Progs. No. 287-1.

From the Commissioner of the Arakan Division to the Secretary to the Chief Commissioner, British
Burma,—No. 104-155, dated the 6th March 1878.

     I HAVE the honour to forward the Annual Report of the lock hospital of Akyab
for the year 1877, with annual statements as compiled by the Civil Surgeon, and
remarks by the Town Magistrate on the Civil Surgeon's report.

     2. It would appear from the report generally that, whilst the number of
registered prostitutes has increased, there has been a decrease in the actual
number of venereal cases treated. Dr. Johnstone observes, however, that this
number includes several cases of simple ulcer, which should not have been entered
under the head of "Primary syphilis ;" and he further shews that during the past
two years there has been a very considerable decrease in cases of secondary syphi-
lis and gonorrhœa.

     3. A large number of cases have been entered under the head of "Syphilitic
rheumatism," which Dr. Johnstone is inclined to attribute to a better diagnosis of
cases, rather than to any real increase of venereal disease.

     4. I conclude, from the report generally, that the Act has been well worked
in this town during the past year, and that both the Civil Surgeon and Town
Magistrate have done all they could to make it effectual, as far as their separate
powers in this respect can be exercised and made available.

     5. Clandestine prostitution cannot all at once be checked amongst a race
of women who, when brought up under the Act, are able to produce husbands to
prove marital relationship and the chastity of their falsely accused wives. Never-
theless, the evil is being gradually grappled with, and already a number of Ara-
kanese women have been registered and brought under the operation of the Act.

     6. It is worthy of remark that, amongst the large amount of shipping at
this port, the Civil Surgeon has treated no case of venereal disease contracted at
the port itself. The cases which have come under treatment have been con-
tracted elsewhere, and brought by sailors to this port.

     7. If the figures did not prove otherwise, this fact might argue the com-
parative absence of disease within port limits. It is sufficient however if it
shews, as I think it tends to do, that the lock hospital in this town, in spite
of the difficulties and drawbacks which characterize similar institutions every-
where in India, is quietly fulfilling a good object, and, under present manage-
ment, continues to be beneficial to a large section of the town community.

Annual Report of the Lock Hospital of Akyab for the year 1877.

I.—Nature and extent of hospital accommodation.

     THE hospital affords, at present, ample accommodation for the daily average number
of patients treated throughout the year. The building is composed of bamboo matting,
plastered over and white washed, with a good, commodious verandah. It is sufficiently lighted,
and at present is being repaired. The building and compound are surrounded by a wooden
stockade with one gate. The enclosure is large and commodious. The building consists
of an office, ward, Native Doctor's quarters, and medicine store-room, each 28 feet by 13.
In the ward there is accommodation for 12 patients, and, even if there were more patients,
one of the other rooms could be converted into a ward ; for instance, the medicine store-
room could be exchanged for one of two other side store-rooms, the largest being 18 feet
by 9. This would be quite sufficient for the medicine-room.

     2. The sanitary arrangements are good. The hospital is well raised from the ground,
the ventilation being ample and sufficient, and the ward is always kept clean. The drain-
age is conducted by kutcha drains and the natural slope of the ground. There are no cess-
pools or stagnant water near the hospital. In the latrines the dry-earth system is as
strictly carried out as possible, but the latrine is not good.

II.—Changes in the medical charge of the hospital during the year.

     From the 1st January till the 17th April the charge of the sick was in the hands of
Dr. Mountjoy ; from that time during the rest of the year they were under my care.