane's Horse, and in November of another battery of Artillery. Tien-tsin was finally given up to the Chinese in April 1862.

Before entering upon the examination of the details respecting the health of the troops it appears necessary to make a few remarks upon the climate of this station. From the date of occupation of Tien-tsin, in November 1860, till the end of February 1862, meteorological observations were carefully made by Surgeon Lamprey, of the 67th Regiment. These have been condensed into a general Table, which will be found in the Appendix, No. XXXI.

Dr. Lamprey thus sums up his description of the climate of Tien-tsin: "The climate of Tien-tsin may be characterised as follows-An extremely cold and prolonged winter and a summer of more than tropical heat. Throughout the year there is an easy progress from one season to the other without sudden alternations of temperature-a remarkably dry atmosphere and a great predominance of blue sky at all seasons. Dust storms and hot winds are liable to occur at certain periods."

An examination of the Table will completely establish Dr. Lamprey's remarks as to the remarkable dryness of the atmosphere, the mean degree of humidity in each month in 1861 ranging between 42 in April and 70 in January. The latter, or highest monthly mean, is under that recorded by the Royal Engineers at Hong Kong in any month in the six years 1853-8,

except May 1853, November 1856, and January, February, and August China.

1858.*

The number of days on which rain fell at Tien-tsin in 1861 was 57, while at Hong Kong it was 117, and the quantity which fell was 14:61 and 75.94 inches at each respectively.

WHITE TROOPS.

The average strength of the European troops in the north of China was 3,113; the admissions among them amounted to 4,405, and the deaths to 159, being in the ratio of 1,415 and 51:08 per 1,000, and if half the deaths among the invalids be added, it will raise the mortality to 54 per 1,000, or more than double the ratio in South China.

The diseases of the troops in North China are stated in detail in Abstract No. XXII. of Appendix, and the prevalence of the various classes is shown in the following Table. As it would be impossible to institute any useful comparison between the diseases which occurred at Tien-tsin in 1861 and in the North of China in 1860, when the army was in the field, the results for the troops in the South of China in 1861 have been substituted for the latter in this Table.

This Table shows the proportion of admissions into hospital to have been nearly one-third lower than in South China, but the mortality to have been more than twice as high. The difference in the admissions has been most marked in miasmatic, enthetic, and dietic diseases, in those of the respiratory,

* Abstracts of the Meteorological Observations taken at the Stations of the Roya Engineers. Edited by Colonel Sir Henry James, R.E. London, 1862.

China digestive, and integumentary systems, and in accidents; while the excess of deaths has been almost entirely in miasmatic diseases and accidents. MIASMATIC DISEASES, when subdivided into groups, give the following results:

Eruptive Fevers. All the admissions in this group were by small-pox, which prevailed among the troops at Tien-tsin during the six weeks of their occupation in 1860, and continued till the end of March. During that period 34 cases and 4 deaths occurred, of which 19 and 2 were in 1861. The men attacked were all reported to have marks of previous vaccination.

Paroxysmal Fevers were only one-third as prevalent in the North as in the South, and it is stated by the Medical Officers that most of the men affected had previously had ague in South China.

Continued Fevers have only prevailed to half the extent in the North, but have given rise to rather more than treble the mortality.

Dysentery Diarrhea and Cholera.-It is to this group that the high rate of mortality by miasmatic diseases in the North is chiefly due; they have caused two-fifths of the whole deaths, and have been twice as prevalent and nearly thrice as fatal as in South China. Of the 60 deaths 32 were reported to have been caused by dysentery, 21 by diarrhoea, and 7 by cholera. Their great prevalence and mortality was in the quarter July to September, the season characterised by the highest mean temperature.

ENTHETIC DISEASES were only half as common in the North as in the South, and the relative proportion of syphilitic to gonorrhoeal cases was also lower.

TUBERCULAR DISEASES were rather less prevalent in the North than the South, but gave rise to a much higher rate of mortality. It is impossible, however, to say whether this may not have been influenced by the greater facilities for invaliding in the latter.

DISEASES OF THE NERVOUS SYSTEM.-A case of hydrophobia occurred in the detachment at the Taku Forts and terminated fatally. The particulars of the case are not given in the report of the Medical Officer, but the patient, a lancecorporal of the Commissariat Staff Corps appears by the returns to have been admitted into hospital on the 24th and to have died on the 27th February.

DISEASES OF THE RESPIRATORY SYSTEM were the cause of a large number of admissions at Tien-tsin, chiefly by bronchitis in January and February, in which months the mean temperature was 19.7° and 23.8°.

ACCIDENTS AND VIOLENCE.-Under this class 20 deaths appear among the troops in the North, but 19 of these ought rather to have been placed among the diseases of the nervous system, having been caused by sunstroke or heat apoplexy. This affection gave rise to 59 admissions and 19 deaths, most of them between the 17th and 23rd of July. The temperature during that time was extremely high, as will be seen by the following extract from Dr. Lamprey's Return;

On the 24th the thermometer fell 11° or to 96°, and did not again rise higher than that point.

CORPORAL PUNISHMENT, which, during the period the army was in the field, had risen to 15.3 per 1,000 of the strength, was inflicted in 21 instances, being in the ratio of 7·4 per 1,000, or more than double the amount among the troops in South China.

NATIVE OR ASIATIC TROOPS.

The Asiatic troops employed in the North of China consisted of Fane's Horse, and they remained only nine months in the Command. Their average strength was 318; the admissions into hospital were 241, and the deaths 2. These numbers, when reduced to the annual ratio per 1,000 of mean strength, give the proportion of 1,013 admissions and 8:40 deaths per 1,000 of mean strength.

The diseases are detailed in Abstract No. XXII. of Appendix, from which the following Table has been framed :—

This Table shows a lower rate of admissions than among the native troops in South China, the difference being almost entirely in miasmatic diseases. The mortality amounts to little more than one-fourth that of the South, the

China exemption occurring entirely in the same class. The number of men employed in North China, however, was too small to justify our drawing any positive deductions from these results.

SECTION II.

On the extent of Invaliding.

During the year there were 392 men of the European force sent to England for change of climate, being in the ratio of 63 8 per 1,000 of mean strength. The causes assigned for invaliding these men were as follows:

During the same period the number of the Asiatic troops sent home to India for change of climate was 25, or 8 per 1,000 of strength, and the causes were as follows:

The number of the European force finally discharged the service as invalids in 1861 was 116, or in the ratio of 18.88 per 1,000 of strength.

The disabilities which occasioned their discharge were reported as follows::

From this it appears that eye diseases have given rise to more invaliding than any other disability, and that pulmonary diseases rank next in frequency. We have no information respecting the number discharged as invalids from the native force.