It is obvious that, with the health tivities of the place so divided, permits of a wide range of difference in the measures taken for the protection of health und the control of epidemic fan indifferent attitude is taken towards health matters by the people ax a whole, Thus we find that even among the forcizrers there is this tendency. The Com: missioner of Public Heal his report for Shanghai It is estimated that during 1922 not more than 50 per cent. of the cases of notifiable diseases among foreigners were notified by medical practi tioners." Owing to the imperfect notification of infectious diseases the actual state of health of the city can, therefore, only be guess ed. In' spite of the admirable efforts being made by the Munigival Health Council to protect "the health of the people and keep out epidemics from the Settlement, it must be emphasized here that' it would be a solve sense of security to entertain the idea that the Settlement is protected against invasion by any epidemic which may manifest. itself in the adjoining ity. Experience shows that land quarantine is n failure, and even if it is possible to place a sanitary cordon of police and soldiers on the border, in time of an epidemic, cannot succeed in keeping the di ecse out. Besides, the Interrational Settlement ' is dependons largely on the adjoining forrit for its fool supples ant cannot be absolutely isolated.
Let us take for our consideration the prevalence in Shanghai of plague, cholera and smallpox, the three most important diseases from the point of view of international quar ai ie. We find that cholera and smallpox claim a few hundred deaths each year in the settlement. Plague has been absent for a mumber of years, but during the past year a few cases have been reported; this shows the necessity of pursuing constantly anti-plague measures. The control of smallpox has been ground' through vaccination to whi not averse. In view of the interrelation of the health of the Settlement with that of the surrounding districts it seems such a pity to allow the good work done to. be: jeopardized by unfavourable health conditions prevailing, say, in the Chinese city.
Text read from the printed page and cleaned; old type leaves the occasional error.