“In the Hongkong Medical and Sanitary Reports, which give the total deaths registered in the Colony, we have examined the records from 1909 to 1917. During these nine years only two deaths were attributed to influenza, and both occurred in 1909. “From a personal letter from Dr. Arthur Stanley, Health Officer in Shanghai, dated February 11, 1919, I quote the following: “‘As to influenza we had an attack beginning at the end of May and lasting through June and again in the latter part of October and lasting through November. The latter was somewhat more severe. The noteworthy features were general absence of catarrhal symptoms, congestive pharynx frequent, as also was a slight erythematous blush on the neck and chest, which made one think at first of scarlet fever. Fatal pneumonia common among the Chinese and Japanese, but among Europeans very little pneumonia.’ “In his report for May, 1918, Dr. Stanley says that the disease was reported to have reached Peking before it came to Shanghai, but subsequent reports showed that most of the river ports were almost simultaneously infected, the rate of spread conforming to the rate of conveyance by railways and boats of infected persons. The mortality was very low. “Newspaper reports indicate that a third appearance of the disease in Shanghai occurred from the middle of February, 1919, which was still prevalent in April. The symptoms were much more severe. “For Hongkong I quote from a personal letter from Dr. Hickling, the Principal Medical Officer of Health, dated January 29, 1919: “‘The epidemic of influenza in the spring was a very mild one, so far as we can judge. The disease did not last more than a few days in most cases. The recent epidemic (October, November, December and January) has been much more severe, often lasting two or three weeks.’ “Only one death, which occurred on May 14th, was reported from Hongkong in the spring. In the later epidemic the deaths reported were as follows: October, 70; November, 95; December, 67. The first of these deaths occurred on October 5th. The figures for January had not been compiled, but the disease was diminishing. “Dr. C. W. McKenny of Hongkong has kindly furnished me with the following facts: ‘During the first five months of 1918 there were twenty-two admissions for influenza to the Civil and Tung Wa hospitals (3 in May). In June there were 269 cases with three deaths. In July, August and September, 43 cases; and during October-November, 130 cases with four deaths.... “‘The June epidemic in Canton appeared first at the Pui Ying School, then among the employees of the Post Office, the staff of the Canton Hospital, the Canton Christian College, and the Kung Yee Hospital. The other schools entirely escaped. Eleven days were taken by the disease to spread from one part of the city to the various other parts.’”