醫務衛生署年報 Medical and Health Department Annual Report 1949-1950

R B B 40i

SANITAR

LIBRARY

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INS

11431

HONG KONG

ANNUAL REPORT

BY THE

DIRECTOR OF MEDIC SERVICES

FOR THE YEAR ENDED THE .ST MARCH, 1950.

NORONHA & Co., LTD..

GOVERNMENT PRINTERS & PUBLISHERS.

RAB 40(1)

22501292936

HONG KONG

ANNUAL REPORT

BY THE

DIRECTOR OF MEDICAL SERVICES

FOR THE YEAR ENDED THE 31ST MARCH, 1950.

NORONHA & Co., LTD..

GOVERNMENT PRINTERS & PUBLISHERS.

WELLCOME INSTITUTE

Call

No.

welMOmec

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1750

CONTENTS.

Page

I. ADMINISTRATION

A. General

Boards

C. Staff

D. Legislation

II. PUBLIC HEALTH

General Remarks

III. VITAL STATISTICS

A. Population

Births

+H-

+++

H+H++

C. Deaths

D. Infant Mortality

E. Maternal Mortality

JLL

F. Principal Causes of Death

IV. HYGIENE AND SANITATION

(i) General Measures

(ii) Anti-Epidemic

(iii) Health Education

(iv) Port Health Work

(v) School Hygiene

(vi) Nutrition

...

(vii) Social Hygiene

... ..

V. MATERNITY AND CHILD WELFARE

VI. HOSPITALS AND DISPENSARIES

VII. DENTAL CLINICS

VIII. PHARMACEUTICS

Page

IX.

MEDICO SOCIAL WELFARE ACTIVITIES

---LJ-ILJ■

X. TRAINING OF PERSONNEL

XI. MEDICO LEGAL WORK

ANNEXURES

(A) Chart of the Organization of the Depart-

ment.

(B) Maps of Medical Institutions.

(D) Table and graph showing deaths by ages for 1949 with the age distribution as found in the 1921 and 1931 censuses.

(E) Graph showing monthly number of births,

for the years 1947, 1948 and 1949.

(F) Notifiable Diseases, Deaths and Notifications

from 1946-1949.

(G) Tuberculosis report.

J - L

(H) School Health. Results of medical inpec- tion of pupils and defects found in schools.

(I) Report of the Tsan Yuk Hospital.

(J) Summary of work of Government Hospitals,

Dispensaries and Clinics.

(K) Cases treated in Government and Govern- ment assisted hospitals with total deaths in the Colony for 1949.

(L) Cases treated as inpatients and outpatients at the main private hospitals in the Colony for 1949.

155

(M) Report of the Principal Almoner.

(N) Mortuaries, Summary of work.

(0) Report of the Malariologist.

(P) Report of the Government Chemist.

(Q) Report of the Government Pathologist.

156

162

169

· ·

169

176

L-ADMINISTRATION,

A. General.

　　Throughout this report all statistics will refer to the calendar year 1949 in conformity with the usual practice for medical statistics, but the text will refer to the financial year April 1st, 1949 to March 31st, 1950.

　　2. At the beginning of the year there seemed hope for development in many aspects of the Medical Department's work but unfortunately, owing to pressure of events outside the Colony, defence expenditure loomed large ahead and it became necessary to curtail the programme in order to create savings to meet this expenditure.

　　3. This call for economy was met by abandoning certain of the less essential services provided, such as the extra feeding of tuberculosis patients, and by leaving a number of less important posts vacant until the end of the financial year.

　　4. Throughout the year there was a steady increase in the demands on the Medical Service both in the out-patient departments and for in-patient treatment in hospitals. This increased demand can only be attributed to an increase in the population as there were no important changes in the health of the community either in the form of epidemics or nutritional deficiency to account for it.

　　5. As might be expected, with the need for economy, there were no major developments in the department and the long anticipated and much needed additional tuberculosis clinic had to be postponed until the latter part of 1950. The date for its completion being set some time in September.

　　6. Since the war the St. John Hospital at Cheung Chau, a hospital of 70 beds, has been administered by the Medical Department, the St. John Ambulance Brigade having insufficient funds at their disposal. In order that Government might have some security of tenure to justify spending considerable sums of money on much needed repairs negotiations were opened with the St. John Council, Hong Kong for an agreement regarding the future administration of the hospital. These negotiations were finally completed in February 1960; by them the Government agreed that the hospital should be known by the name of St. John Hospital, Cheung Chau and that the Government should administer it for five years.

7. In August 1949 the Western Chinese Public Dispensary was closed down and the space made available for an extention of the adjacent Tsan Yuk Hospital.

- 2

8. Once again the Director of Medical Services has had considerable help and advice from the Hong Kong and China Branch of the British Medical Association and the Hong Kong Chinese Medical Association.

9. Among the more important matters discussed with them was the problem of refugee doctors from China who had come to Hong Kong. Many of these doctors were leaders of their profession in their own country and with the great shortage of doctors in Hong Kong it was clear that the possibility of making use of their services required very serious consideration. The great majority of these doctors were not eligible for registration in Hong Kong and would not therefore be permitted to practice without some amendment in the law. The Director of Medical Services proposed to the two Medical Associations that such an amendment should be considered and later met a large representative gathering of the Associations to discuss the matter.

10. At this meeting many cogent arguments were brought forward why these doctors should not be admitted to the register. At the same time all felt that the fullest possible use should be made of their services and it was agreed that as far as possible they should be employed by Government until such time as there was a sufficient number of registered doctors to replace them.

11. This agreement has directed the policy of the Medical Department in this matter and at the end of the financial year 36 doctors out of a total medical staff of 127 belonged to this group of doctors ineligible for registration in Hong Kong.

12. On 7th October, 1949 further discussions were held with the representatives of the two medical associations and in particular the Hong Kong Chinese Medical Association as a result of which 30 doctors offered their services, free, to carry on an evening clinic at Sai Ying Pun for the benefit of those members of the public who could afford a very small fee only. This clinic was opened on 3rd January, 1950 and still continues. Three doctors attend each evening from six to eight and a fee of $3 per visit is paid by the patients. The fees go towards the cost of paying for the additional staff and investigations provided by the Medical Department. An average of 40 patients each evening have attended this clinic.

13. The chart in annexure A shows the system of decentralisation in the Department. Maps showing the position of institutions in the Colony are shown in annexure B.

B. Boards.

14. The Medical Advisory Board to His Excellency the Governor. This Board consists of representatives of the three Services and the British and Chinese Medical Associations, with the Deputy Director of Medical Services as secretary. It met regularly during the year and considered all matters of medical or health importance to the Colony as a whole. The community owes a debt of gratitude to the members of this Board who gave so much of their valuable time for this work.

15. Medical Board. The Medical Board, consisting of the senior Naval and Military doctors for the time being in the Colony, two registered medical practitioners and three other persons appointed by the Governor, is responsible for the control of admissions to the Medical Register and for dealing with matters of professional ethics among medical practitioners in the Colony.

　　16. Dental Board. In August 1949 the size of the Dental Board was increased by the addition of two dental surgeons appointed by the Governor and the Board now consists of the Government Dental Surgeon, two medical practitioners and four dental surgeons appointed by the Governor. It carries out the same responsibilities for the dental practitioners as does the Medical Board for the doctors.

17. Nurses Board. The constitution of the Nurses Board was altered in 1949 by an amendment to the Ordinance whereby the four members appointed by the Governor, two of whom had previously been doctors, should, in future, all be nurses registered in the Colony. The complete Board now consists of the Principal Matron, one member appointed by the University, and four members appointed by the Governor. It is responsible for controlling admissions to the Nurses Register and for the qualifying examinations for nurses throughout the Colony.

18. Midwives Board. The Midwives Board consists of eight persons two of whom must be certified enrolled midwives appointed by the Governor. This Board is responsible for the Midwives register and for qualifying examinations and discipline among Midwives as is the Nurses Board for nurses.

　　19. The Director of Medical Services is ex-officio Chairman of these Boards.

C. Staff.

20. On 2nd May, 1949 the Deputy Director of Medical Services Dr. G. H. Thomas, O.B.E., went on leave prior to retirement which took effect on 12th January, 1950.

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　Dr. Thomas had been in the Department for 37 years and his retirement will leave a gap which it will be very difficult to fill. The Department suffered a further loss in the retirement on pension of Miss I. N. Watkins, O.B.E., Principal Matron, after 23 years service.

21. Other officers who have left the Service are Dr. F. J. Farr, Senior Radiologist, and Dr. J. A. R. Selby, Senior Social Hygiene Officer, Both these officers obtained permission to retire earlier than the normal retiring age and have gone to the United Kingdom where they propose to continue working. These officers could ill be spared but no doubt they will be welcome in their new sphere of activity. Dr. E. W. Hackett who obtained a diploma in oto-laryngology while on leave in the United Kingdom was subsequently appointed Ear, Nose and Throat Specialist in Nigeria. In addition to these losses four of the more senior local doctors have resigned and gone into private practice. These gaps among the more senior medical staff have thrown a great strain on the younger and less experienced doctors who find themselves in charge of large institutions and important sub-departments with insufficient experience to help them. Recruitment both locally and from the United Kingdom has been exceedingly poor during the year in spite of the recent salaries revision, and the work of the department would have come almost to a standstill had it not been for the large number of refugee doctors who have come to the rescue.

22. It seems likely that the department, which depends to a large extent on the medical staff available, will encounter more difficulties in the future unless the emoluments and conditions of service are improved sufficiently for the Medical Department to compete on more level terms with the National Health Service in the United Kingdom.

23. Annexure C shows the establishment of the department as it was on March 31st, 1950.

D. Legislation.

24. The following legislation affecting public health was enacted during the year 1949-50.

The Medical Registration Amendment Ordinance, No. 12

of 1949.

The Public Health (Sanitation) Amendment Ordinance, No.

23 of 1949.

The Registrar General of Births and Deaths (Change of

Style) Ordinance No. 26 of 1949.

The Registration of Dentists (Amendment) Ordinance No.

35 of 1949.

A.176 The Penicillin (and other Substances) (Amendment)

Regulations, 1949.

A.186 The Births and Deaths Registration Ordinance, 1984,

Amendment to the First Schedule.

A.187 The New Territories Regulations Ordinance, 1910

New Territories (Conservancy) Rules 1949.

A.188 New Territories Regulations Ordinance, 1910-

Amendment of rules.

A.190 New Territories Regulations Ordinance, 1910-Rules. A.193 The Nurses Registration (Amendment) Regulations,

1949.

A.214 The Births Registration (Special Registers) Ordin-

ance, 1947-New First Schedule.

A.215 The Deaths Registration (Special Registers) Ordin-

ance, 1947-New First Schedule.

A.226 The Public Health (Food) Ordinance, 1935-New

by laws.

A.237 Coroner's Abolition Ordinance, 1888-The Places

for Post Mortem Order, 1949.

A.260 The Public Health (Sanitation) Ordinance, 1935-

By-laws for Swimming Pools.

The Dogs and Cats Ordinance, No. 1 of 1950.

A.10 The Dogs and Cats Regulations, 1950,

A.34 The Dogs and Cats (Amendment) Order, 1950.

A.39 The Places for Post Mortem (Amendment) Order,

1950.

11. PUBLIC HEALTH.

General Remarks.

　　26. Once again the general health of the Colony was good. There were no major epidemics although during the winter there was rather more diphtheria than is usual.

　　26. No nutritional surveys were carried out during the year but the standard of nutrition remained good and the deaths attributable to nutritional diseases or deficiences again reached a low record.

27. Towards the latter part of the financial year there appeared to be a considerable increase in the number of refugees and others arriving in the Colony which further aggravated the already desperate housing problem.

28. Owing to great pressure of work in connection with the registration of persons in the Colony the Government Statistician was unable to analyse the information obtained by the medico-social survey referred to in my last annual report.

29. In August and September and again in December and January 1950 there was a small outbreak of acute enteritis of infants on the ground floor of the maternity block of the Kowloon Hospital. In the first outbreak there were 43 cases and 4 deaths and in the second outbreak there were 28 cases and no deaths. This institution, like all other medical depart- ment institutions and particularly those concerned with maternity work, was grossly overcrowded. No organism was identified as being responsible.

III. VITAL STATISTICS.

A. Population.

30. In previous reports two population estimates have been given, one published by the Department of Statistics and one based on other sources of information. In recent years these two estimates have differed more and more widely and it is proposed throughout this report to accept the population estimate published by the Government Statistician and base vital statistics on that figure.

31. Unfortunately the proposed census has been further postponed, partly on account of the time occupied by the registration of persons and partly because, owing to conditions outside the Colony, the population is unstable and this would render any census of doubtful value for statistical purposes a very short time after it was completed.

32. Medical Department statistics, such as the number of births, the number of deaths from cancer, intra-cranial vascular lesions and cardiac lesions, all suggest there has been a consider- able increase in the population since 1947 and that an estimate of 1,857,000 for the mid year population for 1949 may well be on the low side; on the other hand a death rate of 8.8 per mille which this population estimate would give must necessarily be accepted with very considerable reserve. Registration of births and deaths is very complete in Hong Kong and approaches the 100% mark, and with the exception of a small number of deaths occurring in the more outlying places in the New Territories, the causes of death are certified by a doctor.

-7-

33. In those outlying places deaths are recorded at the nearest Police Station as being from natural causes or other- wise following an investigation by the Police. Those deaths recorded as being from natural causes amount to 6.7% of the total deaths recorded in the Colony.

　　34. Table 1 gives the population figures from 1920-1949 excluding the period of occupation by the Japanese.

Year

TABLE I.

Estimated Population.

(1) Estimated Population

1920 1921

ILI

648,150

625,116

1922

}

638,300

1923

IL J

667,900

1924

+or

гг.

FIT

695,500

1925

725,100

1926

тгг

...

TII

710,100

1927

1+1

гг.

ITI

---

1928

TII

---

740,300 766,700

1929

...

1930

· · I

802,900

838,800

1931

840,478

1932

IL J

+ L

900,812

1933

гт .

922,643

1934

944,492

1935

1936 1937

- 1 г

.гт

966,341

988,190

1938

---

1939

1940

---

1941

---

· L ·

---

· + ·

• ++

1942-1944

1945 (September)

1946

1947

1948

1949

(1)

1,281,982

1,478,619 1,750,256

1,821,893

1,639,357

Not available

(Japanese Occupation)

Under 600,000

1,500,000

1,600,000

1,750,000

1,800,000

1,857,000

Official estimate published by the Department of Statistics in Government Gazette, Supplement No. 4 of March 4th, 1949.

B. Births.

35. Table 2 shows the number of births recorded and the birth rate per mille according to the population estimates from 1934 when the present Births and Deaths Registration Ordinance was introduced.

No. of Births

Year

Registered

TABLE 2.

Number of Births recorded.

Birth rate using estimated population.

1934

20,886

22.11

1935

25,037

25. 9

1936

27,383

27. 8

1937

+++++

32,303

25.19

1938

++++

85,893

24. 3

1939

46,675

26. 7

1940

45,064

24.73

1941

45,000

27.44

1942

10,343

Not available

(Japanese occupation)

1943

20,732

1944

13,687

1945

3,712

1946

31,098

20. 1

1947

42,473

24. 3

1948

47,475

26. 4

1949

54,774

29. 5

36. In addition to these births 302 post-registered births were recorded.

37. Legislation was introduced in December 1947 to permit re-registration of births recorded in the registers which were destroyed or lost during the Japanese occupation. A total of 381 births were registered under this Ordinance.

38.

　The post-registered and re-registered births are not included in the figure of 54,774 above.

C. Deaths.

39. Table 3 shows deaths registered and the death rate

per mille based on the estimated population.

TABLE 3.

Deaths registered.

No. of Deaths

Death rate using

estimated population

Year

Registered

1926

12,516

17.62

1927

14,761

19.93

1928

14,735

19.21

1929

17,565

21.89

1930

|IT 10

16,268

19. 4

1931

18,797

22.36

1932

19,829

24.74

1933

· +

18,161

22.11

1994

19,766

20.93

1935

22,133

22.90

1936

26,356

26.60

1937

L+

34,635

1938

38,818

26.25

1939

48,283

27. 6

1940

++++

61,010

33.48

1941

61,324

1942

83,435

37. 4

Not available

(Japanese Occupation)

1943

40,117

1944

· +

24,936

1945

23,098

1946

16,653

10. 7

1947

13,231

7. 6

1948 1949

13,434

7. 5

16,287

8. 8

　　40. As in 1947 and 1948 some comment is needed on the very low death rate recorded. As stated above these figures must be accepted with very considerable reserve but the only doubtful factor is that of the population figure, and all other evidence suggests that this population figure errs, if anything, on the low side.

41. It becomes necessary, therefore, to look for some explanation of the remarkably low death rate and the explana- tion lies most probably in the age distribution of the population. Here again no accurate figures are available but the majority of the people who have come to Hong Kong since the reoccupation have come here to obtain work and it is reasonable to assume that they belong to the younger age groups. This explanation is supported by the fact that the number of births recorded during the year was very nearly four times the number of deaths,

42. In December 1947 legislation was introduced to permit re-registration of deaths recorded in the lost registers as was done in the case of births and 18 deaths were registered under this Ordinance.

43. The post-registered deaths for 1949 amounted to 33. These post-registered and re-registered deaths are not included in the figure 16,287 above.

44. The graph in Annexure D shows a comparison between the deaths at different ages and the age distribution found in the censuses of 1921 and 1931.

45.

D. Infant Mortality.

　Table 4 shows the number of infant deaths per thousand live births for the years 1928 to 1949.

TABLE 4.

Infant Mortality.

Infant Mortality Rate

458

Year

1928

1929

662. 9

1930

557. 5

- 1

...

1931

617.42

1932

525.28

1933

454.89

1934

347.34

1935

316.36

1936

372.42

1937

376

1938

343

1939

345

1940

327

1941

1942 to 1945

1946

1947

1948

1949

46.

Not available

Not available (Japanese occupation)

89. 1

102. 8

91. 1

99. 4

The infant mortality rate for 1949 was slightly higher

than that of 1948 but is very considerably lower than the rates recorded before the war.

11.

47. Once again the infants under one year provided almost exactly one third of the total deaths occurring in the Colony during the year.

　　48. There was a higher death rate among female infants, the figure being 104.7, than among male infants where the rate was 94.5. On the other hand there were 28,583 males born as compared with 26,236 females.

49. In Annexure E are graphs showing the number of births each month for the years 1947, 1948 and 1949. From this it will be seen that there is a definite seasonal incidence, the number of births falling each year around about the Chinese New Year that is the February-March period and rising to a peak in the Autumn.

　　50. Table 5 shows the infant and neo-natal deaths and also the neo-natal death rate per thousand live births for the years 1946 to 1949.

TABLE 5.

Neo-natal Mortality rate.

Age period

1946

1947

1948

1949

0-1 day

174

273

221

219

1-7 days

264

376

467

454

1-4 weeks

563

814

745

936

4 weeks-3 months

771

981

900

1136

3-6 months

462

750

665

925

6-9 months

367

731

776

986

9-12 months

169

421

551

788

Total under 1 year ......

2770

4346

4324

5444

Infant Mortality rate..

89.1

102.3

91.1

99.4

No. of deaths under

four weeks

1001

1463

1433

1609

Neo-natal Mortality

tate

32.2

34.4

30.2

29.4

51.

There has been a further drop in the neo-natal mor-

tality rate to 29.4 which is the lowest recorded since the war. Pre-war figures are not available.

E. Maternal Mortality.

52. Table 6 shows the maternal mortality rate for the years 1946 to 1949 with the death rate per thousand live and still births.

TABLE 6.

Maternal Mortality 1946 to 1949.

Deaths, and Rates per 1,000 live and still-births, ascribed to (a) Pregnancy and Childbearing,

excluding Abortion (b) Abortion (Including criminal),

Total

Live

Live Still

Pre- gnancy and Child- bearing

† Abortion

Maternal Mortality Rate

Year

and

Births Birth

Sun Birthe

No. of Deatha

Rate

per

1,000

No. of Deathe

Hate

PET

Bate

Birthe

1,000 Births

No. of Deaths

per 1.000 Births

1946

81,098 685 31,783

1.01

0.22

1.23

1947

142,473 1,348 | 43,821

1.55

0.07 71

1.62

1948

A+PETIT

47,475 1,251 48,726

1.25 7

0.14 72

1.47

1949 ....................... 54,774; 1,321 58,095

113

2.01

0.11 119

2.12

For 1946-1948, Nos. 142-150 of International List of Causes of Death.

For 1949, Nos. 640-649 and Nos. 660-689 of International Statistical Classification of Diseases, Injuries and Causes of Death.

+ For 1946-1948, Nos. 140-141 of International List of Causes of

Death.

For 1949, Nos. 650-652 of International Statistical Classification of Diseases, Injuries and Causes of Death,

53. The rise in the maternal mortality rate in 1949 was disappointing but an analysis of the causes of death shows that there is no reason to believe that the rise was due to defects in the maternity service, the increase being accounted for en- tirely by the greater number of deaths from toxaemias of pre-

gnancy.

54. Throughout the Colony there were reports of a great increase in the severity in the toxaemias of pregnancy but no satisfactory explanation for this has been found. It had pre- viously been assumed that such an increase in severity was associated with nutritional deficiency but there is no evidence

to suggest any appreciable change in the nutritional standard for 1949 as compared with 1946 to 1948, in fact what evidence there is suggests improvement rather than the reverse.

55. Table 7 sets out below the figures of deaths from toxaemias of pregnancy with the rate per thousand total births for the years 1946 to 1949.

TABLE 7.

Deaths from Toxaemias of Pregnancy,

1946

1947

1948

1949

Deaths from

Total Birth Total Birth

Death rate

toxaemias of

(including

per 1000

pregnancy.

stillbirth.)

31,783

0.3

43,821

0.3

48,726

0.3

T☐

56,095

0.9

56.

Table 8 sets out the figures for the causes of death ascribed to pregnancy and child birth, excluding abortions, for the years 1946 to 1949.

TABLE &.

Causes of death ascribed to Pregnancy and Childbirth.

Interna-

tional

No.

Causes of Death

1946 1947 1948

1949

640 Pyelitis and pyelonephritis of pregnancy

642

Toxaemia of pregnancy

-----+

15 15

643 Placenta praevia

644

Other haemorrhage of pregnancy

645

Ectopic pregnancy......

४ 16

646

Annemia of pregnancy

643

Other complications arising from pre-|

gnancy

670

Delivery complicated by placenta praevia

or antepartum haemorrhage

671

Delivery complicated by retained

placenta

123

Causes of death ascribed to Pregnancy and Childbirth.-Contd.

Interna-

tional

Causes of Death

1946

1947!:

1947 1948

1940

No.

672

Delivery complicated by other post-

partum haemorrhage

IT-1-1

17 13

673

Delivery complicated by abnormality of

bony pelvis

674

Delivery complicated by disproportion or

malposition of foetus

673

Delivery complicated by prolonged labour

or other origin

678

Delivery with other complications of

childbirth

681

685 Puerperal eclampsia

Sepsis of childbirth and the puerperium

680

Other forms of puerperal toxaemia

Total

68 65

113

Principal Causes of Death.

57. Table 9 shows the pincipal causes of death for the years 1946 to 1949.

TABLE 9.

Causes of death (Classified by 1938 Revision of International List)

Smallpox

Cerebrospinal fever

Beri beri

Diphtheria

Malaria

Tuberculosis of respiratory system

Other forms of tuberculosis

Syphilitic diseases

Number of Deaths

1946

1947

1948

1949

1,306

129

137

1,318

312

140

100

765

253

193

116

1,475

1,420

1.443

1,712

943

443

518

899

100

TABLE 9.-Contd.

Causes of death (Classified by 1938

Revision of International List)

Number of Deaths

1946

1947

1948

1949

Influenza

243

Cancer, Malignant disease

277

304

397

513

Intracranial lesions of vascular origin

189

234

276

204

Other diseases of nervous system and

sense organs

133

180

Diseases of the heart

379

514

672

620

Other diseases of circulatory system

122

TIL

Bronchitis

839

529

419

611

Pneumonia (all forms)

4,129

3,464

3,157

4,391

Other diseases of respiratory system

197

139

125

105

---

Enteritis and diarrhoea

1,285 1,179

1,757

2,268

Other diseases of digestive system

3371 361

318

454

Non-venereal diseases of genito-urinary

system

226

041

350

343

Premature births, congenital malforma-]

tions and diseases of early infancy...

982

1,289 1,214

1,204

Other defined diseases

786

445

617

690

Old age, senility

142

101

113

----------------■

Violence (Accidents, suicide, homicide,

etc.)

631

686

781

620

Ill-defined causes

489

522

803

846

Total

16,653 13,231 13,434 16,287

58. The principal features are the steady decrease in beri beri and malaria as causes of death. This decrease is more real than apparent because at the same time there has been an increase in the number of persons at risk.

　　59. This increase of the population is shown by the steady increase in deaths from malignant disease, intra-cranial lesions of vascular origin and diseases of the heart.

60. There has been a real increase in the deaths from tuberculosis other than of the respiratory system,

61. The decrease in the number of deaths due to violence is of interest. In view of the fact that there are approximately 32 motor cars per mile of road in the Colony and also taking into consideration the disturbed state across the border with the large influx of refugees, both good and bad characters, this figure of 620 is astonishing and is the lowest recorded since the war.

62. Annexure F. shows the number of cases of notifiable disease with the deaths at all ages for the years 1946 to 1949, also the age groups of diseases notified for 1949 and the notifica- tions, deaths and deaths per 100 notifications for cerebro-spinal meningitis, measles, diphtheria, enteric fever and smallpox since 1928.

(a) Rabies.

63. The outstanding feature of the notifiable diseases was the outbreak of rabies. The first human case occurred in January but the dog was not traced. This was followed by a second human case in April and two further cases in July. In the meantime by the end of June nine animal cases had been proved, five of them occurring in May. At this time 329 people had already received injections or were in the course of having them. In August four human cases were reported followed by four more in September, two in October and five in November. One case only occurred in December and two cases in the first quarter of 1950, but hopes that the disease was dying out were dispelled subsequently by fresh cases occurring. Altogether during 1949 there were 20 human cases and 40 animal cases, the majority of them occurring in the neighbourhood of Kowloon City, 5,335 people received a course of Injections during the year.

64. In January 1950 the Dogs and Cats Ordinance became law making the inoculation of dogs, inter alia, compulsory.

65. Every effort was made particularly during the summer and autumn to impress upon the public the importance of controlling dogs and of the necessity for the shooting and capture of stray dogs. As the number of deaths for both animals and humans rose the public gradually became conscious of the urgency of co-operating and by the autumn there was a considerable improvement, but with the decrease in the deaths notified at the end of the year a general laxness in the control of dogs again became apparent and further efforts will un- doubtedly be needed in 1950 before the disease is under control.

(b) Tuberculosis.

　　66. Once again tuberculosis (all forms) provided the second largest number of deaths for any single disease for all ages and was the chief cause of death among adults. A report on the tuberculosis service is given in Annexure C.

67. Pneumonia again claims

　　　　　　　　　　　　　　claims the greatest number of deaths. The figure 4,391 represents a very considerable increase from the 1948 figure of 3,157. 1,786 of these deaths occurred in children under one year.

(d) Enteritis.

68. This disease has shown a steady increase as a cause of death since 1947 and of the 2,268 deaths from it in 1949, 1,273 were in children under 1 year.

(e) Malignant Diseases.

69.

Table 10 shows the number of deaths and the death rate per million from malignant diseases as a whole for the years 1946 to 1949.

TABLE 10.

Malignant Diseases for the years 1946-1949.

Number of Deaths

Death rate per million

Year

Estimated Population

1946

1,500,000

114

163

277

13.5

105.2

178.7

-1,600,000

1947

1,750,000

126

178

304

101.7 173.7

1948

1,800,000

169

228

397 93.9 126.7 220.6

1949

1,857,000

269

244 513 144.9 131.4 276.3

70. Table 11 shows the number of deaths and the death rate per thousand total deaths from malignant diseases accord- ing to site and sex for the year 1949. Owing to the change in nomenclature in 1949 to conform to the new international statistical classification, it is not possible to compare these figures with those given for previous years.

TABLE 11.

Death rate from Malignant Disease according to site

and sex for the year 1949.

Site

No of Deaths Registered

No. per 1,000 Total Cancer Deaths.

Male Female

140. Malignant neoplasm of lip

141. Malignant neoplasm of tongue

142. Malignant neoplasm of salivary

gland

143. Malignant neoplasm of floor of

mouth

146.

Malignant neoplasm of Laso- pharynx

127

147.

Malignant neoplasm of pharynx

of hypo-

219

152

+++

148. Malignant neoplasm of pharynx,

unspecified

150. Malignant neoplasm of oesophagus

151. Malignant neoplasm of stomach

152.

Malignant neoplasm of small intestine, including duodenum

153. Malignant neoplasm of large

intestine, except rectum

IT-T--++

154. Malignant neoplasm of rectum

155.

Malignant neoplasm of biliary passages and of liver (stated to be primary site)

156. Malignant neoplasm of liver

(secondary and unspecified)

४

130

+++

157. Malignant neoplasm of pancreas...

158. Malignant neoplasm of peritoneum

159.

Malignant neoplasm of unspecified digestive organs

JIL

160. Malignant neoplasm of nose, nasal cavities middle ear, and accessory sinuses

161. Malignant neoplasm of larynx

162. Malignant neoplasm of trachea, and of bronchus and lung specified as primary

།

---

Site

163. Malignant neoplasm of lung and. bronchus unspecified as to whether primary or secondary

No. of Deaths

Registered

No. per 1,000 Total Cancer Deaths.

Male Female Male | Female

164. Malignant neoplasm of medias-

tinum

165. Malignant neoplasm of thoracic

organs (secondary)

170. Malignant neoplasm of breast......

171. Malignant neoplasm

of cervix

uteri

185

172. Malignant neoplasm of

of corpus

uteri

173. Malignant neoplasm of other parts of uterus, including chorionepithe- lioma

+++

174. Malignant neoplasm of uterus, un-

specified

176. Malignant neoplasm of ovary

Fallopian tube, and broad ligament

177. Malignant neoplasm of prostate

178. Malignant neoplasm of testis

179. Malignant neoplasm of other and unspecified male genital organs ...

180. Malignant neoplasm of kidney

181. Malignant neoplasm of bladder]

and other urinary organs

Malignant melanoma of skin

---

190.

192. Malignant neoplasm of eye

193. Malignant neoplasm of brain and other parts of nervous system...

194. Malignant neoplasm of thyroid,

gland

196,

Malignant neoplasm of bone (in- cluding jaw bone)

197 Malignant neoplasm of connective

tisguze

199. Malignant neoplasm of other and

unspecified sites

All Sites

269

244

1,000

(f) Measles.

71. Table 12 shows the notifications, deaths and deaths per hundred notifications for measles for the years 1946-1949. The high death rate is disappointing in view of the availability of antibioties and sulpha drugs. The explanation probably lies in the fact that cases are not brought to the notice of the doctor until far advanced with pneumonia or some other complication.

TABLE 12,

Notifications and Deaths from Measles.

Age Group

0 to 5 years

5 to 15 years 15 to 25 years

25 to 35 years 35 to 45 years

1946

1947

1948

1949

Noll- Deatha Noti- Deaths Not Deatha Not Deaths feations

fications

Restions

deztiona

135 20

Turduth

98 6

291 42

148

135

++++++

46 to 55 years

55 to 65 years

65 to 75 years

75 and over won

Unknown

Total

Deaths per 100

Notifications

317 26

160

190

458

-------

(g) Diphtheria.

72. There was a minor epidemic of diphtheria during the winter of 1949-1950 when between October 1st and March 31st 285 cases occurred with 61 deaths. The deaths per hundred notifications for the year 1949 was higher than in any year since the war.

(h) Dysentery.

78. The tendency for amoebic dysentery to be notified more frequently than bacillary dysentery which showed itself first in 1948 continued in 1949 and 153 cases with 10 deaths were recorded as against 115 cases with 8 deaths from bacillary

- 21

dysentery. There has been a considerable rise in the frequency of amoebic dysentry since 1946 when 76 cases were reported followed by 54 in 1947 and 118 in 1948. This spread of amoebic dysentery may well prove a very serious problem in the future owing to the custom, universal throughout China and well estab lished in the New Territories in Hong Kong, of using raw or practically raw nightsoil for fertilisation. Survival of amoebic cysts in such circumstances is almost inevitable and emphasises the urgency of completing the present experiments in the pro- duction of compost from local refuse and nightsoil.

(i) Enteric Fever.

74. Enteric fever again showed a rise in the number of notifications but there were no foci of infection detected.

(1) Smallpox.

75. 11 cases of smallpox were reported with 7 deaths. Of these 11 cases 5 had a history suggesting that the infection was acquired outside the Colony and 6 were the bodies of unknown infants picked up dead and believed to have been dumped by squatters.

IV. HYGIENE AND SANITATION.

(a) Organisation.

(i) General Measures.

　　　76. The urban health work is carried out under the following Ordinances:

1. Public Health (Sanitation) Ordinance.

Public Health (Food) Ordinance.

Adulterated Food & Drugs Ordinance.

Quarantine & Prevention of Disease Ordinance.

Public Health (Animals & Birds) Ordinance. Hawkers Ordinance.

77. To deal with this work Hong Kong, Kowloon and New Kowloon are divided into 5 Health Districts each with a Health Officer and a Senior Health Inspector. There are 3 districts in Hong Kong and 2 in Kowloon. Each district is then split up into sections under the care of a Health Inspec- tor. Liaison between these sections and areas and the Urban Council is made through a Chief Health Inspector and the Superintendent of Sanitary Services. There are 43 health districts in all 25 in Hong Kong and 18 in Kowloon and New Kowloon,

78. In addition to district duties, other health inspectors are employed on conservancy, refuse collection and disposal, control of hawkers, markets and slaughter houses, meat and food inspection and sampling, and cemeteries.

79. Rodent Control is under a specially appointed officer.

80. As from April 1st, 1949, the administration of the Health Inspectorate of the urban area came directly under the Chairman, Urban Council, whilst the inspectorate of the New Territories remained under the control of the Director of Medical Services.

(b) Sanitation.

81. The sanitation of the urban area is under the control of the Urban Council with a Chief Health Inspector in charge.

82. There are two systems of nightsoil removal in opera- tion by water carriage sewerage and by bucket conservancy. Bucket conservancy is forced on the Colony by factors such as old type of houses, water scarcity and flush restricted areas. Experiments conducted during the year showed that the maturing of nightsoil for four weeks did not destroy the ova of helminths but it probably did destroy bacteria of the enteric, dysenteric and cholera groups. Experiments on the production of compost are being undertaken with the object of eventually converting all available nightsoil and refuse in the Colony into compost.

83. These increased considerably in numbers and at the end of the year were probably double that of the estimated 60,000 at the end of 1948. Legislation introduced in 1948 made some improvement possible in the central part of the town but this resulted in driving squatters to the periphery and made hygiene and anti-malaria measures very difficult. During the latter part of the year attempts were made to establish squatter colonies on a tolerated basis with a better type of hut built to a pattern and with the introduction of lanes to obviate the fire risk. In October with the occupation of Canton by the Peking Government forces there started an influx of National- ist soldiers with their wives and families. The Tung Wah authorities cared for these people in some measure but the numbers were so great that they occupied the whole hospital grounds, the adjacent streets and the small building belonging to the hospital in the western area-the Yat Pit Ting, where again they overflowed into the streets. They presented a pitiful sight and a considerable problem in hygiene. Measures were

adopted to prevent typhus by spraying with anti-louse powder and they were inoculated against typhoid and vaccinated against smallpox. A considerable number were repatriated but new arrivals prevented any appreciable improvement in the situa tion.

(d) Water Supply.

　　84. The main water supply in the urban area is piped and of excellent quality. Many wells exist on the mainland and these provide a continual source of anxiety but are mapped out so that chlorination may be done at once in the case of epidemic bowel disease becoming a threat.

　　85. In February, 1950 water restrictions were imposed as consumption had rapidly risen and the rainfall was below normal.

(e) Rural Health.

86. The title refers to Public Health in the New Terri- tories including the islands of Lantao and Cheung Chau. A Medical Officer of Health was resident for some months of 1949, but on his departure on leave the Malariologist took over his duties. There are 5 Health Inspectors with a Senior Health Inspector in charge.

87. New legislation was passed in September 1949, giving greater powers for control of health matters.

　　88. There are eight Government Dispensaries giving free medical treatment to the villagers at Tai Po, Fanling, Sha Tau Kok, Un Long, San Hui, Sai Kung, Ping Chau and Tai (. Most of these Dispensaries have also a few beds for maternity cases. Midwives attend maternity cases in the villages as well. The medical needs of smaller villages which can be reached by road are attended by two travelling dispensaries. A launch carrying medical supplies makes frequent trips to the islands.

89. Developments following the civil war in China caused much extra work for the health staff of the New Territories and resulted in the arrival of large numbers of refugees who filled every available hut and hovel in the towns and villages. Towards the latter part of the year, as the result of bombing, considerable numbers of people flocked across the border during the day time for safety and returned to their own villages at nightfall. In October the through train service to Canton ceased and traders on both sides of the border crossed on foot either over the railway bridge or the bridge on the main road, and markets for the exchange of goods by these small traders sprang up in the principal towns in the New Territories and

added further to the congestion and further problems for the health staff. Vaccination centres were set up at the two bridges crossing the border river and all persons entering the Colony were vaccinated until machine gunning from aircraft on the Chinese side of the border with the risk of ricochets and stray bullets made these vaccination centres dangerous and the staff were withdrawn to the Kowloon Railway Station.

90. During the latter part of the year the Police Depart- ment operated "Village Penetration Patrols" which visited outlying villages, particularly on the islands which were not normally visited and found a great demand for medical treat- ment. An effort was made by the Medical Department to provide this service. Unfortunately owing to shortage of staff it was not possible to do more than provide simple drugs which could be given safely by a Police Inspector. It soon became clear that more than this was required and the doctors and nurses and other workers of St. John Ambulance Brigade came to the rescue and sent a party with each of these patrols.

91. This medical work proved more and more of a success as greater experience was obtained of the needs of the villagers and it is likely that it will became a permanent feature of the New Territories work, for which a debt of gratitude is owed to the St. John Ambulance Brigade whose workers do this in their spare time and without remuneration,

92. The construction of Luen Wo, a model market town, was nearly completed and occupation was started.

93. Owing to the anticipated difficulties in obtaining vegetables from beyond the border it was decided that every- thing must be done to increase the production in the New Territories and for this reason a calculated risk was taken and some hundred tons of nightsoil per day from the urban area was allowed to be distributed to the farmers in the New Terri-

tories for cultivation purposes. This started on the 15th December and up to the end of the period under review there has been a very satisfactory increase in vegetable production.

(ii)

Anti-epidemic.

94. This branch of the work is controlled from the central office and carried out by a central unit in co-operation with all branches of the department. The main work is devoted to the control of smallpox and cholera. Vaccinations against small- pox and inoculation against cholera, in the winter and summer respectively, is the basis of the work and is directed in the first place to the squatter community and later to the whole urban area and the New Territories.

95. Table 13 shows the number of vaccinations and in- oculations done each month,

TABLE 13.

The number of Inoculations and Vacinations

done during 1949.

Month 1949

Smallpox Anti-

Vaccinations

January

February

136,417

4,956

1,799

242

377

640

160,211 4.752 1,262

2,183

202

494

600

March

101,371

7,950

1,077

2,061

224

982

481

April

148,937 35,681

146

2,568

293

709

909

May

98,719 147,197

420

2,650

236

985

827

June

-------

60,981

06,424

678

2,867

129

920

800

July

kundeba

18.184

80,641

823

2,274

314

1,013

520

August

17,506

68,067

214 1,841

679

819

September

JILI

47,561

$6.937

2,136 3,284

570

1,169

061

October

CILJI

9,122

November

December

Total

120,009

165,462 8.629 1.644

230,904 8,924 1,921

1,386,264 512,210 13,052 26,073

2,216 1,701

2,418

801

660

1,287

766

821

794

1,452

213

644

602

765

$27 5,335

9,291 9,526

96. Rodent control forms an integral part of anti-epidemic work. The systematic destruction and control of rodents was carried out on the general principles laid down in "Infestation Control: "Rats & Mice", H.M.S.O. (1946), and adapted to the circumstances and conditions in the Colony. Block control was aimed at, using prebaiting and poison treatments followed by post-baiting to detect the presence of survivors. Minor infesta- tions were dealt with by trapping. Rats caught by trapping were chloroformed and examined for fleas which were counted and classified enabling information to be obtained on the prevailing flea index. The public is encouraged to put dead rats in public rat bins whence they are collected and sent to the mortuaries for examination. All rats were examined microscopically, and a percentage, including those showing abnormality, had spleen smears taken and microscopic examina- tion was made.

　　97. R. norvegicus was the more common type of rat found in the tenement houses and R. rattus more common in ships, but some were also found in tenement houses. Final disposal of all rats was by burial,

98. In addition the Health Inspectorate conducted routine activities such as the prevention of sale of cut fruit, shell fish or ice cream products made by unlicensed factories. There are also routine sampling of milk and ice cream. All food factories, restaurants and eating houses were inspected regularly.

99. Immunisation against diphtheria was carried out in school and infant welfare centres. Plans were laid to increase this service amongst infants and young children in 1950.

100. Government and Service Medical Officers still con- tinued to notify malaria cases thus providing some means of checking on the incidence and locality of such cases.

101, Services Medical Officers notified infective hepatitis by courtesy.

) Health Education.

102. This has now become a recognized branch of the Medical Department's activities. A regular programme is arranged to cover all parts of the Colony in rotation, including the New Territories. One of the principal methods used is a cinema van fitted with a generator, projector and public address system and with a screen so shaded that it can be used during the day time. Films produced by the Medical Depart ment and imported films are shown in this way and addresses are given on health matters which are of current importance. The education programme has been furthered with the assis- tance of Radio Hong Kong and the main cinemas, and to lesser extent by the issue of posters.

103. Spitting in the streets, which had improved con- siderably, had a set-back with the arrival of large numbers of refugees; but the anti-spitting talking film produced by one of the local film studios combined with anti-spitting posters has had a good effect.

104. The anti-spitting patrols were continued during the year with an Inspector doing this duty one day each week in the larger districts in the urban area. A Police van co-operated with the inspector and a policeman arrested any individual found spitting who was then put into the van and charged at the Police station of the district. Some offenders were allowed out on bail, usually of about $30; others were detained, having no money. In all 540 arrests were made in Hong Kong and 248 in Kowloon. By the end of the year the situation improved and it was decided to cease the patrols, but policemen were instructed to approach offenders and warn them.

105. No general health week was held during 1949 but in October a special effort was made in connection with children. This was called "Baby Week" but in fact lasted 3 weeks; each of the three principal Infant Welfare Centres held an exhibition covering one week. These exhibitions were supported liberally by press and radio and by Rediffusion. Among the principal visitors to the exhibitions were senior school children of whom 1,880 attended. Excluding children under 14 a total of 7,545 visits were paid. Talks and demonstrations were given by the nurses at the centres throughout the day for the whole period of the week and evidence of the success of this project has been shown be requests received subsequently from schools for in- struction on infant welfare work to be given by the nurses from these centres to the senior pupils.

106. A special effort at educating the public in connection with rabies was made in the autumn as it proved exceedingly difficult to make dog owners appreciate the seriousness of the situation produced by the rabies outbreak.

107. Two films were produced by the department during the year, the titles being "Family Health" and "Good Habits" also a film strip entitled "Healthy Family".

(iv) Port Health Work.

108. The activities of the Health Officer cover work at the Port of Victoria, the railway terminus and Kai Tak Airport,

　　　109. The staff of the Port Health Office consists of a Port Health Officer, a Second Port Health Officer and Seven Assistant Port Health Officers.

110. Further work was done on the plans for the quaran- tine station at the old Rennie's Mill site at Junk Bay. Estimates and plans were obtained from Singapore and the Philippine Islands for comparison and the scheme was brought to the stage where financial approval was needed before further work could be done.

111. During the year 13,707 ships and junks with 592,186 passengers and 584,102 crew were examined at the quarantine anchorages. 11 cases of infectious disease, 8 of chicken pox and three of measles, were removed and one ship, S.S. Ninghai from Bangkok, a cholera-infected port, was held in quarantine for 24 hours as a result of a suspected case of cholera,

112. 42,297 emigrants and 20,200 crew from 164 emigrant ships were examined with eight rejects. 179 ships totalling 273,871 net tons were fumigated and 1,948 rats were recovered. Either sulpher or cyanide fumigation was used. 151 exemp- tions were granted.

113. There was a further increase in the number of bills of health issued, the total reaching 3,062 of which 3,011 were issued to merchant ships, forty-nine to H.M. ships and two to aircraft. Fifty-six Radio Pratiques were issued. 110 ships were examined from plague-infected ports.

114. Inspection of passengers arriving by train from Canton was carried out during the following periods.

8. 1.49 to 22. 6.49 (at terminus Station).

15. 8.49 to 15.10.49

14.11.49 to 18.12.49

20.12.49 to 31.12.49 (At Lo Wu Station).

115. The total of 696,237 passengers were seen and of these 398,890 were vaccinated. 16 cases of chicken-pox, five of measles and two of leprosy were discovered and isolated; five dogs were also found and handed over to the Police.

116. Through trains to Canton ceased on 14th October 1949. On an average each train brought in approximately 700 pas- sengers and the examination and vaccination, where necessary, of these passengers presented a big administrative problem if long delays were to be avoided. It was due to the voluntary co-operation of the workers of the St. John Ambulance Brigade, who are trained and gazetted as public vaccinators, that it was possible to clear a trainload of passengers in an average time of half-an-hour,

117. 4,377 aircraft from infected ports were inspected with 70,950 passengers and 19,900 crew. 1,041 yellow fever inocu- lations were carried out by the Port Health Officer.

118. There was an increase in the fees charged for vaccina- tion and inoculation certificates from fifty cents to two dollars from the 1st December and the stamp duty on bills of health was increased from $6, to $10. on the 10th December 1949.

119. On 22nd March 1950, Dr. P. H. Teng, Senior Port Health Officer departed for the United Kingdom to study port Health administration in the United Kingdom and if possible in the United States of America and to discuss mutual problems with the port health authorities in these countries.

(v) School Hygiene.

120. The staff of the School Hygiene Branch consists of one medical officer in charge, four assistant medical officers, one nursing sister, four nurses, two health inspectors and clerica! staff. In addition to this full time staff there is a part-time staff consisting of two ophthalmic surgeons and an ear nose and throat surgeon.

　　　121. During the year there were 28,536 medical examina- tions of pupils. Medical inspections were carried out twice a year in the school premises.

122. The pupils inspected included the following groups: -

(1) All new entrants.

(2) Periodicals, ie. old pupils falling under the age

groups of 5, 10, 12, 15 and 18.

(3) Re-examinations, ie. all children placed under observation in the previous examinations, those referred by their teachers for special examina- tions and those due for annual examination of vision and teeth.

　　　123. The schools visited may be classified under the fol- lowing groups: -

(A) Five Government Schools with a total number of 868 students. Most of the pupils in these schools were European. The total number of medical inspections undertaken during the year was 1,323.

(B) Twenty-six Government Schools with a total number of 7,795 students. Most of the pupils in these schools were Chinese. The total number of medical inspec- tions undertaken during the year was 10,950.

(C) Sixty-nine Subsidized Schools with a total number of 12,580 students. Most of the pupils in these schools were Chinese. The total number of medical inspec- tions undertaken during the year was 16,263. 11 of these schools (all Workers' Children's Schools) with a total enrolment of 844 pupils were closed after the summer vacation.

　　　124. The number of medical inspections undertaken in these schools, with the results, are shown in Annexure H.

125. It will be noted that dental caries, conjuctivitis, defec- tive vision and worm infections were the most common defects found amongst pupils attending all types of schools. Anaemia,

malnutrition, cheilitis, trachoma, otorrhoea and enlarged tonsils were found only amongst pupils attending B and C types of schools.

126. The percentage of children found with no apparent defects rose from 21.68% in 1948 to 37.14% in 1949.

127. General school clinics are held in three centres:- the Harcourt Health Centre, the Ellis Kadoorie school building, and the Kowloon Hospital out-patient department. Special eye clinics, dental clinics and ear nose and throat clinics were held in the Harcourt Health Centre and Kowloon Hospital out-patient department.

128. Pupils requiring surgical attention could go to the Kowloon and Queen Mary Hospitals and all cases of suspected pulmonary tuberculosis were referred to the Tuberculosis Clinic at the Harcourt Health Centre.

129. In October, 1949, an orthoptic clinic was started which ran until January 1950 when the orthoptist who gave her services voluntarily left the Colony. There were 15 cases of strabismus treated out of a total of 19 discovered.

130. Attendances at the school clinics were as follows:

General School Clinic.

8,719 1,268 5,562

5,881

Eye Dental E.N.T. Orthoptic Clinics Clinics Clinics Clinic.

389

766 1,742

463

New cases Revisits

----ITI

Total

14,600 2,034 7,304

131. The optical workshop supplied 1,072 pairs of spec- tacles to pupils during the year.

132. Fifty visits were made by school nurses to the homes of school children who were in serious need of medical attention but whose attendance at the clinics had been unsatisfactory.

133. During the year 2,031 inspections of school premises were carried out as follows:

Government (New)

New applications: Day Schools New applications: Night Schools

Applications for extension

Re-inspections

Application for relaxation of health

requirements in schools

1,633

201

2,031

134. Of the premises inspected four were refused in their entirety and one in part as being unsuitable for use as school premises. The results of the inspection of school buildings are shown in Annexure H(2).

185. At the present time while all school buildings are inspected by the Schools Health Service only some 17,000 children out of a total of approximately 140,000 attending school are included in the service.

136.

　　　　　　Plans are being laid and negotiations started with the school managers to extend the school service in batches of 20,000 children until ultimately all children are included. The cost of the scheme is estimated at an average of $15 per child, which would include all medical attention, in-patient and out- patient, dental attention including conservative work for the second dentition, and the provision of spectacles were needed.

　　　137. It is too early yet to say what the reaction will be but it is likely that while the school managers will support it many of the parents will not, for a variety of reasons.

(vi)

Nutrition.

　　　138. In the last two years the standard of nutrition in the Colony was good with little evidence of undernourishment or malnutrition.

139. No surveys were carried out during the year.

　　　140. Deaths from beri-beri during the year, mostly re- ported from the public mortuaries, numbered 100 as compared with 140 last year and 312 in 1947. In 1940, when there was a similarly large influx of refugees into the Colony, the number of deaths from beri-beri amounted to 7,289 and it is not easy to say why the standard of nutrition of the present lot of refugees should be so much higher.

141. Throughout the year the rationed quantity of rice has averaged approximately 143 catties per month per person. The price of average grades remained at 54 cents per catty, but

lower grades were sold at 45 cents and 48 cents per catty and higher grades at 60 cents per catty. Rice was also available on the free market at prices very little higher than the price of rationed rice.

142. It seems possible that as results of shortage of rice during the war and post-war period there has been some change in the Chinese food pattern resulting in a greater variety of diet and this may possibly account for the very small amount of malnutrition to be seen at the present time.

(vii) Social Hygiene.

143. In February 1950, Dr. J. A. R. Selby, Senior Social Hygiene Officer went on leave prior to retirement when Dr. K. L. Cheung took over his duties.

144. The Senior Social Hygiene officer has a staff of 5 doctors to assist him, 1 technical assistant, 8 dressers and 17

nurses.

145. There are five Government clinics:-Queen's Road West, (male and female), Wanchat (female), and the Harcourt Health Centre (male) on the Island, and in Kowloon one at Ashley Road (male) and one at Tsimshatsui Health Centre (female). In addition to these centres, there is a small hospital at the Wanchai Social Hygiene centre which has 16 beds for women and four cots. There are also six male beds and two female beds in the Queen Mary Hospital. Attendances at these clinics are shown in Table 14.

TABLE 14.

Attendances at Social Hygiene Clinics.

Male

Female

Total

Clinic

New Old

Queen's Road West, 1,470 23,475

Wanchai

Tsim Sha Tsui

2,819

WIL

3,111

1,020 21,391

28,283 1,897 23,658

25,734 2,208 27,538

2,490 44,866

4,716 51,941

5,319

53,272

Total

7,400

77,492

5,125 72,587

12,525 150,079

146. Home visits were paid by the nurses attached to the clinics where attendance for treatment was irregular and efforts were made to persuade the patients to attend more regularly.

　　147. At the Wanchai Social Hygiene Hospital 681 cases were treated as compared to 623 in 1948. This included 45 cases of congenital syphilis. This hospital was used primarily for a rapid sterilisation of patients.

　　148. A total of 286 cases of congenital syphilis were treated at the various clinics as compared with 149 in 1948.

-MATERNITY AND CHILD WELFARE.

(a) Centres.

149. In addition to the three main maternity and child wel- fare centres, one at Tsim Tsa Tsui in Kowloon and one each at the Harcourt and Western Health Centres on the Island, three small subsidiary teaching centres were opened on June 1st, one at Shaukiwan on the extreme eastern end of the urban area of the Island, one at Stanley on the south side of the Island and one at Aberdeen, an important fishing centre also on the south side of the Island.

150. At both the main and subsidiary centres the emphasis is laid upon the instruction of mothers and classes are held showing films, lantern slides and demonstrations of all kinds, the endeavour being to select the more intelligent mothers for this purpose so that they may spread their knowledge among their friends. Table 15 and 16 show the attendance at the main and subsidiary centres.

TABLE 15.

Attendances at Main Infant Welfare Clinics.

New

Revisits

Total

Harcourt Centre

2,136

25,808

28,034

Kowloon Centre.....

2,804

28,034

30,838

Western Centre

■IITI

2,135

29,906

32,041

Total

7,075

83,838

90,913

TABLE 16.

Attendances at Infant Welfare Teaching Centres.

NEW

REVISITS

Under

Over

Under

Over

Grand Total

Total

1 year 1 year

Í year

1 year

Clinics held.

No. of

No.of Home

violka.

Shaukiwan..

389

436

1,112

357

1,469

1,905) 31) 204

Stanley

149

178

515

168

683

861

■

27 157

Aberdeen ... 166

179

558

135

693

872 16 162

Total

694

-----

793 2,185 660 2,846 8,638

74 553

151. Reference has already been made in the section on Health Education to the Healthy Baby Weeks held at each of the three main centres.

152. 5,724 domiciliary visits were paid by the nurses.

153. The distribution of milk provided by UNICEF amounted to 15,064 lbs.

154. The number of ante-natal attendances at the three centres was as follows:-Western 1,026, Kowloon 1,224, Har- court 774.

155. Of a total of 90,913 babies attending the centres 42,891 were classified as healthy, details are shown in Table 17.

TABLE 17.

State of Health of Attendances at Infant Welfare Clintes.

Under

NEW

Over

REVISITA

Under

Over

Western Infant

Welfare Centre

Kowloon Infant

Welfare Centre

Harcourt Infant

Welfare Centre

Total

---

one FEAT

ONE YEST

Healthy

Unhealthy

Healthy

¡Unhealthy

Total

Healthy

Unhealthy

Healthy

Unhealthy

Grand Total

Total

1,376

700

9,135 18,016 8,786 | 3,845 |(4,879 | 99,906

32,041

604 1,928 虹 141

5,504 | 12,498 | 8,440 | 4,592 | 5,500 | 79,004

30,836

I LI

189

1,846

102

2,186) 5,506 | 18,495 1,080 | 4,717 | 25,808

29.094

9,962 | 1486 87 301 1,076 31,148 38,671 5,457 9,505 63,098

90,919

(b) Government Maternity Hospitals and Homes.

　　156. There are two Government Maternity Hospitals, the Tsan Yuk Hospital with 75 beds and the Eastern Maternity Hospital with 24 beds. In addition maternity cases are admitted to special wards at Queen Mary Hospital and St. John Hospital, Cheung Chau, and to a separate block at Kowloon Hospital making a total of 189 beds available for maternity cases.

157. Besides these hospitals 18 midwives were employed in 14 districts, in 8 of which there was a small maternity home attached. The total number of domiciliary cases treated in the maternity homes totalled 2,013 making 4,265 cases treated in 1949 as compared with 3,336 in 1948.

158. A detailed report on the work done at the Tsan Yuk Maternity Hospital is given in annexure I by Professor Gordon King, Consultant to the Government and Professor of Obstetrics and Gynaecology in the University of Hong Kong.

159. 102 private maternity homes were registered in 1949 and table 18 shows details of size and situation.

TABLE 18.

Size and site of Private Maternity Homes.

Number of beds in each Home

JILI LJILJ

21 3 4 5 6 7 Total

Number of Homes in Hong Kong

Number of Homes in Kowloon

----

г гт г т т г-

2 11 15 19 31

16' 201 6 5

Grand Total

Number of beds

-------

254

2 | 27 35 25: 8 3 2

54 | 105 | 100 | 40 | 18 | 14 333

102

160. These private maternity homes were visited for inspection purposes by the Supervisor of Midwives who made 112 visits to the Government Maternity Homes and 959 visits to the private maternity homes.

161. 803 midwives were registered during 1949; of these 49 were new graduates. Only 198 of the midwives registered were in actual practice and regular inspections of their records and maternity outfits were made by the Supervisor of Midwives. Table 19 shows the number of births attended by doctors and midwives for the years 1946 to 1949.

TABLE 19.

Births attended by a doctor or midwife.

1946

1947

1948

1949

Queen Mary Hospital...

117

398

719

1,164

Kowloon Hospital

979

1,261

1,189

1,287

Tsan Yuk Hospital

2,645

8,826

4,458

4,223

Eastern Maternity

Home

868

1,633

1,831

1,783

J-L--|-

Private Hospitals

4,058

9,066

12,161

15,387

Govt. Dispensaries

(Attended by Mid-

wives)

640

1,260

1,582

2,013

Private Maternity

Homes

9,586

13,150

14,324

18,730

Total births delivered

in hospitals and

maternity homes

18,893

30,594

36,264

44,587

Domiciliary Cases

delivered by Mid-

wives

5,628

1,237

10,120

8,991

Total number of births

attended

24,521

39,831

48,384

53,578

Number of births un-

attended

·---- LII

6,577

2,642

1,091

1,196

Total number of births

31,098

42,473

47,475

54,774

78.9%

93.8%

97.7%

97.8%

Percentage of births

attended

162. The astonishing figure of 97.8% of all births attended either by the doctor or a midwife, one decimal point higher than in 1948, shows a remarkable appreciation of the services pro- vided from both private and Government sources. This state of affairs, in which practically every child comes under the care of a trained worker at birth, provides an administrative link with the infants born in the Colony by which it is hoped to encourage a far greater attendance at the infant welfare centres and which may be used in later projects for B.C.G. immunisa- tion of all infants born in the Colony.

163. The Supervisor of Midwives is also Secretary of the Midwives Board and gives the Board first hand information of the standard of work of the midwives and the conditions of their maternity homes, and so facilitates their control of the practice of midwifery in the Colony,

VI. HOSPITALS AND DISPENSARIES.

164. Annexure J gives a summary of the cases treated in the Government and Government assisted hospitals, clinics and dispensaries.

165. Annexure K shows cases treated at Government and Government-assisted hospitals and the total deaths in the Colony for 1949.

166. Owing to the great influx of people into the Colony during the year all hospital and out-patients' facilities were grossly overtaxed. Doctors, nurses and Dispensers were all working at a speed which made proper attention to each patient well-nigh impossible. These overworked and harassed officers had the ever present fear that working in such circum- stances there was a greatly increased risk of some serious mistake being made. The fact that no such serious mistakes were made during the year reflects very highly on their skill and patience.

(a) Queen Mary Hospitol.

　　167. This is the largest and most fully equipped hospital in the Colony containing normally 550 beds. In September additional beds were put up in the wards bringing the total to 576. This hospital provides not only a training centre for nurses, but is the hospital at which the medical students receive their clinical instruction, and approximately 200 beds are allotted to the University units for this purpose.

168. There is no general out-patient department at this hospital which is situated four miles out from the centre of the town but a large out-patient clinic held at Sai Ying Pun is directly linked with it and special clinics are held there and at the Violet Peel Polyclinic by the staff of the Queen Mary Hospital.

169. All admissions to the hospital pass through the hands of the almoners who assess their ability to paying fees and investigate their home conditions and give financial or other assistance where necessary. During the year 8,794 in-patients were treated as compared with 7,099 in 1948. Maternity cases total 1,233 as compared with 760 in 1948. There were 569 deaths, 200 of them occurring within 24 hours of admission. 4,459 operations were performed compared with 4,258 in 1948. 348 physical examinations were carried out in connection with appointments to the Government service or for confirmation to the permanent establishment.

(b) Kowloon Hospital.

170. This hospital is the emergency hospital for the main- land and contains 131 beds but owing to the pressure of work additional beds were put up bringing the total to 179. 80 beds at Lai Chi Kok hospital were also placed at the disposal of Kowloon Hospital.

171. During 1949 5,427 in-patients were trented as com- pared with 5,025 in 1948. There were 382 deaths of which 173 occurred within 24 hours of admission. 1,315 births took place in the maternity block as compared with 1,352 in 1948. This decrease was due to the fact that in part of July and August the ground floor of the maternity block was closed as a result of an outbreak of neo-natal enteritis.

172. 1,963 operations were performed as compared with 1,761 in 1948.

173. The work in the outpatient department increased so rapidly that it proved at times impossible for the staff to com- pete with the numbers. 94,009 new cases were treated as compared with 68,522 in 1948 and the total attendance during the year amounted to 150,830.

174. In April it became impossible to see all patients attending in the out-patient department and some were turned away. This immediately led to the formation of queues, which, in the course of a week or so began to form the night before and numbers of patients or substitutes waited all night, often in the rain, for the very brief consultation with the doctor the next day. In September four extra doctors were employed to help to deal with the crowds and by re-arranging duties addi- tional doctors were made available from the hospital staff in the afternoons. As a result all patients were seen and the queue disappeared, but by the end of the period under review a further influx of people had again increased the attendances beyond the facilities available and once again queueing all night had started. Plans had been made to deal with this possibility and are being put into operation.

175. An interesting indication of the magnitude of the problem being faced by the Kowloon Hospital staff is shown by two facts:-first, that as many prescriptions were made up in the first quarter of 1950 as in the whole of 1949, which was in fact a record year, and secondly that the daily attendance in March, 1950, if all patients had seen a doctor, would have enabled the 10 doctors working 7 hours a day to allot 24 minutes to each patient.

　　176. This hospital was built many years ago in sur- roundings which now are quite unsuitable as it has become a closely built-up area. The garden accommodation for patients. consists in what is little more than two large yards.

177. The hospital has accommodation for 123 patients. The daily normal average number for the year being 118.9 as compared with 95 last year. This means, of course, that there were many occasions when the hospital was grossly over- crowded. A total of 685

A total of 685 patients were treated as compared with 482 in 1948 and of these 461 were discharged home, 47 were transferred to Canton in the early part of the year, 27 were discharged to other hospitals, 20 died and 130 remained in at the end of the year.

178. Although the surroundings of the hospital are un- sightly modern methods of treatment were available such as electro-convulsive therapy, insulin shock therapy, modified insulin treatment, continuous narcosis and simple forms of occupational therapy. 10 prefrontal leucotomies were per- formed on chronic cases, 4 of which improved, three sufficiently well to be discharged, 3 died, two as a result of the operation, and three have showed no improvement.

179. In the first quarter of 1950 there was a rapid increase in the demands for admission to the hospital due to the fact that mental cases were being brought in from China where their relatives felt they might not be safe and at the end of March there were 154 patients. This threw a great strain on the resources of the hospital and seriously hampered effective treat- ment.

(d) Sai Ying Pun Hospital.

180. This hospital of 88 beds, capable of being increased to 150 in an emergency, is the infectious diseases hospital on the island. A total of 870 cases were treated as compared with 557 in 1948. Of this 162 died as compared with 88 in the previous year. Under the same administration, but not associated with the infectious diseases hospital, is the Sai Ying Pun out-patient department. 164,676 patients were treated as compared with 158,105 in 1948.

(e) Lai Chi Kok Hospital.

　　181. This hospital continued to operate in two sections, the lower section, consisting of 290 beds, being used as an infectious diseases hospital of 88 beds and a pulmonary tuberculosis hospital

with 202 beds. The upper section contains 180 beds for con- valescent cases, one ward of 26 beds was not brought into operation due to lack of equipment.

182. During the year a total of 2,370 cases were treated with 184 deaths. These cases were made up as follows:

General cases

Infectious diseases cases.

Tuberculosis cases

HOOL I

1,282

439

649

183. In 1948 only 339 tuberculosis cases were treated with the same accommodation and this was due to the fact that there was a large carry over of chronic cases which were transferred during 1949 to other more suitable accommodation.

(f) St. John Hospital-Cheung Chau.

184. This hospital was built before the war and was run by the St. John Ambulance Association, but as a result of financial difficulties following the Japanese occupation an agree- ment was reached by which the Government undertook to run the hospital.

185. It has accommodation for 76 patients including 31 beds for tuberculosis cases and 12 for maternity cases. A total of 1,089 in-patients were treated during the year as compared with 1,049 in the previous year. These were composed of 733 general cases, 77 tuberculosis cases, 266 maternity cases and 13 cases of infectious disease, with 13,933 attendances in the out-patient department as compared with 9,869 in 1948.

186. The tuberculosis cases admitted were convalescent cases needing no special medical treatment.

(g) Stanley Prison Hospital.

187. This hospital which is incorporated in the Prison, contains 3 wards of 16 beds each, and 6 isolation cells. There were 874 admissions with a daily average of prisoners in hospital of 52.8. 19,275 prisoners reported sick during the year. There were 21 deaths, of which two were due to judicial hanging.

188. An anklylostomiasis survey was carried out among prisoners and 2,000 specimens were examined. These showed anklylosteme ova to be present in 68% of prisoners examined. About 98% of prisoners who had been farmers in the New Territories were found to be positive. The floatation method of examination was adopted.

- 41

　　189. Connected with this survey an examination of 20 specimens of stool taken from different parts of the maturing tanks at Castle Peak showed anklylostome ova in every specimen.

(h) Tsan Yuk Hospital.

　　190. This is the largest maternity hospital in the Colony and contains 62 beds. A total of 5,506 patients were admitted with 11 maternal deaths. Annexure I gives a summary of the cases dealt with during the year.

(i) Eastern Maternity Hospital.

　　191. This hospital consists of 24 beds. During the year 1,852 cases were admitted with 1 death.

(1) Government Assisted Hospitals.

192. There are five of these hospitals which receive con- siderable grants from Government. Three of them, known as the Chinese Hospitals, comprise the Tung Wah Hospital with 467 beds, the Kwong Wah Hospital with 340 beds, and the Tung Wah Eastern Hospital with 230 beds. The other two assisted hospitals are the Nethersole & Affiliated Hospital under the ægis of the London Mission Society with 131 beds, and the Hong Kong Antituberculosis Association's Ruttonjee Sanatorium with 120 beds which was opened on the 24th February, 1949.

(k) The Chinese Hospitals.

193. These provide hospital treatment primarily for the poor but have a few private wards. The total number of cases treated in the three hospitals during the year was 33,793 and there was an out-patient attendance of 128,815,

194. Although the official bed accommodation for these three hospitals totalled 1,065 for most of the year the patients actually treated in these hospitals at any one time exceeded this figure by anything up to 250.

195. Experience has shown that newcomers to the Colony tend to settle, as squatters, in any hut, hovel or other shelter that they can find on the foothills surrounding Kowloon, Later when they find occupation or better quarters there is a tendency for them to infiltrate over to the Island and become scattered. As the result of this the hospitals in Kowloon have borne the brunt of any sudden flood of refugees.

196. In order to get some information on the numbers coming into the Colony records were kept from July until the end of October as to the length of stay in Hong Kong of cages admitted to the Kwong Wah Hospital and it was found that, on an average, one quarter of the patients had been resident less than one year in the Colony, but there were occasions when the proportion rose to as high as one third.

(1) Nethersole Hospital.

197. The Nethersole Hospital caters in the main for patients who can pay a very small amount towards their treat- ment.

198. A total of 4,634 in-patients were treated during the year, 1,414 of which were maternity cases. 80,341 out-patients were treated.

(m) The Ruttonjee Sanatorium.

199. The Ruttonjee Sanatorium, staffed by the St. Colum- ban Mission of Eire among whom are registered doctors, nurses and pharmacists, caters for tuberculosis cases only and all treat- ment is free. In general, early open cases are admitted and there is a close liaison between the Sanatorium doctors and the Government tuberculosis clinic at the Harcourt Centre, which makes selection of this type of case possible. 1949 was the first full year's working for this hospital and was a period of steady development. At the beginning of the year 60 beds were opened and these were increased until at the end of the first quarter of 1950 the full number of 120 beds were occupied.

200. 157 adult cases were admitted during the year and 94 children, making a total of 251. There were 9 deatha, all among children. There were 315 attendances in the follow-up clinic.

(n) Private Hospitals.

201. In Annexure L is shown the cases treated as in- patients and out-patients at the main private hospitals in the Colony.

(0) Violet Peel Polyclinic.

202. It was still not possible, owing to staff difficulties, to open the ophthalmic hospital on the upper floor of this clinic and it continued to operate solely as an out-patient 'polyclinie. There was a total of 99,482 attendances during the year which was its first full year of working.

- 43

(p) Chinese Public Dispensaries.

203. There are 8 public dispensaries in the urban areas. One of these the Western public dispensary was closed down on August 6th, 1949, and the accommodation made available to the adjacent Tsan Yuk Hospital. These dispensaries provide, primarily, an out-patient service, but in some cases there are a few maternity beds and in all cases there is a domiciliary maternity service. These dispensaries also form a base from which the anti-epidemic work for the area is operated.

204. In view of the high proportion of the total deaths occurring in children under one year and the finding of the committee appointed to enquire into this in 1948, that 98% of the children under one year of age who died had not seen a doctor for more than 24 hours before death, it was decided to devote the morning's work at each of these dispensaries to a sick children's clinic and to deal with the adults in the after- noons. A start was made in January and the attendances at these children's clinics which totalled approximately 3,000 in January reached a figure of 10,732 in December. Details show- ing the attendances in all out-patient clinies in Government institutions is shown in Annexure J.

Table 20 summarizes the work done at these public dispen- saries.

TABLE 20.

Attendances at Chinese Public Dispensaries.

Out-Patients

Deliveries

Public Dispensaries

Vacci+ Inocula nationa tione

New

Ca.a

Attend-

IA ¦ Domici-

patients

Hary

Central

Eastern

TH - - - - -

19,815

21,450 37,496

40,458

6,651

4,200

1,837

24,708

2,424

Western

7,387 12,075

3,538 8,375

Aberdeen

9,688. 19,104

286

2,860

198

Hungbom

19,180 30,443

4,204

957

Shaukiwan

LIIPI ·l■d

24,769 49,078

54!

4,301 1,811

Yaumati

NIHI

50,660 69,047

125

12,492

2,005

Shamshuipo

33,895 65,402

342

20,177 9,201

Stanley

$tau7 ཏ"ཏརཾསམཾཙམ*

1,229

6,361

177

1,152

586

Total

188,023 | 329,465

2,014

1,321

80,083 24,85,7

(p) New Territories Medical Centres & Maternity Homes,

205. There are 10 fixed medical centres operating in the New Territories together with two mobile units. The work of these fixed and mobile dispensaries is co-ordinated by an officer combining the functions of a medical officer and medical officer of health. Table 21 gives a summary of the work done by these units.

TABLE 21,

Medical Centres-New Territories.

Out-patients

Deliveries

Dispensaries

New Cases

Attendances In-patients Domiciliary

Taipo

Ho Tung

Shataukok

+un+dk++++++++++/

11,389

28,586

551

1,927

4,839

2,648

7,073

サウ

Un Long

Sun Hui

Sai Kung

14,202

33,349

570

112

1,822

3,823

147

3,449

6,547

Tai O

---- TIIT------

8,709

15,761

263

Silver Mine Bay

Ping Chau

434

553

ILIIIIL

1,552

2,971

Travelling (East)

------

2,689

6,314

(West)

1,980

3,192

Total

50,861

112,008

1,595

499

206. In October 1948 it was decided to organize the Ho Tung Dispensary to enable a small number of general in-patients to be admitted, primarily for members of the Police Force who would otherwise be "sick in quarters". 112 patients were treated during 1949.

207. The Ruttonjee Dispensary which was originally presented to the Government by Mr. J. H. Ruttonjee, C.B.E. was formally handed back to him in January 1949.

(q) Ambulance Service.

208. The Medical Department provides an ambulance service for all parts of the Colony for cases other than accidents and street emergencies which are dealt with by the Fire Brigade. This service is provided free of charge for all patients. The total mileage run by Medical Department transport during the year was 281,239 miles; of these 129,261 miles were run by the ambulance service.

209. There were 13 ambulances in use, 6 in Hong Kong, 5 in Kowloon and 2 in the New Territories. 6,021 patients were carried by the ambulances in Hong Kong and 15,120 in Kowloon.

(r) X-ray Department.

210. The transfer of the Royal Navy to their own hospital at the beginning of the year released a considerable amount of space in the X-ray Department and as a result the physiotherapy department at the Queen Mary Hospital was able to move back into its pre-war quarters. Table 22 gives a summary of the work done in the X-ray Department during 1949.

TABLE 22.

Work done in the X-ray department.

Queen Mary

Kowloon

Examinations made

Hospital.

Chest

51,913

10,419

Bones

4,351

4,098

Abdomen

1,037

567

Barium Meals

511

186

Intravenous Pyelography...

195

Bronchogram

Cystogram

Myelogram

Cholecystogram

Retro: pyelogram

Pleurogram

Cholangiogram

Ventriculogram

Encephalogram

Arteriogram

Salpingogram Dental

385

478

58,629

15,831

Films expended

Mass Miniature

15" x 12"

12" x 10"

10" X

ΓΓ

6" X

7" x Dental

Queen Mary

Kowloon

Hospital.

39,433

6,912

9,600

4,646

9,557

3,201

4,742

2,610

5,914

3,293

1,363

924

1,323

764

211. Radiation therapy was restarted with the arrival of Dr. H. C. Ho on 16th August, 1940. The supply of radio- active cobalt element in the form of wires and cylinders from the Atomic Energy Research Establishment, Harwell, provided an interesting new development. At present their strengths are being checked and experiments are being carried out on the form of application. Professor Davies, Professor of Physics at the University, has given valuable help in this work. Work was also started on a radio-active cobalt "bomb" unit; the "bomb" carrier is now under construction and the cobalt is being radiated at the Atomic Energy Research Establishment.

211. The Physiotherapy Department is under the adminis- tration of the Government Radiologist and a sunimary of the work done is set out below.

TABLE 22.

Physiotherapy Department.

In-patients. Treatments. Out-patients. Treatments.

Queen Mary

Hospital

513

3,923

1,293

12,093

Kowloon

Hospital

157

LILJ

4,257

2,062

17,768

212. Gifts of baths for the treatment of poliomyelitis and kindred discases were received from UNICEF. These have been installed and are in use.

VIL

DENTAL CLINICS.

213. There are three Government Dental Clinics, one in Kowloon and two in Hong Kong. All three clinics have been In operation throughout the year and in July, with the appoint- ment of two assistant dental surgeons, two dentists have been functioning at Kowloon Hospital and two at Sai Ying Pun Health Centre in Hong Kong.

　　214. These two assistant dentists were appointed at the expense of two assistant medical officers as although there was, as always, a shortage of doctors the need for dentists was even greater. Some Government servants and families had been on a waiting list for dental attention for nearly eight months.

　　215. The principal groups dealt with are Government Servants and their families, children in the Schools Health Service and the free patients among the general public. Table 23 shows the numbers and types of patients dealt with at the three clinics.

TABLE 23.

Government Dental Clinics.

Harcourt Health Kowloon Sai Ying Pun

Centre.

Hospital.

Government Servants

752

1,411

2,910

Families

471

1,027

1,554

School Children

5,341

1,827

164

General Public

3,323

5,037

Total

6,655

7,588

9,665

　　216. In September 1949 a dental surgery was equipped and opened in the Queen Mary Hospital which operated part-time for the benefit of in-patients and the staff of the hospital.

　　217. There are two dental inspectors whose work it is to inspect the premises and equipment of registered dentists and to investigate cases of dental practice by unregistered persons.

VIII. PHARMACEUTICS.

218. During the year 92 institutions were provided with drugs and equipment from the two distributing centres under the control of the Chief Pharmacist. The arrival and installa- tion of simple equipment has increased the efficiency of the distributing centre and many sterilised solutions for injection purposes are now prepared in the dispensary.

　　219. The Streptomycin Committee which was appointed in October, 1947, continued to operate during the year and has taken under its control the administration of Chloramphenicol and Aureomycin.

220. This Committee controlled the treatment of cases receiving these antibiotics in Government institutions and was responsible for the selection of the cases and the standardising of the records.

221. During the year preliminary work was carried out on the formation of a Pharmacy Board which would control the training and registration of pharmacists in the Colony and draft legislation was being prepared.

IX.-MEDICO-SOCIAL WELFARE ACTIVITIES.

222. In September Miss A. M. Ballantyne was appointed Principal Almoner and took over charge of the Almoners sub- department from Miss Cheng Sui Chan who had been acting Principal Almoner,

223. The work of this sub-department has increased steadily and it now represents one of the major activities of the Medical Department. A report on this work will be found in Annexure M.

X.-TRAINING OF PERSONNEL.

224. It is the policy of the Medical Department, wherever possible, to train its own technical officers up to the standard set in the United Kingdom, and table 24 sets out the technical groups who have received training during the year and the numbers trained.

TABLE 24.

Technical Officers who have received training during the Year.

Probationer Masseuses

Appoint- Resigna- Strength

ments

tiona at $1.1.50

Passed

　Radiographic Assistants 3 Probationer Dispensers

Laboratory Assistants ... 4

Assistant Almoners (Students in training) 4

Nurses

Midwives

AADAETH

Dressers

XI.-MEDICO-LEGAL.

　　225. In 1st August, 1949, Dr. T. C. Pang returned to the Colony after a period of 11 months' study in forensic medicine in the United Kingdom. In December a medico-legal laboratory was equipped at Police Headquarters and came under the direction of Dr. Pang with one laboratory assistant to help with the work.

　　227. The examination of stains, blood group, determining of species, seminal and other examinations, such as for powder marks, presence of hair and fibres and determination of sex are carried out.

228. In addition the Police Surgeon has the resources of the Government Chemist and the Pathological Institute to assist him.

　　229. Apart from his own laboratory work the Police Surgeon is responsible for the physical examination of victims of assault and, for examinations made at the scene of crimes.

　　230. Post mortem examinations which are likely to be followed by court proceedings are normally done by the Police Surgeon; other post mortems, although possibly of some medico- legal importance, are carried out by the pathologist attending the public mortuaries. The table below sets out the work done from August 1949 until the end of March 1950,

Medico-legal post mortems

Examination of blood stains (including blood

grouping and determining of species)

IL I

Rape & Indecent Assault

Physical Examinations

Examination of bones

Examination of hairs

Examination of Note Book

6th September, 1950.

327

· ·

LILJ J

I. NEWTON,

Director of Medical Services.

ANNEKURE A

CENTRAL RETREATME

DIT NARAY

STEWARD

DEPUTY DIRECTOR

MEDICAL SERVICES

'STARANDA E

SENIOR DENTAL SURGEON

ZEN TRE

Tamás JubETON

UN TAR Peer

DENTAL CLINTE

TAL

DIRECTOR OF MEDICAL SERVICES

ALMOHER

GOVERNMENT

PECRETARY

TACCOUNTANT

QUEER, HULET SGENITAL

HIDE PITAL.

ART ÄÜNON ZA

COUT RATHE

"DEPËRTHENT

ADDY ALMAGDA VALET PIL

GOVERNMENT

ART.

CHENKET

ASSISTANT.

MEETING AANGEWIL LANGER BR

POLYCLINI HOSPITAL

ASLE AUNGER KATTING FU NHOSPITAL TRAN

VOOR MATRITAL VALENTAL HEA

VICTORIA

PUNCIPAL

MATRONS Benatting STAFF - HSPITALS

PALETAS MAD

Bjarns RequFTRY

PRINCIPAL CLERK

CRETION

HEALTH

MEDICAL LIBRARY

SECTION

THE A Stanyl AspNET

SOUPLI

SLOKETARY Tyka wan Spor

MADICAL COMITTEE

NOMSUNG Sapph CLINKS

MUSICAL

SCHOOL HEALTHIO

METCAL OFFICE MAALTHYAJ

WIFT IN FAST HELENCE CENTRE

HEALTH NURSES

HAËTIM FÉN TON LAZARE WELFARE

Turd war;

MASPITAL

MEDICAL

CENTER

HOWE

JOE HARCOURT TUBERCULATig cume

NA E QUEEN_KARY

DETAL

Мина не м

НАЙМЕНТАL HOFPITAL

HOSPITAL

MR-JËTIAN Yak

NGGITAL

BAS MENTAL

HO. POLICE

METCAL CUwid

FAMILIES WAITIN MEDICAL OFFICES HASE POVILET

NASE CANTICAL

DESPITAL

ALDEL SUPERINTENDENT

KHANG WA

MARITAL

SENIJA NEAL TH ZASTRO PERS

Sudedare E ARK MARKETS

HEALTH ENERIC DO CEMETERY

|TED SALATHAM

Aud MEZENTANT

Auto P PRALIN

LoteriasETA

P PL

ŽS ABAPEN SUPERAKT

INKFINEART

MALE ZASTRIH AMK DISPENSARY

Chort showing the Organization

Medical Department

1949

DEPUTY DIRECTOR

HEALTH SERVICES

SUPER VEEDA.

DE MIDWIVES

MALARIOLOGJIT

Jintor Peer REALTH OFFICER

THE CARTIE

HEALTH.

INFANT

TAI 0

ST. JOHN HANTAL

bifrantasY APSE TAI PO

RISTRÆDENT DE

CHIEF REALT=

INSPECTOR

PAL MALTE INSPECTRA FortidAmen

ASSE PAT

AIST PORT HEALTH

KAI TAK,

PART MÉRITA |

CANTLE

SENYOR MEALTH OFFICER

ANTAST

Pear

AST. PIRT

HEALTH OFRACES

POAT

AIR PLAT HEALTH OFFICER

PAT

Aart. Potr MAALTH OFFICE FRI ZEGADE Bunching PRT HEALTH CANINE.

Asen Phay WEALTH OFFICER MARINE Building PET HEALTH CONTAI

JUTAH VOINN

FULL RECTA

HER THE

RODENT CANTREL

ARCHERIC

JANITA Fede

INSPECTOR JAMPTATION

1,:h

SENIDA HEALTH

STALOR HEALTH FASPECTOR

HEALTH OFFICIA

OFFICE

SENTER HEALTH OFFICER

BOCIAL HIGIENE

SENIOR HEALTH INSPECTOR

LEAST

HEALTH

[WZET)

HEALTH OFFICI

MEALTH

OFFICER

ME DE QUEENS BAND WEST

PLOSÉ MATRAN

(DART)

CENTRE

FIL

HYGIENE ÜRITAT

MOJ ASHLEF KLAS SOCIAL WIETENE DENTAL

PLATE WANCHAY SOCIAL, HYGIENE

Annexure

COLONY OF HONG KONG MEDICAL FACILITIES MAP REFERENCE 1949

10. Govt HiSPITALS.

20 YAYAL HOSPITALS

8 ▼

MUTARY HOSPITALS

GRANT - IN- ArD HOSPITALS

PRIVATE HOSPITALS

GovT DISPENSARIES

PolyclING

INFANT WELFARE Clime

9 A SIGAL HYGIENS CLINIC

10+ ST. JORNS AMBULANCÉ BUGORE CENTRE

X DENTAL CLINIS

12 § GENERAL CLINIC

13 (c) CHILDREN CUNIC

14 E T. 6. CLINIC

LOK MA CURV

ONITLE

AKTE-NATAL CUNIC

16 @ POST-NATAL CLINIC

17✪ GYNAECOLOGICAL CLINIC

18 O EYE CLINIC

19 0 E.N.T. CLINIC

200 MENTAL DISEASE CLINIC

21 (c) VACCINATION CENTRE.

TAI PO

KOM TIN

MATERNITY}

How

LAN TAU

"CHEUNG CHAU.

HONG

KONG

(TAI YU SHAN)

(SEN SEPARATE, MAB "B")

Dovt. HospiYATI.

2. Hospital.

4. A HAMAny Hargitada.

4. (c) Crent-fonáló Soapitala

50 Printy Hooplitala.

part. Theptanzian,

Polyollato.

That Tolfare Chlade,

1 A Soolal Hygiene chinte.

10. X Dostal 01lala,

14. À exildren Clinik,

10. 21. 2 clinée,

15. 4 Port-katal (ltało.

o Thu An

* 1 * 1 Clinio,

MALAGA DELAnna chiado,

Tamaination Garten

+ 26. Jelita kabyliss Belaude Castro.

ANNELURE 8

'B'

HONG

WIL

JUNE

KONG

'À

10.

11.

18.

13.

14.

15.

16.

17.

18.

19.

20.

Govt. Hospitals, Naval Hospitals, Military Hospitale. Grant-in-Aid Hospitals.

Govt. Dispensaries, Polyclinic.

Infant Telfare Clinic.

A Social Hygiene Clinic.

X Dental Clinic,

General

Clinic,

Children Clinde,

T. B, Clinic,

#Ante-Natal Clinic,

Post-Natal Clinic,

Gynaecological Clinio,

✪ By Clinic.

O B. N. T. Glinio,

Vaccination Centre,

21. + St. John's Ambulance Brigade Centre,

KWONG WAN

TRIM SNA

OMILITARY

dalet KOWLOON

HUNG SOM

ANNEXURE C.

Staff of Medical Department as at 31.3.1950.

Director of Medical Services

Deputy Director of Medical Services

Deputy Director of Health Services

Senior Medical Officer

Senior Health Officer

Medical Specialist

Gynæcological & Obstetrical Specialist

Surgical Specialist

Senior Port Health Officer

Ophthalmic Surgeon

Government Pathologist

Pathologist

Senior Dental Surgeon

Dental Surgeon

Malariologist

т..г 1

Government Chemist

Chemist

Medical Officers & Health Officers

Senior Radiologist

Radiologist

Nursing Staff

Almoners

+++

Executive Officers

Clerical Staff

Pharmaceutical Staff

X-ray Staff

Massage Staff

Laboratory Staff

Dental Staff

Stewards

...

Health Staff

Vaccinators

Others

Total

י +

י -

111

537

י י

י -

132

1,641

2,617

55-

ANNEXURE D.

Annual Mortality Return for 1949.

T.125/314.

Male

Femate

Total

Under 1 year

C++------➖➖➖➖➖➖---------

2,697

2,747

5,441

1 Year

780

785

2 years

3 Years

---------------uktZENEILL----------

JILLI...JB-‒‒‒‒‒‒‒‒

1,865

511

977

367

324

601

4 years

172

146

313

5-9 years

10-14 year

tattere

228

170

303

108

192

16-19 20-24 25.29

170

200

316

227

543

204

627

30-34 35-39

➖➖➖➖➖--------boboLT

429

717

431

992

723

40-44 45-49 50-54

418

239

קי

380

195

675

487

217

➖➖➖➖------------------------

601

55-59

213

512

➖➖➖➖-----------------¬----------

60-64

220

508

D++------------------------

65-69

160

203

372

70-74

-------------------------------

127

137

264

75-79

181

80-81

100

86 years and over ............CCTTAAPELITAR

Unknown age

Bex and age

Total

IILI

8,789

7,494

16,287

Age Distribution as Found in 1921 and 1931 Censuses.

Year

192 1

| Pemakan

L 9 3 1

Total | Malon

Femalon

Tatal

0- 5

8-10

11-15

16-20

TTI

21-25

28-30

31-30

36-10

41-45

46-50

61-56

------+TTE

58-00

81-65

LLL. IIJJJJJJJ

---11-----111-

---------------

27,206 26,451 63,7.17 23,413 24.756 48,149 30,151 25,736 55,987 50,216 28.242 73,458 49,786 22,608 72,399 1 45,305 23,596 69,809 | 37,950 20,080 58,030 36,050 19,680 55,690 24,231 12,704 38,985 19,297 11,201 30,598 12.310 7,146 19,456 8,268 0.210 14,578 4,450

43,639 32,436 31,734

43,695

87,234

$4,170

40,676 34,270 64,665 || 35,648 63,280 37,410 52,162 | 36,413 42,870 | 29,268

74,940

100,318

100,699

88,575

72,138

86,030 26,579

63,514

28,690 20,374

49,261

23,976 16.492 12,266

17,797

41.733

28,758

114215

10,059

21,169

3.772 8,223

6,538

6,947 | 12,785

66-70

3,792

2,591

0,380

3,455

4,032

7,187

71-75

1,126

1,600

2,726

1,661

2,228

3,812

76-80

I-ILL

463

847

1,310

508

1,226

1,824

81-100

485

720

266

677

Unknown

1,936

2,026

笛

No. OF DEATHS.

11,000

ANNEXURE D

ANNUAL MORTALITY RETURN FOR THE YEAR 1949 WITH AGE DISTRIBUTION AS FOUND IN 1921 AND 1931 CENSUSES.

NUMBER OF DEATHS,

HALE FEMALE →

TOTAL

AGE DISTRIBUTION.

1921

POPULATION

1931

20,000

10,000

8000

8,000

7,000

6,000

5,000

4,000

3000

2,000

1,000

ار کمانے کا یکے

NOTE:

UNTIL THE NEXT CENSUS HAS BEEN TAREN IT WILL NOT BE POSSIBLE TO CALCULATE THE NUMBERS OF DEATHS ON A PER MILLE BASIS, BUT THE TWO CURVES RELATING TO AGE DISTRIBUTION OF THE POPULATION, ASFOUND IN THE 1921 AND 1931 CENSUSES, AFFORD SOME ÎNDICATION OF THE SIGNIFICANCE OF THE ACTUAL NUMBERS OF DEATHS, IT WOULD APPEAR PROBABLE THAT THE AGE DISTRIBUTION IS STILL SUBSTANTIALLY THE SAME, THE PEAK OCCURING IN THE FIRST YEAR OF LIFE IS DUE TO THE GREAT NUMBERS OF DEATHS FROM BRONCHO-PNEUMONIA AND ACUTE ENTERITIS. THE RISE IN DEATHS AFTER THE AGE OF 20 WHEN THE POPULATION FOR THE AGE-GROUP FALLS IS LARGELY DUE TO THE GREAT RISK OF DEATH FROM TUBERCULOSIS BETWEEN THE AGES OF 20 AND SEE TABLE. OF ANNEXURE

点

AGES.

י.

100,000

90,000

80,000

70,000

60,000

DEPARTMENT OF SATI

REFERENCE NOG 22.7/247.

STATIEGS.

50,000

40,000

30.000

20,000

10,000

BIRTHS

4000_

J500_

3000

2500

BIRTHS

1947

1948

1949

ANNEXURE E

BIRTHS AND DEATHS

1947,1948 AND 1949

DEATHE

1947

1948

19*9

DEATHS

foo

500

FEB

JPLY AVG SEXT

ACT

How JE

ANNEXURE F.

NOTIFIABLE DISEASES.

Notifications and Deaths-1946-1949.

Total No. of Notifications

Total No. of deaths at all ages

Diseases

1946

1947

1948

1949

1946

1947

1948

1949

137

246

115

765

| NA_ALGEBRA_

253

CORER**

193

116

1,306

129

1,818

1,863

1,961

OOH-NOOWNWA

2,611

སྙaནྡྷཐཎཱ་ྒུ །བྷཱཝཡཿཧཱâཅུ༠ནྡྷབྲཱཧྨ༠༠སྶ

C. S. M.

203

566

Chickenpox

123

116

146

Cholera

514

Diphtheria

161

122

140

Dysentery

172

158

183

Enteric Fever

221

246

311

Malaria

2,422

608

Infantile Paralysis

Measles

----------+

317

160

190

Plague

Puerperal Fever

སྒྱུཙུདྡྷཙཙྪཱ །དྡྷཛདཿསྐ

Rabies Human

Animal

Relapsing Fever

Scarlet Fever

Smallpox

1,958

214

Tuberculosis

------

2,801

4,855

6,279

Typhus Fever

Yellow Fever

Whooping Cough

NOTE: Malaria not notified after May, 1948,

Whooping Cough and Infantile Paralysis notifiable diseases since 23.10.47 and 30.7.48 respectively.

Disesses

ANNEXURE F.

Age Group of Notifiable Diseases-1949.

Total

0-One year

1 year to years

4 years to 9 years

10 years to 14 years

Över 14 yeaTA

Total

Cerebro-spinal Meningitis

Chickenpox

-------+

}

27 |

108

196

Diphtheria

125

114

147

261

Dysentery amoeble

--------+

}

132

101

153

Bacillary

115

Clinical

Է.

ELLI

Enteric Fever

205

114

319

254

154

408

Measles

112

201

129

210

239

458

Puerperal Fever

LILIJE

Rabies Human

ம்

Animal

→

Scarlet Fever

Sinallpox

與

2 1

Tuberculosis

134

118

252

396

344

740

222

169

381

10$

$,089

2,045

6,081

4,798

2,712

7,510

Typhus Fever

Whooping Cough

Infantile Paralysis

口

門

Total

186

169

355

615

580 1,195

301

388

729

128

112

240

4,447

2,299 4,736

6,767

3,488

9,296

-------T

Nil return for Cholera, Plague, Relapsing Fever and Yellow Fever.

N.A. Figures not available.

Nor Figuren for War year 1941 to 1945 are not available.

Year

Notideations

Deaths

Carbo-spinal Honingitin (Meningococcal)

Deaths per 100

Natifications

Notifications

Deatha

Beadles

Deaths per 100 Notifications

Notifications

Deaths

ANNEXURE F.

Diphthoria

Deaths per 100 Notifications

Notifications

1923

240

616

304

1929

140

207

977

B64

1930

9.5

221

270

249

1931

231

214

Figures prior

1932

207

122

200

20%

219

175

1938

191

113

122

207

6.4

$66

433

to 1946 nat

1934

246

125

162

212

153

104

1935

110

200

136

319

1936

123

available.

376

214

118

136

193†

157

破

308

140

404

176

129

1938

483

203

319

147

639

187

2,327

1,823

1939

488

214

N.A.

142

N.A.

385

N.A.

198

163

1940

N.A.

130

N.A.

324

N.A.

335

270

1948

203

317

141

221

115

1,998

1,306

1947

586

137

160

122

246

214

129

1948

190

140

311

1949

458

2G1

408

7 & 8 8 2 2 2 2 2 2 8 8 9

8:3

Deaths

Enteric

Fever

Deaths per 100

Notifications

Deathe

Smallpox

Deaths per 100

Notifications

ANNEXURE G.

Tuberculosis-1949,

　　　In the absence of accurate population figures it is not possible to present reliable mortality or morbidity rates in respect of tuberculosis. Its relative importance as a killing disease has however increased, accounting as it has for 16% of all deaths recorded as against 14.6% in 1948. In considering local conditions it is not at all surprising that some increase has taken place. Housing conditions, which have not at any time been good, have further deteriorated as a result of increased overcrowding brought on by the arrival of large numbers of refugees in the Colony. At the same time the Urban Council have been conducting an active campaign against squat- ters in the Urban areas who have been obliged to leave their illegal huts and seeks accommodation elsewhere, some to erect huts in less accessible sites, others to crowd into the already overcrowded tenements. The degree of this overcrowding is almost impossible to imagine. One case of pulmonary tuber- culosis was recently found to be living on a floor, legally capable of housing 10-12 persons, but occupied by 23 families. Under such conditions, and with numerous cases of open tuberculosis at large among the population, it is not surprising that there has been an increase in the total number of individuals who were notified as suffering from, or who have died from, this disease. These increases have been much more apparent in the acute forms of the disease such as miliary disease and tuber- cular meningitis.

　　　Attempts have been made to limit the spread of this disease by propaganda, by loud speaker vans, by public notices, by pamphlets, by cinemas and by instruction of the patient in the clinic, in hospital and in his own home, but little real improve- ment can be anticipated until there is a fall in density of the population, some control over the open cases is obtained, or there is a diminution in the number of susceptibles. An under- standing of the local conditions is necessary before the difficulty of instituting any such measures can be appreciated. As an immediate measure the possibility of a B. C. G. vaccination campaign is under examination.

The figures available on the notifications of and deaths from tuberculosis are supplied herewith:

TUBERCULOSIS.

(All Forms).

Notifications and Deaths.

Rates per

Year

Estimated Notifica- population

Death D/N Ratio

tion

100.000 estimated population

1920

648,150

2,082

321.2

1921

625,116

1,894

303.1

1922

638.300

2,096

328.8

1923

667,900

2.108

315.6

1924

695,600

1925

725,100

1926

710,100

1927

740,300

1928

766,700

1929

802,900

1930

838,800

1931

840,473

1932

900,813

1933

922,643

1934

944,492

NOT NOTIFIABLE

2,358

339.0

2.201

316.9

1,912

269.2

2.123

286.7

2,537

330.0

2,158

268.7

1,994

237.7

1,983

235.9

2.042

226.6

2,226

241.2

2,179

230.7

1935

966,341

2,237

281.6

1936

988.190

2,416

244.5

1937

1,281,982

4,028

314.2

1938

1,478,619

4,920

332.7

1939

1,750,256

7,591

4.443

1 to 1.7

253.8

1940

1945

1946

1,600.000

2.801

1,752

1 to 1.6

109.5

1947

1,750,000

4.855

1,861

1 to 2.6

106.3

1948

1,800.000

6.279

1.961

1 to 3.2

108.9

1949

1,857,000

7,510

2,611

1 to 2.8

140.6

It can be seen from the above that the generally favourable trend of tuberculosis has been interrupted by sharp rises occuring in 1937 and 1949 when upheavals in the neighbouring areas of China took place. How much these rises are due to changes in population and how much they are secondary to social and economic deterioration is difficult to determine. is a significant fact to the statistician that in the list of the causes of death the proportions due to the more stable diseases such as cancer, and diseases of the heart and circulatory system are little altered compared with the figures for 1948, hut expressed as a rate per 100,000 of the population as estimated, these figures have increased by 25 and 20 percent respectively. A similar comparison of the pulmonary tuberculosis figures shows that this disease accounted for 10.5% of the total deaths in 1949 as against 10.6% last year, but expressed as a rate

per 100,000 estimated population the figure has increased in 1949 to 92.2 per 100,000-a 15% increase over the figure for 1948. On the other hand, the figures for deaths from other forms of tuberculosis have, in relation to the total deaths, increased by 45% over last year's return-a most significant fact.

Deaths from tubercular meningitis account for 22% of the total Tuberculosis deaths as against 17.7% in 1948 and a steady rise each year since 1946, while at the same time there has been a progressive fall in the age at death,

Year

Total deaths from Tubercular Meningitis

below 5 years

of age

1946

169

1947

264

1948

347

1949

580

　　　Deaths from tuberculosis (other forms) have shown a significant increase over the fairly steady figures recorded in the period 1946-1948 and show a similar fall in the age at death.

Year

Total deaths of Tuberculosis (other forms)

% below 5 years of age

1946

1947

1948

1949

174

179

171

325

　　　This rise in the number of deaths below 5 years of age from meningeal and other forms of tuberculosis is also shown in the pulmonary returns. These rises may be partially due to an increase in the total number of children at risk in the Colony but are more probably due to a rise in the intensity of infection.

PULMONARY TUBERCULOSIS

　　　Pulmonary Tuberculosis is undoubtedly the most important medico-social problem in the Colony not only because of the large numbers of deaths it causes annually but also on account of the prolonged nature of the illness with resulting disability

bringing hardship and starvation to many families. There is no general form of social insurance in the Colony and the unfor- tunate sufferer must continue to work. A few of the more considerate employers are prepared to continue to pay tuber- culous employees while they are under treatment, this being the exception rather than the rule; but even so, due to the shortage of hospital accommodation, the sufferer may be obliged to recover as best he can within his own home where conditions and diet are far from suitable. There are undoubtedly many who do recover in spite of such conditions while many others show evidence of having suffered from extensive disease without severe disability and have recovered without special treatment. Hospital accommodation generally falls far short of the requirements. Based on the widely accepted standard of one hospital bed for each tuberculosis death in the year, the accommodation available for the treatment of tuberculosis is about 20% of the requirements.

The details of the notifications of pulmonary tuber- culosis are set out below. It should be noted that the figures in this and in subsequent tables showing age and sex distribution have been reorganized to conform to the standards set forth by the World Health Organization.

NOTIFICATIONS OF PULMONARY TUBERCULOSIS

1948 and 1949.

1949

1948

Age Group

Mole

Female

Persona

Mole

Female

Persona

Under 1

128

205

5-9

125

149

10-14

15-19

167

111

278

651

299

960

20-24

630

220

850

25-29

787

310

1,097

1,842

689

2,031

30-34

707

343

1,050

36-39

607

319

926

85G

508

1,364

40-44

332

237

599

45-49

254

136

390

367

269

636

50-54

191

116

307

55-59

117

214

---- - - - - -

121

128

249

60-64

112

65-69

70-74

75-79

80-84

85 & Over

Unknown

It is a noteworthy fact that only 522 notifications were

made by private practitioners, an average of 1.5 per practi-

tioner.

Notifications of Tuberculosis (All forms),

classified according to origin.

Harcourt Tuberculosis Clinic

Government Institutions

Non-Government Institutions

Private Practitioners

Total

3,145

1,123

2,720

522

7,510

Analysis of the pulmonary tuberculosis notifications is extremely difficult without knowledge of the age and sex distri- bution of the population. Such information as can be obtained indicates that males are in excess in the adult groups but to what degree is not known.

The same remarks apply also to the deaths from pul- monary tuberculosis which are classified according to age and sex and appended herewith:-

PULMONARY TUBERCULOSIS

1949

Age Group

Male Female Persons

DEATHS

1948

1947

1946

Under 1

129

--------H

5.9

10-14

15-19

20-24

25-29

30-34

132

35-39

160

40-44

130

45-49

50-54

114

+--

55-59

60-44

65-69

70-74

75-79

80-84

85 & Over

Unknown

RED* NOO

*** 86 29 93 R

126

84 210

133

220

143

231

117

160

242

165

397

260

172

438

256

151

407

226

240

222

116

338

236

116

352

247

101

348

197

137

144

236

154

219

146

69 215

162

121

59 59

118

No of deaths per 100 notifications

100

Graph showing the number of deaths per 100 notifications in each age group: -

Male

Female

0 1

5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-7175-79

HOSPITAL BEDS.

There is no organized system for the treatment of non- pulmonary tuberculosis. Such cases are looked after in general hospitals, usually in the surgical wards. No correlated data is available on the subject.

Hospital beds for the treatment of pulmonary tuberculosis are distributed as follows:

(a) Government Hospitals

Queen Mary Hospital

Lai Chi Kok Hospital

St. John Hospital

202

Total:

291

(b) Government Subsidized Hospitals

Tung Wah Group ........

110

Ruttonjee Sanatorium

120

Grand Total:

521

　　　A limited number of beds are used for treatment in private hospitals but their contribution to the general scheme is negligible.

　　　The beds in hospitals listed at (a) above are available to the general public after the requirements of Government employees have been met. Treatment is provided free to patients in poor circumstances--by far the majority-while a small maintenance charge is made if the income of the individual so indicates. Admission is possible only through the Govern- ment Tuberculosis Clinic.

　　　The hospitals at (b) are operated by a board of Chinese business men on a charitable basis as part of a general charitable scheme. The average tuberculosis case admitted there is in an advanced condition as the resources of the institutions are not organized to cope with sanatorium treatment.

　　　Ruttonjee Sanatorium is an institution set aside specifically for the treatment of pulmonary tuberculosis, in adults and children. It was opened in the early part of 1949 and now plays a valuable part in the Tuberculosis programme of the Colony. It is operated by the Hong Kong Anti-Tuberculosis Association and is financed principally from public contribution. The cases admitted there are diagnosed at Harcourt Tuberculosis Clinic and selected by the medical staff of the Sanatorium who undertake the treatment and after-care,

CLINICS.

The principal free diagnostic clinic open to the general public for the diagnosis of pulmonary tuberculosis is situated at Harcourt Health Centre. The whole government tuber- culosis scheme is operated in conjunction with this clinic and is supervised and co-ordinated by the medical officer in charge. All the various elements which go to make up a tuberculosis scheme are operated, some modified to meet local circumstances, others in rudimentary form. The scheme as a whole has been in operation for three years only, the growth of its various activities being limited mainly by finance. The clinic itself is conducted under considerable difficulty due to general unsuita- bility of the building, lack of space and the absence of X-ray facilities on the premises. The number of patients who present themselves for diagnosis and treatment is greater than can be

adequately dealt with but the construction of an additional clinic, specifically designed and equipped for the purpose and expected to open in late 1950, should to some extent relieve the present situation,

The report of the activities of the existing clinic at Harcourt Health Centre follows herewith, together with details of branch clinics operated at various places in the Colony remote from the principal centre but operated by the staff of the parent clinic:

(1) Total attendances during 1949.

Harcourt Tuberculosis Clinic Subsidiary Clinics

47,393

1,879

Total:

49,272

(2) Number of New Patients.

Harcourt Tuberculosis Clinic

Aberdeen Clinic

18,135

153

Stanley Clinic

Taipo Clinic

182

Un Long Clinic

124

Total:

18,606

(3) Number of Return Visits.

Harcourt Tuberculosis Clinic Aberdeen Clinic

29,258

607

L+

Stanley Clinic

Taipo Clinic

Un Long Clinic

510

266

Total:

30,666

(4) Origin of New Patients.

Voluntary Attenders

13,322

Referred by Private Practitioners

182

Referred by Hospitals

873

LII

Contacts

386

Survey

3,372

Total:

18,135

Contacts examined through the clinic but who were not required to attend

Total:

3,381

　　The total attendances recorded during the year show a fairly substantial reduction over the figure for 1948 for two

reasons:

(a) The administration of liver and vitamin injections

was discontinued early in the year.

(b) The diagnostic scheme was streamlined to curtail the number of visits made by each patient before disposal.

On the other hand the number of first visits has risen by 36 percent, the principal increase being among voluntary attenders, while the percentage of these found to be suffering from active disease has fallen from 23 to 18, due no doubt to the publicity received by the clinic during the year and the increasing use made of it by the public. The details of diagnoses are as follows:

(1) Number found free of Tuberculosis

Harcourt Tuberculosis Clinic

Aberdeen

Stanley

Taipo

Un Long

8,808

117

Total:

9,057

(2) Number suffering from Tuberculosis

Inactive or healed

890

Suspicious

Harcourt Aberdeen Stanley

1,083

------

Total:

1,092

Harcourt Aberdeen

•

3,181

Active

Taipo

111

- ·

Un Long

+++

Total:

3,394

Diagnosis Incomplete

(a) Attended clinic but did not

attend for X-ray

(b) Examination incomplete at

3,334

31st December, 1949

839

Total:

4,173

A distressingly large number of individuals attended but failed to complete the examination, the proportion being rather less than last year.

Bacteriological Investigations.

All such work is carried out at the Government Patho- logical Institute, the details being as follows:

Positive. Negative. Total.

Sputum

672

1,636

2,308

Gasteric Lavage 6

Pleural Liquid...

Kahn Test

Stage of disease on first attendance.

Of those found to be suffering from active pulmonary tuberculosis more than two-thirds were suffering from bilateral disease.

Cases selected for hospital treatment were, apart from Government Servants who are accorded priority treatment, chosen from the less extensive types of case, who appeared most likely to derive permanent benefit from such treatment.

Number admitted to Hospitals.

Government Hospitals

Queen Mary Hosp. Lai Chi Kok Hosp. St. John Hosp.

184

257

449

Non-Govt. Hospitals

Ruttonjee Sanatorium... 252 Tung Wah Group Hosp. 11

Grand total of Admission to Hospitals

263

712

It is unfortunately not possible to do more than give advice and symptomatic treatment to the more advanced type of cases who must do what they can for themselves at home. A sub- sidiary scheme for the provision of extra nourishment to such individuals, commenced in 1948, was discontinued on 30th June, 1949 as part of a general economy measure.

The details of out-patient treatment carried out at the clinic was as follows:-

Number Treated (specifying forms of treatment)

a. Injections

778

b. A. P. T.

Initial

Refill

Abandoned

e. P. P. T.

Initial

Refill

Unsatisfactory Completed treatment

1,459

102

d. Specific Drug Treatment

Streptomycin

P. A. S.

e. Aspiration

Contact Examination.

For the first two months of the year the only method of ensuring contact examination was to encourage the examination of contacts through the patients themselves. In March, how- ever, the first batch of six tuberculosis workers completed their training. These Visitors, all girls, had no preliminary nursing or hospital training, but started off on the course of training for tuberculosis workers with no knowledge of medical or social work whatever. After five months training they were con- sidered fit to commence work. They work under the immediate direction of the Almoner. Their principal duties are in con- nection with the examination of contacts. Each Visitor is responsible for a district and visits the home of each case known in her area. The addresses of patients are obtained from the Harcourt Clinic and from the notification returns. The reception given by the patients to the Visitors, who are designedly not uniformed, has been much better than expected and gradually it has been possible to gain the confidence of the patients. Generally speaking it has been comparatively easy to persuade contacts to come for examination. The system in operation is that children 8 years and under are tuberculin tested and only the positive are X-rayed. For simplicity a patch test is used. In the case of contacts over 8 years of age X-ray is arranged so as to avoid the necessity of the contacts' visiting the clinic. If positive X-ray findings are recorded the patient is encouraged to attend the Clinic for treatment. The figures obtained are as follows:

Contacts 8 years and under Tuberculin Tested. 930

Positive and subsequently X-rayed... Negative

307

623

Contacts all ages-X-rayed

3,144

Active

235

---

X-ray findings

Inactive Suspicious

194

165

2,550

Not Tuberculous

In addition these Visitors assist the patients by advice as to diet and prevention of spread of infection, and they encourage regular attendance at the Clinic. The details of the work for the ten months ending 31st December, 1949 are as follows:

(1) Total number of first visits

(2) Number of addresses not found (3) Total number of visits

(4) Patients known to have died.

··· ++++

2,921 510 4,886

366

(5) Patients known to have returned to village. 171

Under present circumstances it has been found necessary to make use of the Tuberculosis Visitors in the Clinic to assist in registration of the patients which, in addition to their own clerical work, has curtailed considerably the time available for visiting. In spite of this the work done has been of consider- able value not only from the point of view of immediate benefit to the patient but also from the point of view of early diagnosis of disease among contacts, and by dissemination of propaganda, The experiment of using staff without the usual qualifications has been amply justified and the results obtained are a credit to their trainers.

Almoners' Department.

The Almoners' Department is operated under one Almoner and two assistants. Details of the work done are incorporated in the report of the Principal Almoner.

Surveys,

X-ray surveys are considered as being more appropriate to the administrative rather than the clinical sphere and are not now arranged through the tuberculosis clinic. Responsibility for final assessment is however undertaken in respect of certain surveys. Three such surveys were carried out during the year, details of which are appended herewith.

A. Government Servants.

School teachers-Non-Government.

C. Prisoners in Stanley Prison.

-73

　　In the case of Government Servants an annual survey is intended. This is the first complete survey carried out and should diminish the amount of investigation necessary at subse- quent surveys. The results of the survey are as follows:-

Queen Mary Hospital

Total X-rayed

Kowloon Hospital

Total

H+L

13,347

9,047

22,394

Referred to Harcourt Clinic and further examination considered unnecessary

223

Total referred to Harcourt Tuberculosis Clinic

for examination

Calcified

Healed

Quiescent

Active

Suspicious

Not Tuberculous

►

1,295

223

300

573

213

гг. г гт.

104

Diagnosis not complete

- J-L

Included in the above are those Government Servants who have been attending regularly during the year, subsequent to last year's survey which was incomplete and involved only about 25% of Government Servants.

Healed

Quiescent

Active

Suspicious

124

TII

ILJI➖➖➖ILL

Not Tuberculous

Diagnosis not complete...

　　The survey of school teachers was planned as part of the campaign against tuberculosis in children. Teachers in private schools are an unfortunate section of the community, who, by

virtue of their low salaries and close contact with children, merit special attention. The results are as follows:

Total X-rays of school teachers referred to Harcourt Clinic, 46

Healed

Quiescent

Active

Suspicious

Not Tuberculous

Diagnosis not complete...

Failed to attend

2 (Left Service)

The prisoners at Stanley Prison were surveyed originally in the hope of preventing spread of infection in this institution which has been and still is overcrowded. The intention was, on completion of the first survey, to examine all subsequent prisoners on first admission. This latter arrangement finally proved impracticable and the scheme had to be temporarily abandoned. The result of the first survey makes interesting reading and reflects considerable credit on conditions there, indicating that, at least from a health point of view, a prison sentence is no hardship. The results of this survey are as follows:-

➖ ➖ ➖ ➖ ➖➖ ➖ ➖➖➖

Number of inmates X-rayed

re-X-rayed (large film)

active cases

-----

tuberculosis

Long term. Short term. Total.

1,054

1,407

2,461

124

-----

2.65%

4.76% 3.86%

Percentage suffering from active

Hospital treatment.

The results of treatment of tuberculosis sufferers in the Government hospitals are herewith consolidated for simplifica- *ion.

(a) No. of patients remaining in Hospital at

last day of previous year

(b) Admissions

221

1. Admitted through Harcourt Clinic.

2. Transfers from Non-Tuberculosis

and Convalescent Hospitals

449

3. Transfers from Ruttonjee Sana-

torium

++++

Total admissions

466

-75

1. Completed treatment

(i) Improved

(ii) In same condition

119

(iii) Worse

Total of (i) to (ii)

181

2. Discharged against medical advice.

3. Died

143

4. Transferred to Non-Tuberculosis

and Convalescent Hospitals

Total of patients discharged

396

(d) Number

of patients remaining in Hospitals as at last day of the year.

291

Future development.

Plans are now in being for extension of the Clinic service by the erection of a new clinic in Kowloon.

　　The amount of money requested for tuberculosis main- tenance for the financial year 1950-1951 has been doubled.

Plans for B.C.G. campaign are slow to materialise but action is planned to commence probably within the next eighteen months.

Outlook.

　　To make any forecast as to future commitments of the tuberculosis service would be to make prediction as to future political developments in China, which is beyond the scope of this report. It is not the present policy to restrict treatment to bona fide Hong Kong citizens and in the absence of such qualification, we must face the prospect of ever increasing demands on the service as its scope and resources expand.

A. S. MOODIE, M.O. i/e Tuberculosis Clinics.

ANNEXURE H.

Results of Medical Inspection of Pupils.

Number of Pupils with Defects Requiring Attention.

Number of

Schools

medical

inspections

Number

of pupils with no

Treatment

undertaken

apparent defect

Observation at General Clinics

at Eye

Treatment at Dentai

Treatment Treatment

at E.N.T.

Clinics

at Surgical Clinics

Treatment

at Anti-

T. B.

Clinics

Admission to hospital

'A' type

1,323

505

253

113

204

38.17%

64.47%

2.57%

8.54%

15.42%

0.76%

'R' type

10,950

4,172

5,811

1,470

1,274

2,250

194

= 26

38.10%

53.07%

13.42%

11.63%

20.55%

1.77%

0.02%

'C' type

16,269

5,924

7,134

3,220

975

4,723

231

36.43%

43.87%

19.8%

6.0%

29.04%

1.42%

0.04%

Total

28,536

10,601

13,798

4,724

2,362

7,177

435

= 100

37.14%

48.35%

16.55%

8.27%

25.15%

1.52%

0.007%

0.02%

ANNEXURE H.

Defects Found in Schools.

Details of Defects found

Schools

Number of School promises inspected

Government

Grant-Aid

Number found with defecta

Doors

Black-

boards

Ventilation

Lighting

Latrines

and Windows

not matt

Water Closets

Windows

Seats without backrests

White- washing rapoic required

General

required

surfaced

]

Subsidized

Hong KonE

Subsidized

Kowloon

Private

Hong Kong

145

Private

Kowloon

129

Total .....................PUNTEE

350

138

ANNEXURE L

TSAN YUK HOSPITAL,

Report for the year 1949.

The attached summary indicates the amount and type of work done in the Tsan Yuk Hospital during the year 1949.

The following features are of interest:

Admissions. The total of 4,572 admissions is only slightly less than that for 1948, which was the record year in the history of the hospital. Of this total 4,301 patients were delivered of children.

Antenatal Care. Over 85% of the patients delivered in the Hospital received antenatal care. This is a very encourag- ing result of the crusade in favour of antenatal care which has been going on since 1938, as illustrated by the following figures:-

1939

1940

Cases receiving

1941

antenatal care in

1947

1948

1949

Triplets. There was the

8.0%

27.3%

30.7%

69.5%

76.9%

85.4%

record number of 3 cases of Two sets survived in entirety.

triplets born during the year. but the third set was too premature for survival.

Pregnancy Toxemia. There was a recurrence of a very severe type of pregnancy toxemia this year with an increase in the number of cases of severe pre-eclampsia and eclampsia.

Operative delivery. There were altogether 170 deliveries. by forceps, version, Cæsarean section, etc. making the usual low percentage of slightly less than 4% of operative deliveries. Twenty-five Cæsarean sections were done of which three were extra-peritoneal operations, after the new technique of Waters, all of which did favourably.

Maternal Morbidity. Cases of puerperal pyrexia were again few in number, the figures being 1.39% for booked eases and 2.22% for non-booked cases, making an average of 1.51%.

　　　Maternal Mortality. There were 11 maternal deaths for the year (2.6 per thousand), which compares unfavourably with the exceptionally low figure of only 2 deaths (0.4 per thousand) for the previous year.

The causes of death were:-

Concealed accidental hæmorrhage with eclampsia.

Placenta prævia with eclampsia

Severe pre-eclampsia

Eclampsia

Post-partum hæmorrhage

Adenocarcinoma of ovary complicating labour

Total:--- 11

It will be noted that 7 of the deaths were due directly to toxæmia of severe degree and that in 2 others eclampsia was present as a complication of antepartum hæmorrhage. The tendency of the toxemias, particularly eclampsia, to occur in great severity in certain years is well known, and it would appear that other hospitals in the Colony have had a similar experience, notably the Queen Mary Hospital.

　　　University teaching work has continued throughout the year with successive groups of approximately 4 students at a time receiving instruction in all branches of obstetrical work. The Tsan Yuk Hospital is now able to offer a thorough training in Obstetrics to senior students, house officers and clinical assistants, as well as to a full class of pupil midwives.

GORDON KING,

Professor of Obstetrics and Gynecology: Consultant to Government.

TSAN YUK HOSPITAL.

Report for the year, 1949.

Medical Summary,

Booked. Non-booked. Total.

1. Delivered in Hospital:

a. discharged well

b. transferred

2. Admitted after delivery

3. Discharged undelivered

4. Died:

a. after delivery

b. undelivered

5. Abortion

3,660

624

4,284

208

256

IN CO

Total

3,889

689

4,572

Of the 3,889 Booked Cases, 1,146 were primigravida and

2,743 were multigravidæ.

Of the 683 Non-booked Cases, 166 were primigravide and

517 were multigravida.

Total number of deliveries

Booked

Non-booked

Total

- IT-IIL

3,671

630

4,301

Numerical Summary of Cases Delivered in the Tsan Yuk Hospital Admitted for Treatment or Admitted after Delivery.

PRESENTATIONS (EXCLUDING TWINS):-

Booked. Non-booked.

Total.

Anterior Position of Occiput... 3,367

556

3,923

Posterior Position of Occiput.

173

202

Breech

Face

Transverse

Compound

----+-

TWIN PRESENTATIONS:-

Booked. Non-booked. Total.

Occiput Anterior

Occiput Posterior

Breech

Transverse

Face

Compound

TRIPLETS:

Occiput Anterior

Occiput Posterior

Breech

+++

3,671

630

4,301

119

149

---+

PATIENTS DELIVERED IN

HOSPITAL

PREGNANCY TOXÆMIA:

a. Pre-eclampsia

b. Eclampsia

ILL

c. Nephritic Toxemia

d. Essential Hypertension

PRESENTATION & PROLAPSE

OF CORD

HYDRAMNIOS

PRIMARY UTERINE INERTIA.

OPERATIVE DELIVERY:

a. Forceps (Labour not

induced)

b. Version

c. Willetts Forceps applica-

tion

d. Craniotomy

e. Hysterostomatomy

f. Cæsarean Section

OPERATION FOR POST-

PARTUM STERILISATION...

100

125

2ND & 3RD DEGREE PERINEAL

LACERATION & EPISIO-

TOMY

Booked. Non-booked. Total.

ANTE-PARTUM HÆMORRHAGE:

240

277

a. Accidental Hæmorrhage

b. Placenta Prævia

POST PARTUM HÆMORRHAGE

MANUAL REMOVAL OF

PLACENTA

MATERNAL MORBIDITY:

a. Cases (1) Puerperal Infection 26

(ii) Other Causes

b. Percentage

1.39%

----

2.22%

1.51%

MATERNAL MORTALITY:

a. Cases

b. Percentage

.16%

.79%

.26%

INTERCURRENT DISEASES:

Cardiac Disease

Oedema

Syphilis

Influenza

Pulmonary Tuberculosis

Old right Tb. hip

Malaria

+ ·

Constipation

Pyelitis

Anaemia

Typhoid

的

पच

++++

Cystitis

Urinary infection

Adenocarcinoma of ovary

Uterine fibroid

---

Small submucous fibroid

Fibromyoma of cervix

Prolapse of uterus

Ulceration of buttock

Cellulitis of left leg

Infected haematoma of left

knee-joint

Coryza

Breast congestion

Booked. Non-booked. Total.

INFANTS' REPORT.

Booked. Non-booked. Total.

MATURE INFANTS:

Born alive and survived

3,199

485

3,684

Stillbirths

(Including macerated foetus) 27

Neo-natal deaths

Total

3,240

502

3,742

PREMATURE INFANTS:

(Birth weight 2,500 grams or 5 lb. and under)

Booked. Non-booked. Total.

Born alive and survived

396

482

Stillbirths

(Including macerated foetus) 34

Neo-natal deaths

Total

477

136

613

TOTAL NUMBER OF INFANTS

DELIVERED

3,717

638

4,355

Stillbirth rate

(including macerated foetus) 1.64%

5.64%

2.23%

Neo-natal death rate

1.64%

4.86%

2.11%

Combined stillbirth and Neo-natal

Mortality rate

3.28%

10.50% 4.34%

INSTITUTION

Dressings

General

Outpatients

ANNEXURE J.

OUTPATIENTS-1949,

Total Attendances at Government and Government

Assisted Hospitals, Clinics and Dispensaries.

Children's

Clinics

Ante-Natal

Post-Natal

Gynaecological

Social Hygiene

Hospitals

Queen Mary

4,304

7,123

1,671

768

108

104

14,189

Kowloon

21,016

87,235

Sai Ying Pun

37,477

82,067

10,186 13,355

6,905

796

1,634

19,551

607

160,830

2,875 342

2,400

24,546 | 1,605

164,676

Tsan Yuk

13,045

281

13,326

Stanley Prison

St. John

26,103 12,496

4,325 7,066 2,499

1,231

2,0.17

41,877

13,933

Clinics & Dispensaries

Violet Peel

16.159 53,394 21,391

7,188 1,050

99,482

Harcourt Tuberculosis...

49,272

Social Hygiene

150,079

9 Public Dispensaries

65,304

98,394 154,096

2,509

8,885

123 139

11 New Territories

Dispensaries

----LILJEL➖➖

54,144

52,634

2,700

873

531

1,126

Family Clinic

5,201

Police Medical Post

2,785

11,383

4,353

115

Victoria Remand Trison

2,343

12,96B

216

205 181

Ma Tau Chung Camp...

138

307

166

North Point Relief Camp

518

827

479

Port Health

1,648

2 309↓

329,465

112,008

5,201

18,665

15,928

671

1,871

1,548

Health Centres

Western

1,026

Kowloon

1,224

Harcourt

Total of Govt.

Institutions

774

124 285 431

1,150

1,509

1.205

237.916

432,703

Tung Wah Group Nethersole Hospital

25,133 10,845

51,499 44,503

209,225 29,760 5,056

31,060 | 1,484 | 14,565

Grand Total

ATT

274,194 | 528,705 | 244,049

1,017

3,832 5,876 | 770 | 13,292

37,953 | 2,254 | 31,689

151,528 | 52,264 | 3,621 | 52,519

17,265

1,186,885

128,815

80,341

151,528 | 69,529 | 3,621 | 52,519

1,396,041

Eye

Ear, Nose &

Throat

Tuberculosis

TOTAL

ANNEXURE J.

OUTPATIENTS-1949.

Total New Cases at Government and Government

Assisted Hospitals, Clinics and Dispensaris.

INSTITUTION

Dressings

General

Outpatients

Children's

Clinics

Ante-Natal

Hospitals

Queen Mary

4,285

5,155

349

Kowloon

1,999

Sai Ying Pun

5,707

73,241 63,273

Tsan Yuk

8,217 1,618 8,210 1,317 301 1,141

5,946 217

419

Post-Natal

Eg Gynaecological

Social Hygiene

Eye

Ear, Nose &

Throat

Tuberculosis

TOTAL

105

10,663

7,502

263

94,009

4,785 659

85,373

6,163

Stanley Prison

11.612

St. John

1,709

7,332 3,761 1,462

159

172

19,275

6,970

Clinics & Dispensaries

Violet Peel

5.100

36,996

15,257

1,864

622

59,839

Harcourt Tuberculosis...

18,135

18.133

Social Hygiene

12,630

9 Public Dispensaries

18,740

62,9 16

101,290

1,743

3,170

188,023

Dispensaries

11 New Territories

Family Clinic

15,823

32,897

913

507

358

303

1,038

Police Medical Post

884

6,814

732

Victoria Remand Prison

637

2,737

Ma Tau Chung Camp...

105

251

141

North Point Relief Camp Port Health

180

428

304

1,050

Health Centres

Western

170

Kowloon

423

Harcourt

291

197

1181111 88,

50,801

1,038

8,482

3,550

497

946

1,050

222

505

488

------------

Total of Govt.

Institutions

Tung Wah Group Nethersole Hospital

Grand Tetal

66,781 7,932

298,219

136,526

12,444

26,068 12,992 13,053 | 1,420

428

74,713 | 337,340 | 150,938

5,731 1,749 1,913 715❘ 5,103

14,785 | 1,652 | 12,583

937

12,839 | 14,769 | 1,762 | 18,661

6,047

568,659

5.5.216

22,204

12,839 20,806 | 1,762 | 18.6611

646,079

ANNEXURE J.

Inpatients Treated in Government and Government

Assisted Hospitals 1949.

General

Name

Cases

Infectious Tuber- Cases

culosis

Maternity

Mental

Total

Cases

Queen Mary Hospital

Kowloon Hospital

6,839

609

Lai Chi Kok Hospital

LILJILJA

Sai Ying Pụn Hospital

Tsan Yuk Hospital

Mental Hospital

Stanley Prison Hospital

-----T----

Eastern Materniy Hospital

-------

Wanchai Social Hygiene Hospital

---------------

St. John Hospital

3,785

322

507

622

215

681

1,282

430

649

733

ខ្លួន | F | g-

1,233

8.794

1.441

5,427

870

5,565

685

1,874

681

2,370

266

1,089

81185

5,565

685

921

Total Government Hospitals New Territories Dispensaries Tung Wah Group Hospitals Nethersole Hospital Ruttonjee Sanatorium

Grand Total

-----

****

14,264

1,344

1,636

10,379

28,276

111

1.711

1,823

-----+

17,671

3,074

226

2,847

13,049

33,793

110

1,414

4,634

251

35,120

1,606

4,745

26,553

753

69,777

98 -

ANNEXURE K.

Cases treated in Government and Government assisted hospitals with the total deaths in the Colony for 1949.

Cases Treated 1949

Diseases

I-INFECTIVE & PARASITIC DISEASES. Tuberculosis of respiratory system (001-008) 001 Respiratory tuberculosis with mention of pccupational diseases of lung (This title includes any disease assigned to 002-008 with mention of occupational disease of lung (523-524)

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Whole Colony

Male

Female

002 Pulmonary tuberculosis

1,084

2,361

1,110

1,010

696

003 Pleural tuberculosis

++++

004 Primary tuberculosis complex with

symptoms

005 Tracheobronchial glandular glandular tuberculosis

with symptoms

006 Radiological evidence suggestive of active respiratory tuberculosis not classifiable

elsewhere

+---

Carried forward

1,102

2,457

1,113

1,013

698

Diseases

Brought forward

007 Other respiratory tuberculosis 008 Tuberculosis, unspecified site

Cases

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Govern-

Whole Colony

ment

Hospitals Hospitals

ment

Assisted

Hospitals

Male

Female

1,102

2,457

1,113

1,013

698

Tuberculosis, other forms (010-019)

010 Tuberculosis of meninges and central nervous system

102

49G

399

334

246

011 Tuberculosis of intestines, peritoneum, and mesenteric glands

012 Tuberculosis of bones and joints, active or unspecified

182

013 Late effects of tuberculosis of bones and

joints

014 Tuberculosis of skin and subcutaneous cellular tissue

015 Tuberculosis of lymphatic system 016 Tuberculosis of genito-urinary system 017 Tuberculosis of adrenal glands 018 Tuberculosis of other organs 019 Disseminated tuberculosis

Syphilis and its sequelae (020-029) 020 Congenital sypailis

➖ ➖➖➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖ ■

+TTN

~! - 1 - 1

ཏུམ||

101

19-013

ፍሪ

Ел

Carried forward

1,807

3,260

214

1,647

1,513

1,181

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Whole Colony

Male

Female

diseases (030-039)

Carried forward

021 Early syphilis

022 Aneurysm of aorta

023 Other cardiovascular syphilis

024 Tabes dorsalis

025 General paralysis of insane

027 Other forms of late syphilis

028 Latent syphilis

029 Syphilis, unqualified

Gonococcal infection and other venereal

030 Acute or unspecified gonorrhoea

031 Chronic gonococcal infection of genito-

1,607

3,260

214

1,647

1,513

1,131

4.1

026 Other syphilis of central nervous system

---

213

དྷརྨཱཐཱཡ

urinary system

-----TOPL

032 Gonococcal infection of joint

125

| | ! │

A 1 MA

! │

033 Gonococcal infection of eye

034 Gonococcal infection of other sites

035 Late effects of gonococcal infection 036 Chaneroid

037 Lymphogranuloma venereum

038 Granuloma inguinale, venereal

Brought forward

2,455

3,899

228

1,678

1,567

1,144

➖ ➖ ➖ ➖ ➖TI

Diseases

Brought forward

--------

039 Other and unspecified venereal diseases

Infectious diseases commonly arising in

intestinal tract (040-049)

040 Typhoid fever

041 Paratyphoid fever

042 Other Salmonella infections

Casea

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Whole Colony

Male

Female

2,455

3,399

228

1,678

1,567

1.144

043 Cholera

044 Brucellosis (undulant fever)

045 Bacillary dysentery

047 Other protozoal dysentery

046 Amoebiasis

048 Unspecified forms of dysentery

049 Food poisoning (infection and intoxication)

Other bacterial diseases (050-064)

186

172

1 | |

的

++---------

251

NGN

1801

050 Scarlet fever

061 Streptococcal sore throat

------------

052 Erysipelas

053 Septicaemia and pyaemia 054 Bacterial toxaemia

055 Diphtheria

Carried forward

།| |ལ

3,060

3,649

337

1.760

1,686

1,246

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

3,060

3,649

337

1,750

1,686

1,246

056 Whooping cough

057 Meningococcal infections

058 Plague

059 Tularaemia

-----II

060 Leprosy

061 Tetanus

108

HTHITTI ++

062 Anthrax

063 Gas gangrene

|||

! | | 9.

||| 8 ||

| |~:

064 Other bacterial diseases

Spirochaetal diseases, except syphilis (070-074)

070 Vincent's infection

072 Leptospirosis icterohaemorrhagica

071 Relapsing fever

(Weil's disease)

073 Yaws

infections

074 Other spirochaetal and leptospirochaetal

Diseases attributable to viruses (080-096)

080 Acute poliomyelitis

081 Late effects of acute poliomyelitis

~ | | | |

Carried forward

++----------

3,206

3.776

374

1,840

1,762

1,307

Diseases

Brought forward

082 Acute infectious encephalitis

083 Late effects of acute infectious encephalitis

084 Smallpox

085 Measles

086 Rubella (German measles)

087 Chickenpox

088 Herpes zoster

089 Mumps

090 Dengue

091 Yellow fever

Cases

Treated 1949

Deaths 1949

Govern-

ment

Govern-

ment

Whole Colony

ment

Hospitals

Assisted

Hospitals

Assisted

Hospitals

Male

Female

3,200

3,776

309

129

----TI

| | | | | |~||~|~33 |

092 Infectious hepatitis

093 Glandular fever (infectious mononucleosis)

094 Rabies

095 Trachoma

096 Other diseases attributable to viruses Typhus and other rickettsial diseases (100-108) 100 Louse-borne epidemic typhus

101 Flea-borne endemic typhus (murine) 102 Brill's disease, not specified as louse- or flea-borne typhus

Carried forward

----

374

1,840

1,762

1,307

3,746

3,833

392

1,841

1,801

1,341

Diseases

Brought forward

103 Tabardillo (Mexican typhus), not specified

as louse-or flea-borne

104 Tick-borne typhus

105 Mite-borne typhus

106 Wolhynian fever (trench fever) 107 Typhus, unspecified

+-----

Cases

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Govern-

Whole Colony

ment

Hospitals Hospitals

ment

Assisted

Hospitals

Male

Female

3,746

3,833

392

1,841

1,801

1,341

108 Other rickettsial diseases

Malaria (110-117)

+7 --------------

110 Vivax malaria (benign tertian)

111 Malariae malaria (quartan)

112 Falciparum malaria (malignant tertian)

113 Ovale malaria

ILLI➖ ➖ ➖ ➖ ➖ ➖ ➖

114 Mixed malarial infections

115

Blackwater fever

+++---------+

--JLI

116 Other and unspecified forms of malaria 117 Recurrent induced malaria

Other infective and parasitic diseases (120-138)

120 Leishmaniasis

121 Trypanosomiasis

122 Other protozoal diseases

Carried forward

IIT

---

106

ཎྜམྦྷཊྛཾ །༥

246

284

ப

ار

BUSI

| | | | | |

| | |

|||

4,029

4,408

302

1,896

1,884

1,375

Diseases

Cases Treated 1949

Deaths 1949

Govern-

ment

Govern-

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Whole Colony

Male

Female

4,029

4,408

398

1,896

1,884

1,375

mixed,

བྲཱམྦྷསྶ

187

109

328

Brought forward

123 Schistosomiasis

124 Other trematode infestation

125 Hydatid disease

126 Other cestode infestation

127 Filariasis

128 Trichiniasis

129 Ankylostomiasis

. г.

130 Infestation with worms of other,

and unspecified type

131 Dermatophytosis

182 Actinomycosis

133 Coccidioidomycosis

134 Other fungus infections

-------------

135 Scabies

136 Pediculosis

137 Other arthropod infestation

138 Other infective and parasitic diseases

II. NEOPLASMS

Malignant neoplasm of buccal cavity and pharynx

(140-148)

140 Malignant neoplasm of lip

Carried forward

4,312

4,944

398

1,906

1,892

1,379

Diseases

Cases Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

4,312

4,944

398

---

TO LOO

+ LO

Tan

HH| |

1,905

1,891

1,892

1,379

| 1811

།

Brought forward

141 Malignant neoplasm of tongue 142 Malignant neoplasm of salivary gland 143 Malignant neoplasm of floor of month 144 Malignant neoplasm of other parts of mouth and mouth unspecified

145 Malignant neoplasm of oral mesopharynx 146 Malignant neoplasm of nasopharynx 147 Malignant neoplasm of hypopharynx 148 Malignant neoplasm of pharynx, unspecified

Malignant neoplasm of digestive organs and peritoneum (150-159)

150 Malignant neoplasm of oesophagus 151 Malignant neoplasm of stomach

101

152 Malignant neoplasm of small intestine, including duodenum

-----

153 Malignant neoplasm of large intestine. except rectum

154 Malignant neoplasm of rectum

156 Malignant neoplasm of biliary passages and of liver (stated to be primary site)

Carried forward

4,524

5,225

450

2,006

2,046

1,469

- 95

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

ment

Govern-

Whole Colony

ment

Hospitals

Assisted

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

4,524

5,225

450

2,006

2,046

1,469

*NN

Brought forward

and unspecified)

...

156 Malignant neoplasm of liver (secondary

HEET➖➖➖

157 Malignant neoplasm of pancreas 168 Malignant neoplasm of peritoneum 159 Malignant neoplasm of unspecified digestive organs

Malignant neoplasm of respiratory system (160-165) 160 Malignant neoplasm of nose, nasel

cavities, middle ear, and accessory sinuses

161 Malignant neoplasm of larynx 162 Malignant neoplasm of trachea, and of bronchus and lung specified as primary

163 Malignant neoplasm of lung and bronchus, unspecified as to whether primary or secondary

TIIT-----

164 Malignant neoplasm of mediastinum 165 Malignant neoplasm of thoracic organs

(secondary)

Malignant neoplasm of breast and genito-urinary

organs (170-181)

170 Malignant neoplasm of breast

Carried forward

--------++

4,633

5,336

467

2,063

2,116

1,528

Cases Treated 1949

Deaths 1949

Diseases

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

171 Malignant neoplasm of cervix uteri 172 Malignant neoplasm of corpus uteri 173 Malignant neoplasm of other parts of uterus, including chorionepithelioma

4,633

5,336

467

2,063

2,116

1,528

....

174 Malignant neoplasm of uterus, unspecified 175 Malignant neoplasm of ovary, Fallopian tube, and broad ligament

■+ILLI

| *

176 Malignant neoplasm of other and un- specified female genital organs

177 Malignant neoplasm of prostate

178 Malignant neoplasm of testis

179 Malignant neoplasm of other and specified male genital organs

un-

180 Malignant neoplasm of kidney

urinary organs

19 - "

CON

|| ! | |

| | -

125

||-

4,798

5,490

488

2,106

2,140

1,605

181 Malignant neoplasm of bladder and other

Malignant neoplasm of other and unspecified

sites (190-199)

190 Malignant melanoma of skin

191 Other malignant neoplasm of skin

192 Malignant neoplasm of eye

HON

Carried forward

+ |

Diseases

Cases Treated 1949

Deaths 1949

Whole Colony

2,140

Female

1,605

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

4,798

5,490

488

2,106

Brought forward

193 Malignant neoplasm of brain and other parts of nervous system

194 Malignant neoplasm of thyroid gland 195 Malignant neoplasm of other endocrine

glands

-------------++TELIT

196 Malignant neoplasm of bone (including

jaw bone)

197 Malignant neoplasm of connective tissue 198 Secondary and unspecified

malignant

neoplasm of lymph nodes

199 Malignant neoplasm of other and un- specified sites

Neoplasms of lymphatic and haematopoietic tissues (200-205)

! | | |

| | | | *

If on

Էլ

| | | | | |

的

~ || | |

* | | |* |

4,860

5,515

500

2,120

2,166

200 Lymphosarcoms and reticulosarcoma 201 Hodgkin's disease

202 Other forms of lymphoma (reticulosis) 203 Multiple myeloma (plasmocytoma) 204 Leukaemia and aleukaemia

205 Mycosis fungoides

T............TII

Carried forward

1,631

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

יי

4,860

5,515

500

2.120

2,166

1,631

Benign neoplasm (201-229)

210 Benign neoplasm of buccal cavity and

pharynx

211 Benign neoplasm of other parts of digestive system

-----

212 Benign neoplasm of respiratory system

213 Benign neoplasm of breast

214 Uterine fibromyoma

215 Other benign neoplasm of uterus

216 Benign neoplasm of ovary

217 Benign neoplasm of other female genital

organs

218 Benign neoplasm of male genital organs 219 Benign neoplasm of kidney and other

SARRER EN

། ཡ།ཎྜ|༞རྒྱུུ

urinary organs

220 Benign melanoma of skin

221 Pilonidal cyst

222 Other benign neoplasm of skin

223 Benign neoplasm of brain and other parts

of nervous system

224 Benign neoplasm of endocrine glands

Carried forward

ཞལ

LJILI

SUH

5,103

5,685

501

2.121

2,166

1,633

Cases

Treated 1949

Deaths 1949

Diseases

Brought forward

225 Benign neoplasm of bone and cartilage 226 Lipoma

227 Other benign neoplasm of muscular and

connective tissue

228 Haemangioma and lymphangioma

229 Benign neoplasm of other and unspecified

organs and tissues

Neoplasm of unspecified nature (230-239)

230 Neoplasm of unspecified nature of

digestive organs

---➖➖ ➖➖ ➖ ➖

231 Neoplasm of unspecified nature of

respiratory organs

---

232 Neoplasm of unspecified nature of breast 233 Neoplasm of unspecified nature of uterus 234 Neoplasm of unspecified nature of ovary... 235 Neoplasm of unspecified nature of other female genital organs

Govern,

Govern

Govern-

Whole Colony

ment

Hospitals

ment

Assisted Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

5,103

5,685

501

2,121

2,166

1,633

~ 63 88

མ༐|ཌ

** |||* |

236 Neoplasm of unspecified nature of other

| | _| ||

genito-urinary organs.....

237 Neoplasm of unspecified nature of brain and other parts of nervous system

Carried forward

T------➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖➖ ➖│

5,228

5,695

602

2,125

2,168

1,636

100

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

5,228

5,695

502

2,125

2,168

1,636

Brought forward

238 Neoplasm of unspecified nature of skin

and musculo-skeletal system

239 Neoplasm of unspecified nature of other

ווז------

and unspecified organs

III, ALLERGIC, ENDOCRINE SYSTEM. METABOLIC, AND NUTRITIONAL DISEASES

Allergic disorders (240-245)

240 Hay fever

241 Asthma

242 Angioneurotic oedema

289

00 10:00

--------------

243 Urticaria

244 Allergic eczema

245 Other allergic disorders

Diseases of thyroid gland (250-254)

250 Simple goitre

251 Non-toxic nodular goitre

252 Thyrotexicosis with or without goitre

253 Myxoedema and cretinism

254 Other diseases of thyroid gland

Carried forward

HEI

མ།།

&|||

|| 91 -

5,426

6,018

508

2,143

2,191

1,662

101

Cases Treated 1949

Deaths 1949

Diseases

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Brought forward

Diabetes mellitus (260)

5,426

6,018

508

2,143

2,191

1,662

260 Diabetes mellitus

४

Diseases of other endocrine glands (270-277)

270 Disorders of pancreatic internal secretion other than diabetes mellitus

271 Diseases of parathyroid gland 272 Diseases of pituitary gland 273 Diseases of thymus gland 274 Diseases of adrenal glands 275 Ovarian dysfunction

276 Testicular dysfunction

277 Polyglandular dysfunction diseases of endocrine glands

Avitaminoses, and other metabolic

(280-289)

280 Beriberi

281 Pellagra

282 Scurvy

•

283 Active rickets

| | __|| | |

and other

diseases

|| | .

| | | | |

~~ | |

|||8

Carried forward

++NA+TI

5,493

6,142

516

2,162

2,262

1,713

102

―

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

284 Late effects of rickets

5,493

6,142

516

2,162

2,262

1,713

285 Osteomalacia

286 Other avitaminoses

deficiency states

origin

288 Gout

289 Other metabolic diseases

and

nutritional

151

287 Obesity, not specified as of endocrine

-----

||-

IV. DISEASES OF THE BLOOD AND BLOOD-FORMING ORGANS

Diseases of blood and and blood-forming organs

(290-299)

290 Pernicious and other hyperchromic

anaemias

291 Iron deficiency anaemias (hyperchromic

anaemias)

292 Other anaemias of specified type

293 Anaemia of unspecified type

294 Polycythaemia

++------+

295 Haemophilia

༞│་ྒུབ།

297

| - | | | |

-| Bol

HAG | A

------▬▬▬▬▬

Carried forward

5,580

6,626

519

2.181

2,282

1,738

103

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Whole Colony

ment

Hospitals

Assisted Hospitals

Male

Female

Brought forward

5,580

6,626

519

2.181

2,282

1,738

296 Purpura and other hæmorrhagic conditions

297 Agranulocytosis

298 Diseases of spleen

اته

299 Other diseases of blood and blood-forming organs

IN |

V.--MENTAL, PSYCHONEUROTIC, AND PERSONALITY DISORDERS

Psychoses (300-309)

300 Schizophrenic disorders (dementia praecox)

301 Manic-depressive reaction

231

149

■ I

302 Involutional melancholia

וז

303 Paranoia and paranoid states

---------

304 Senile psychosis

305 Presenile psychosis

306 Psychosis with cerebral arteriosclerosis

307 Alcoholic psychosis

309 Other and unspecified psychoses

Carried forward

IIL

308 Psychosis of other demonstrable etiology

- P+

6,147

~ | | | | - | | |│

- | | - | - | | | -

~ | | | | - | | |│|

6.675

531

2.189

2,291

1,753

104

―

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

6,147

6,675

531

2,189

2,291

1,753

ILIL

ا أمر

Brought forward

Psychoneurotic disorders (310-318)

310 Anxiety reaction without mention of

somatic symptoms

311 Hysterical reaction without mention of

anxiety reaction

312 Phobic reaction

313 Obsessive-compulsive reaction

314 Neurotic depressive reaction

316 Psychoneurosis with somatic symptoms (somatization reaction) affecting cir- culatory system

------runtiu

516 Psychoneurosis with somatic symptoms (somatization reaction) affecting diges- tive system

317 Psychoneurosis with somatic symptoms (somatization reaction) affecting other systems

318 Psychoneurotic disorders, other, mixed, and unspecified types

Carried forward

6,267

6,721

531

2,189

2,291

1,753

105

Diseases

Brought forward

Disorders of character. behaviour, and intelligence (320-326)

Cases

Treated 1949

Deaths 1949

Whole Colony

Govern-

Deaths 1949

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

6,267

6,721

531

2.189

2,291

1,753

320 Pathological personality

321 Immature personality

322 Alcoholism

323 Other drug addiction

324 Primary childhood behaviour disorders

325 Mental deficiency

326 Other and unspecified

character, be-

LEU

haviour, and intelligence disorders

VI. DISEASES OF THE NERVOUS SYSTEM

AND SENSE ORGANS

Vascular lesions affecting central nervous system

(330-334)

330 Subarachnoid hemorrhage

831 Cerebral hemorrhage

332 Cerebral embolism and thrombosis 333 Spasm of cerebral arteries.....

Carried forward

+ITI

119

127

མས།

100

6,495

6,911

571

2,309

2,443

1,894

106

Diseases

Cases Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

ment

Hospitals

Assisted

Hospitals

Male

Female

6,495

6,911

571

2,309

2,443

1,894

-----

1o | ||

Brought forward

334 Other and ill-defined vascular lesions affecting central nervous system

Inflammatory diseases of central nervous

@ystem (340-345)

-----

340 Meningitis, except meningococcal and

tuberculous

341 Phlebitis and thrombo-phlebitis of intra-

cranial venous sinuses

342 Intracranial and intraspinal abscess

343 Encephalitis, myelitis, and encephalo- myelitis (except acute infectious)

344 Late effects of intracranial

Pyogenic infection

345 Multiple sclerosis

HITHI

* al $

abscess

Other diseases of central nervous system (350-357)

| ||

בלו

107

360 Paralysis agitans

351 Cerebral spastic infantile paralysis 352 Other cerebral paralysis

353 Epilepsy

| | - -

- 138

~ |-*

ཌ།

222

Carried forward

6,622

7,083

616

2,320

2,481

1,918

354 Migraine

Diseases

Brought forward

--------------+

Cases

Treated 1949

Deaths 1949

Govern-

Deaths 1949

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

6,622

7,083

616

2,320

2,481

1,918

at com

124

----

...

1997 **

355 Other diseases of brain

356 Motor neurone disease and muscular

atrophy

----

357 Other diseases of spinal cord

Diseases of nerves and peripheral ganglia

(360-369)

360 Facial paralysis

361 Trigeminal neuralgia

362 Brachial neuritis

363 Sciatica

364 Polyneuritis and polyradiculitis

and neuritis

- - - - -

365 Erythraedema polyneuritica

366 Other and unspecified forms of neuralgia

367 Other diseases of cranial nerves

368 Other diseases of peripheral nerves except autonomic

369 Diseases of peripheral autonomic nervous system

Carried forward

伯

| | | | |

| | | | | │

6,703

7,160

619

2,324

2,486

1,920

108

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Whole Colony

ment

Hospitals

Assisted

Hospitals

Male

Female

Brought forward

6,703

7,160

619

2,324

2,486

1,920

--+ +-

Inflammatory diseases of eye (370-379)

370 Conjunctivitis and ophthalmia

372 Hordeolum (stye)

371 Blepharitis

373 Iritis

374 Keratitis

OutLIILI

375 Choroiditis

376 Other inflammation of uveal tract

377 Inflammation of optic nerve and retina 378 Inflammation of lachrymal glands and ducts

379 Other inflammatory diseases of eye

Other diseases and conditions of eye

(380-389)

380 Refractive errors 381 Corneal ulcer

382 Corneal opacity

383 Pterygium 384 Strabismus

385 Cataract

· ·

Carried forward

Selwol

ENDIN

| ! | | | |

6,765

7,306

619

2,325

2,487

1,920

109

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

Whole Colony

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

386 Detachment of retina

++++

387 Glaucoma

------

388 Other diseases of eye....... 389 Blindness

Liseases of ear and mastoid process

(390-398)

390 Otitis externa

391 Otitis media without mention of

mastoiditis

392 Otitis media with mastoiditis

393 Mastoiditis without mention of otitis

media

LITHOTI

394 Other inflammatory diseases of ear

395

Menière's disease

396 Other diseases of ear and mastoid process

397 Deaf mutism

398 Other deafness.............

Carried forward

חחח חחח חחח חחח

6,765

7,306

619

2,326

2,487

1,920

160

83 3 |-

~~|~||

| | | | | |

6,871

7,541

623

2,331

2,491

1,926

110

Cases Treated 1949

Deaths 1949

Whole Colony

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Male

Brought forward

VII. DISEASE OF THE CIRCULATORY SYSTEM

Female

6,871

7,541

€23

2,331

2,491

1,926

Rheumatic fever (400-402)

400 Rheumatic fever without mention of heart involvement

401 Rheumatic fever with heart involvement 402 Chorea

וי

Chronic rheumatic heart disease (410-416)

410 Diseases of mitral valve

411 Diseases of aortic valve specified as rheumatic

412 Diseases of tricuspid valve

413 Diseases of pulmonary valve specified as

rheumatic

414 Other endocarditis specified as rheumatic 415 Other myocarditis specified as rheumatic.. 416 Other heart disease specified as rheumatic

Carried forward

126

249

* |

|*N**

ཋ།

- 2 12 201

མ །

2 - 191!

111

7,018

7,879

637

2,417

2,570

2,030

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

ment

Hospitals Hospitals

ment

Assisted Hospitals

Male

Female

Brought forward

7,018

7,879

637

2,417

2,570

2,030

Arteriosclerotic and degenerative heart disease (420-422)

420 Arteriosclerotic heart disease, including coronary disease

421 Chronic endocarditis not specified as rheumatic

422 Other myocardial degeneration

297

121

143

104

Other diseases of heart (430-434)

430 Acute and subacute endocarditis

431 Acute myocarditis not specified as rheu- matic

432 Acute pericarditis specified as non-

rheumatic

+++

433 Functional disease of heart

434 Other and unspecified diseases of heart

* 8 ***

HNG

Hypertensive disease (440-447)

440 Essential benign hypertension with heart disease

Carried forward

7,125

8,484

659

2,594

2,826

2,237

112

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern.

Whole Colony

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

441 Essential Malignant hypertension with

7.125

8,484

659

2,594

2,826

2,237

heart disease

------IILI ------

442 Hypertensive heart disease with arteriolar

nephrosclerosis

443 Other and unspecified hypertensive heart

disease

-+-+ +-

444 Essential benign hypertension

without

mention of heart

445 Essential malignant hypertension without

mention of heart

446 Hypertension with arteriolar

sclerosis without mention of heart

447 Other hypertensive disease without

mention of heart

Diseases of arteries (450-456)

450 General arteriosclerosis

451 Aortic aneurysm specified AS поп- syphilitic, and dissecting aneurysm.

452 Other aneurysm, except of heart and aorta

453 Peripheral vascular disease

454 Arterial embolism and thrombosis

J-I ➖ ➖ ➖➖

----------

IT 1 ☐☐ T1 T

nephro-

-----+

IN24

Carried forward

7,191

8,525

671

2,600

2,881

2,273

113

Diseases

Brought forward

455 Gangrene of unspecified cause 456 Other diseases of arteries

Diseases of veins and other diseases of circulatory system (460-468)

Cases Treated 1949

Deaths 1949

Govern-

ment

Whole Colony

ment

Hospitals

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

7,191

8,525

671

2,600

2,881

2,273

460 Varicose veins of lower extremities

461 Hæmorrhoids

125

233

462 Varicose veins of other specified sites 463 Phlebitis and thrombo-phlebitis of lower extremities

འ |

| | |

1 | !

།ཥ!

| | |

464 Phlebitis and thrombo-phlebitis of other sites

465 Pulmonary embolism and infarction 466 Other venous embolism and thrombosis 467 Other diseases of circulatory system 468 Certain diseases of lymph nodes and lymph channels

TT----

VIII. DISEASES OF THE RESPIRATORY

SYSTEM

Acute upper respiratory infections (470-475) 470 Acute nasopharyngitis (common cold)

Carried forward

7,425

8,833

674

2,601

2,884

2,275

114

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

Whole Colony

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

471 Acute sinusitis

472 Acute pharyngitis..........

7,425

8,833

674

2,601

2,884

2,275

473 Acute tonsillitis

139

110

474 Acute laryngitis and tracheitis

475 Acute upper

respiratory infection of

multiple or unspecified sites

TIIT-PT--+

Influenza (480-483)

480 Influenza with pneumonia

LILII

481 Influenza with other respiratory mani- festations, and influenza unqualified

--'וז.

482 Influenza with digestive manifestations, but without respiratory symptoms

483 Influenza with nervous manifestations, but without digestive or respiratory symptoms

166

192

수

Pneumonia (490-498)

490 Lobar pneumonia

491 Bronchopneumonia

492 Primary atypical pneumonia

493 Pneumonia, other and unspecified

Carried forward

111

515

380

2,422

149

217

1,538

475

1,743

336

1,760

124

8,312

12,461

863

4,372

5.165

4,422

115

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Brought forward

8,312

12,161

863

4,372

5,165

4,422

Bronchitis (500-502)

500 Acute bronchitis

501 Bronchitis unqualified

502 Chronic bronchitis...

238

113

150

196

267

395

393

Other diseases of respiratory system (510-527)

510 Hypertrophy of tonsils and adenoids

127

511 Peritonsillar abscess (quinsy).

612 Chronic pharyngitis and nasopharyngitis 513 Chronic sinusitis

+1.

514 Deflected nasal septum ......

615 Nasal polyp

516 Chronic laryngitis

517 Other diseases of upper respiratory tract...

518 Empyema

Lil

519 Pleurisy

--------------➖➖➖➖➖➖➖---------

520 Spontaneous pneumothorax

ANRHPS |

HONOMON

Carried forward

8,722

13,583

873

4,485

5,457

4,789

116

Diseases

Cases Treated 1949

Deaths 1949

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

8,722

13,583

873

4,485

5,457

4,789

Brought forward

521 Abscess of lung

+++-

522 Pulmonary congestion and hypostasis 523 Pneumoconiosis due to silica and silicates (occupational)

524 Other specified pneumoconiosis and pul- monary fibrosis of occupational origin

525 Other chronic interstitial pneumonia

526 Bronchiectasis

-----

527 Other diseases of lung and pleural cavity.

IX. DISEASES OF THE DIGESTIVE SYSTEM

Diseases of buccal cavity and oesophagus

|--

| | | | │

| ||-

117

―

8,852

13,684

880

4,501

6,487

4,809

(530-539)

530 Dental caries

531 Abscesses of supporting structures of teeth

532 Other inflammatory diseases of supporting structures of teeth

➖ ➖➖➖ITI

Carried forward

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

Flospita's

ment

Whole Colony

ment

Hospitals

Assisted

Hospitals

Male

Female

Brought forward

8,852

19,684

880

4,501

5,487

4,809

533 Disorders of occlusion, eruption, and tooth

development

structures

536 Stomatitis

534 Toothache from unspecified cause

536 Other diseases of teeth and supporting

537 Diseases of salivary glands

539 Diseases of oesophagus

Diseases of stomach and duodenum (540-545)

540 Ulcer of Stomach

541 Ulcer of duodenum

538 Other diseases of buccal cavity

-----------

---

| | | - |

118

―

271

107

542 Gastrojejunal ulcer

ย

543 Gastritis and duodenitis

166

544 Disorders of function of stomach

545 Other diseases of stomach and duodenum.

273

***** |

Appendicitis (550-553)

550 Acute appendicitis

216

--------------++

+--

Carried forward

----TITTHI++++REMTE-

9,472

14,524

899

4,544

5,589

4,848

Diseases

Cases Treated 1949

Deaths 1949

Govern-

Govern→

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Unknown

Sex.

9,472

14,524

899

4,544

5,589

4,848

Brought forward

551 Appendicitis unqualified 552 Other appendicitis

553 Other diseases of appendix

+++

Hernia of abdominal cavity (560-561)

560 Hernia of abdominal cavity without mention of obstruc- tion

178

561 Hernia of abdominal cavity with obstruction

Other diseases of intestines and

peritoneum (570-578)

570 Intestinal obstruction, without mention of hernia

571 Gastro-enteritis and

colitis.

except ulcerative,

age

weeks and over

488

1,968

1,082

1,113

1,071

572 Chronic enteritis and ulcers-

tive colitis

164

573 Functional disorders of intes- tines

Carried forward

10,451

16,987

991

5,730

6,803

5,982

119

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

ment

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

Sex.

10,451

16,987

991

5,730

6,803

5,982

▬▬

ITI I

289

קד

Brought forward

574 Anal fissure and fistula

Abscess of anal and rectal

575

regions

576 Peritonitis

577 Peritoneal adhesion

578 Other diseases of of intestines

and peritoneum

------

| │!

N |

Diseases of liver, gallbladder, and

pancreas (580-587)

580 Acute and subacute yellow atrophy of liver

581 Cirrhosis of liver

-----

582 Suppurative hepatitis and liver

abscess

583 Other diseases of liver

584 Cholelithiasis

585 Cholecystitis without mention of calculi

586 Other diseases of gallbladder and biliary ducts 587 Diseases of pancreas

-8 8 8 29

156

26 539

N ANG SN

BỘ CH

Carried forward

10,857

17,438

1,046

5,848

6,959

6,057

120

Diseases

Cases Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

Sex.

10,857

17,438

1,045

5,848

6,959

6,057

++H

| . || ||

* 38 21

104

F @@ 91

| | |

DONN

LỆ LÊN -

4空1

-------------¬----

In-

....

263

160

Brought forward

X. DISEASES OF THE GENITO-

URINARY SYSTEM

Nephritis and nephrosis (590-594)

690 Acute nephritis

591 Nephritis with oedema,

cluding nephrosis

592 Chronic nephritis

593 Nephritis not specified acute or chronic

594 Other renal sclerosis

Other diseases of urinary system

(600-609)

600 Infections of Kidney

601 Hydronephrosis

602 Calculi of kidney and ureter 603 Other diseases of kidney and ureter

604 Calculi of other other parts of urinary system

ILLINI

Carried forward

" | *3 |

11,158

18,100

1,065

5,983

7,140

6,195

121

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Govern-

ment

Assisted

Govern-

Whole Colony

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Hospitals

Unknown

Sex,

Brought forward

605 Cystitis

11,158

18,100

1,065

5,983

7,140

6,195

606 Other diseases of bladder 607 Urethritis (non-venereal} 608 Stricture of urethra 609 Other diseases of urethra

||||

- | | | | |

Diseases of male genital organs (610-617)

610 Hyperplasia of prostate 611 Prostatitis

612 Other diseases of prostate 613 Hydrocele

614 Orchitis and epididymitis 615 Redundant prepuce and

--------

phimosis

---

107

616 Sterility, male

617 Other diseases of male genital organs

།བྲཱམྨཝ ངྒཱ ཧྨ

Diseases of breast, ovary, Fallopian tube, and parametrium (620-626) 620 Chronic cystic disease of breast

Carried forward

11,352

18,378

1,066

5,992

7,153

6,200

122

Cases

Treated 1949

Deaths 1949

Whole Colony

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

Sex

Brought forward

11,352

18,378

1,086

5,992

7,153

6,200

621 Other diseases of breast

622 Acute salpingitis and oophoritis 623 Chronic salpingitis and

oophoritis

624 Salpingitis and oophoritis, un-

qualified.

625 Other diseases of ovary and Fallopian tube

-----

626 Diseases of parametrium and pelvic peritoneum (female)

Է-

1 | 1

Diseases of uterus and other female genital organs (630-637)

108

---IT

203

137

+++

417

630 Infective disease of uterus, vagina, and vulva

631 Uterovaginal prolapse

632 Malposition of uterus

633 Other diseases of uterus 634 Disorders of menstruation 635 Menopausal symptoms 636 Sterility, female

Carried forward

ས||

123

11,985

19,287

1,066

5,995

7,153

6,205

Diseases

Cases Treated 1949

Deaths 1949

Govern-

ment

Govern-

ment

Assisted

Govern-

Whole Colony

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

Sex

11,985

19,237

1,066

5,995

7,153

6,205

Brought forward

637 Other diseases of female

genital organs

XI. DELIVERIES AND

COMPLICATIONS OF PREGNANCY,

CHILDBIRTH, AND THE

PUERPERIUM

Complications of pregnancy (640-649)

640 Pyelitis and pyelonephritis of

pregnancy

641 Other infections of of genito- urinary tract during pre-

gnancy

642 Toxaemias of pregnancy

226

103

643 Placenta praevia

644 Other haemorrhage of pre-

gnancy

----++-----

643 Ectopic pregnancy

646 Anaemia of pregnancy

-JLI

647 Pregnancy with malposition of foetus in uterus

Carried forward

|མཊཿ |མ།

LAN

12,365

19,432

1,082

6,034

7,153

6,274

124

Cases

Treated 1949

Deaths 1949

Whole Colony

Diseases

Govern-

ment

ment..

Assisted

Hospitals

ment

Assisted

Hospitals

Male

Female

Unknown

sex.

Brought forward

12,365

19,432

1,082

6,034

7,153

6,274

TILII

648 Other complications

arising

from pregnancy

129

649 Pregnancy associated other conditions

with

103

Abortion (650-652)

650 Abortion without mention of

sepsis or toxaemia

651 Abortion with sepsis

652 Abortion with toxaemia, with- out mention of sepsis

ILI ------

Delivery without complication (660)

660 Delivery without complication...

Delivery with specified complication (670-678)

670 Delivery complicated by placenta praevia partum haemorrhage

213

645

7,807

13,262

20,708

33,494

1,085

6,050

7,153

6,295

OT ante-

671 Delivery complicated by tained placenta

Te-

Carried forward

125

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Unknown

Male

Female

sex.

20,708

33,494

1,085

6,060

7,153

6,295

293

100

Brought forward

672 Delivery complicated by other post-partum haemorrhage

673 Delivery complicated by

abnormality of bony pelvis

----

674 Delivery complicated by dis- proportion or malposition of foetus

675 Delivery complicated by pro- longed labour of other origin

676 Delivery with laceration perineum, without mention of other laceration

677 Delivery with other trauma

678 Delivery with other complica- tions of childbirth

Complications of the puerperium

(680-689)

680 Puerperal urinary infection without other sepsis

641

412

627

-----

681 Sepsis of childbirth and the

puerperium

---+---++UE

Carried forward

21,896

34,688

1,090

6,060

7,153

6,321

126

Cases Treated 1949

Deaths 1949

Whole Colony

Unknown

sex

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Brought forward

21,896

34,688

1,090

6,060

7,153

6,321

682 Puerperal phlebitis and throm-

bosis

683 Pyrexia of unknown origin during the puerperium

684 Puerperal pulmonary embolism

685 Puerperal eclampsia

686 Other forms of puerperal

toxaemia

687 Cerebral haemorrhage in the

puerperium

-----

688 Other and unspecified com- plications of the puerperium.. 689 Mastitis and other disorders of lactation

----ITI

XII. DISEASES OF THE SKIN AND

CELLULAR TISSUE

Infections of skin and subcutaneous

tissue (690-698)

690 Boil and carbuncle

-| -

| | | | | | |

| | "

691 Cellulitis of finger and toe

THIH

152

102

109

Carried forward

CH+++

22,211

34,830

1,092

6,066

7,158

6,328

127

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

ment

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

sex

22,211

-------

34,830

1,092

6,066

7,158

6,328

112

1,124

RIH

22** | 9

without mention of

lymphangitis

Brought forward

692 Other cellulitis and abscess

693 Other cellulitis and abscess

with lymphangitis

694 Acute lymphadenitis

695 Impetigo

696 Infectious warts

697 Molluscum contagiosum

698 Other local infections of skin

and subcutaneous tissue

ILI ILI

Other diseases of skin and subcutaneous

tissue (700-716)

700 Seborrhoeic dermatitis

701 Eczema

702 Occupational dermatitis

703 Other dermatitis ..................

TH------

704 Pemphigus

------

705 Erythematous conditions

IIILI ++

706 Psoriasis and similar disorders

707 Lichen planus

Carried forwara

| | | |~~ | |

298||

| | | | | || |

| | | |

- 128

22,511

36,081

1,097

6,083

7,176

6,347

Diseases

Cases Treated 1949

Deaths 1949

Govern-

Whole Colony

Govern-

ment

Assisted

ment

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

şex_

22,511

36,081

1,097

6,083

7,176

6,347

+------

~||

|||

------------

EZA

321

297

Brought forward

708 Pruritus and related conditions 709 Corns and callosities

710 Other hypertrophic and

-----

atrophic conditions of skin

711 Other dermatoses

712 Diseases of nail

LIIIT++

---

713 Diseases of hair and hair

follicles

714 Diseases of sweet and seba- ceous glands

-------TOOLI

715 Chronic ulcer of skin

716 Other diseases of skin

XIII. DISEASES OF THE BONES

AND ORGANS OF MOVEMENT

Arthritis and rheumatism, except rheumatic fever (720-727)

720 Acute arthritis due to pyogenic organisms

THI

721 Acute non-pyogenic arthritis 722 Rheumatoid arthritis and allied conditions

Carried forward

ن في

22,611

36,774

1,097

6,086

7,177

6,349

129

Diseases

Brought forward

723 Osteo-arthritis (arthrosis) and

allied conditions

724 Other specified forms of

arthritis

725 Arthritis, unspecified

726 Muscular rheumatism

727 Rheumatism unspecified

➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖

Osteomyelitis and other diseases of bone and joint (730-738)

700 Osteomyelitis periostitis 731 Osteitis deformans

Cases

Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

22,611

36,774

1,097

6,085

7,177

6,349

LES

217

| | | | |

||||

~ || | |

129

732 Osteochondrosis

738 Other diseases of bone

+++

734 Internal derangement of knee

joint

+++

735 Displacement of intervertebral

disc.

736 Affection of sacro-iliac joint

737 Ankylosis of joint

738 Other diseases of joint

115 | || ||

Carried forward

Unknown

sex

| | | | │

|1|| | 11 ||

22,814

37,175

1,097

6,087

7,180

6,350

130

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Male

Deaths 1949

Whole Colony

Female

Unknown

sex.

Brought forward

22,814

37,175

1,097

6,087

7,180

6,350

Other diseases of musculo-skeletal system (740-749)

740 Bunion

741 Synovitis, bursitis, and tenosy- novitis without mention of occupational origin

742 Synovitis, bursitis, and tenosy- novitis of occupational origin

743 Infective myositis and other inflammatory diseases tendon and fascia

744 Other diseases of muscle,

tendon, and fascia

745 Curvature of spine

746 Flat foot

747 Hallux valgus and varus

748 Clubfoot

749 Other deformities

ग

ILJILLII

Carried forward

22,860

37,202

1,097

6,087

7,181

6,350

131

Diseases

Cases

Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

Assisted

Hospitals

Assisted

Hospitals

Male

Female

HITKIH +

22,860

37,202

1,097

6,087

7,181

6,350

Brought forward

XIV. CONGENITAL MALFORMATIONS

Congenital malformations (750-759)

750 Monstrosity

---------------

751 Spina bifida and meningocele.

752 Congenital hydrocephalus

753 Other congenital malforma-

tions

nervous

and sense organs

gystem

754 Congenital malformations of

| 19

NAJ

| to an

circulatory system

755 Cleft palate and harelip

756 Congenital malformations of digestive system

CA LA

---------------

757 Congenital malformations of genito-urinary system

18 18

* N

ཁཱ།

00,

758 Congenital malformations

bone and joint

759 Other and unspecified

Con-

genital malformations, elsewhere classified

not

Carried forward

Unknown

Bex

| | |

23,017

37,247

1,126

6,114

7,223

6,380

132

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

gex.

Brought forward

23,017

37,247

1,126

6,114

7,223

6,380

XV. CERTAIN DISEASES OF

EARLY INFANCY

Birth injuries, asphyxia, and infections

of newborn (760-769)

760 Intracranial and spinal injury

at birth

761 Other birth injury

螢

ཙ་ྲཝ།སརྒྱས།

103

762 Post-natal asphyxia and

atelectasis

258

763 Pneumonia of newborn

764 Diarrhoea of newborn .... 765 Ophthalmia neonatorum

766 Pemphigus neonatorum ... 767 Umbilical sepsis

I ILI - - - - -

arising

768 Other sepsis of newborn 769 Neonatal disorders from maternal toxaemia

སྲམ སྣུམ|*|* ཝཱ

ཋ|

| |

2-7|||* |

TO!

Carried forward

----

23,354

37,455

1,156

6,253

7,443

6,574

133

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

sex

Brought forward

23,354

--+ +-+

37,455

1,156

6,253

7,443

6,574

Other diseases peculiar to early infancy (770-776)

770 Haemolytic disease of newborn (erythroblastosis)

४

771 Hæmorrhagic disease of new-

born

772 Nutritional maladjustment 773 Ill-defined diseases peculiar to early infancy

O LA

** **

- 22

--++++

774 Immaturity with mention of any other subsidiary condi- tion

یت

775 Immaturity subsidiary to some

other cause

776 Immaturity unqualified

630

182

140

337

292

| | | │

| ||

134

Carried forward

+++++

24,021

37,689

1,268

6,431

7,823

6,912

Diseases

Brought forward

XVI. SYMPTOMS, SENILITY AND ILL-DEFINED CONDITIONS

Symptoms referable to systems or organs (780-789)

780 Certain symptoms referable to nervous system and special

senses

781 Other symptoms referable to nervous system and special

senses

782 Symptoms referable to cardio- vascular and lymphatic system

783 Symptoms referable to T23- piratory system

Cases

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

Unknown

sex.

24,021

37,689

1,268

6,431

7,823

6,912

784 Symptoms referable to upper gastro-intestinal tract

785 Symptoms referable to

abdomen and lower gastro- intestinal system

Carried forward

24,066

37,708

1,268

6,437

7,827

6,918

135

Cases

Treated 1949

Deaths 1949

Whole Colony

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

sex

Brought forward

24,056

37,708

1,268

6,437

7,827

6,918

786 Symptoms referable to genito-

urinary system

787 Symptoms referable to limbs

and back

---------------

~N I

139

| | | │

788 Other general symptoms

789 Abnormal urinary constituents

of unspecified cause

Senility and ill-defined diseases

(790-795)

790 Nervousness and debility

791 Headache

792 Uraemia unqualified

HND

793 Observation, without need for further medical care

276

213

++++

794 Senility without mention of psychosis

112

795 Ill-defined and unknown causes of morbidity and mortality.

| |* | | `-

||* |

136

486

350

Carried forward

24,413

88,203

1,281

6,461

8,338

7,325

Diseases

Cases Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Female

24,413

38.203

1,281

6,461

8,338

7,325

Brought forward

N XVII. ALTERNATIVE

CLASSIFICATION OF ACCIDENTS, POISONINGS AND VIOLENCE

(NATURE OF INJURY)

Fracture of skuil, spine, and trunk

(N800-N809)

N800 Fracture of vault of skull N801 Fracture of base of skull N802 Fracture of face bones

131

* ||

N803 Other and unqualified skull fractures

N804 Multiple fractures involving skull or or face face with other

bones

N805 Fracture and fracture dis- location of vertebral column

without mention of spinal

cord lesion

----------

N806 Fracture and fracture dis- location of vertebral column with spinal cord lesion

Carried forward

---+

154

пост

Unknown

sex.

24,729

38,228

1,362

6,465

8,493

7,372

137

Diseases

Cases Treated 1949

Deaths 1949

Whole Colony

Female

Unknown

sex

7,372

Govern-

ment

Hospitals Assisted Hospitals

Govern.

ment

Hospitals

Govern-

ment

Assisted

Hospitals

Male

24,729

38,228

1,382

6,465

8,493

++------T--- +1

NIA

CAR

Brought forward

N807 Fracture of rib(s) and

sternum

N808 Fracture of pelvis

N809 Multiple, and ill-defined frac-

tures of trunk

Fracture of upper limb (N810-819)

N810 Fracture of clavicle

N811 Fracture of scapula N812 Fracture of humerus

110

ILI

117

ུཌདྡྷཎྜས༣

N813 Fracture of radius and ulna N814 Fracture of carpal bone(s) N815 Fracture of metacarpal bone(s) N816 Fracture of one or more

N817 Multiple fractures of hand bones

phalanges of hand

N818 Other, multiple, and ill-defined

fractures of upper limb

N819 Multiple fractures involving both upper limbs, and upper limb with rib(s) and sternum

Carried forward

| | | || ||

| | | |

| | | | |

| | ||

25,147

38,231

1,370

6,465

8,505

7,376

138

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

ment

Hospitals

Assisted

Hospitals

Male

Deaths 1949

Whole Colony

Female

Unknown

Brought forward

Fracture of lower limb (N820-N820) N820 Fracture of neck of femur N821 Fracture of other and specified parts of femur

N822 Fracture of patella

N823 Fracture of tibia and fibula N824 Fracture of ankle

25,147

38,231

1,370

6,465

8,505

7,376

- - - -

un-

201

00:00

N825 Fracture of one or more tarsal and metatarsal bones

---

265

...

N826 Fracture of one or more phalanges of foot

N827 Other, multiple, and ill-defined fractures of lower limb

N828 Multiple fractures involving both lower limbs, lower with upper limb, and lower limb (s) with rib(s) and

sternum

T+-+

N829 Fracture of unspecified bones...

Carried forward

25,771

38,253

1,381

6,465

8,514

7,382

139

Diseases

Cases Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

mient

ment

Hospitals

Assisted

Hospitals

Male

Female

25,771

38,253

1,381

6,465

8,514

7,382

Brought forward

Dislocation without fracture (N830-839)

N830 Dislocation of jaw

N831 Dislocation of shoulder

N832 Dislocation of elbow

N833 Dislocation of wrist

N834 Dislocation of finger N835 Dislocation of hip N836 Dislocation of knee N837 Dislocation of ankle

N838 Dislocation of foot

N839 Other, multiple, and ill-defined

dislocations

Sprains and strains of joints and adjacent muscles (N840-848)

N840 Sprains and strains of shoulder and upper arm

N841 Sprains and strains of elbow

and forearm

• Ko-El-Gao

| Torilaul

N842 Sprains and strains of wrist and hand

Carried forward

| 1

Unknown

sex.

25,827

38,274

1,381

6,465

8,515

7,382

140

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

Whole Colony

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Unknown

Male

Female

sex

Brought forward

25,827

38,274

1,381

6,465

8,515

7,382

N843 Sprains and strains of hip and

thigh

and leg

N844 Sprains and strains of knee

N845 Sprains and strains of ankle

and foot

४

N846 Sprains and strains of sacro-

iliac region

N847 Sprains and strains of other

and unspecified parts of back

N848 Other and ill-defined sprains

and strains

Head injury (excluding skull fracture) (N850-856)

N850 Open wound of scalp

N851 Contusion and hæmatoma of

scalp

N852 Concussion

484

N853 Cerebral laceration and con-

tusion

Carried forward

26,399

38,295

1,389

5,466

8.522

7,384

141

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

Whole Colony

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Unknown

Male

Female

sex.

26,399

38,295

1,389

6,466

8.522

7,384

Brought forward

N854 Subarachnoid, subdural, and

extra-dural hæmorrhage

following injury

(without

mention of cerebral lacera- tion or contusion)

N855 Other and unspecified intra- cranial hemorrhage follow- ing injury (without mention

of cerebral

contusion)

laceration of

N856 Head injury of other and un-

specified nature

Internal injury of chest, abdomen, and pelvis (N860-N869)

N860 Traumatic pneumothorax and

hæmothorax

N861 Injury to heart and lung

N862 Injury to other and unspecified intrathoracic organs

| | | |

| | |

Carried forward

26,449

38,295

1,422

6,466

8,559

7,388

N863 Injury to gastro-intestinal

tract

142

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Hospitals

Deaths 1949

Whole Colony

Female

Unknown

зех

Brought forward

26,449

38,295

1,422

6,466

8,559

N864 Injury to liver

7,388

N865 Injury to spleen

N866 Injury to kidney

N867 Injury to pelvic organs

-----++

N868 Injury to other and unspecified intra-abdominal organs

LILJIPI

זי

N869 Internal injury unspecified or involving intrathoracic with intra-abdominal organs

Laceration and open wound of face, neck, and trunk (N870-N879)

N870 Open wound of eye and orbit N871 Enucleation of eye

N872 Open wound of ear

N873 Other and unspecified lacera-

tion of face

N874 Open wound of neck

N875 Open wound of chest

N876 Open wound of back

N877 Open wound of buttock

Carried forward

----------

143

| | | | │

~|| ||||

| | | |~~||

| | |

~|| 1° |||

|||

E8862 aan d

26,667

38,314

1,446

6.466

8,597

7,401

Diseases

Brought forward

Cases

Treated 1949

Deaths 1949

Govern-

Whole Colony

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

sex.

26,667

38,314

1,446

6,466

8,597

7,401

N878 Open wound of genital organs, including traumatic amputa-

tion

N879 Multiple and unspecified open wounds of face, neck, and trunk

Laceration and open wound of upper limb (N880-N888)

N880 Open wound of shoulder and upper arm

N881 Open wound of elbow and forearm, and wrist not in- volving tendon(s)

N882 Open wound of wrist involving

tendon(s)

►

N883 Open wound of hand, except

finger(s)

N884 Open wound of finger(s)

← BA

N885 Multiple and unspecified open wounds of one upper limb

LII

Carried forward

│1

- 144

26,860

38,356

1,449

6.466

8,501

7,403

Cases Treated 1949

Deaths 1949

145

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Govern-

Whole Colony

Govern-

ment

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

Unknown

sex.

Brought forward

26,860

38,356

1,449

6,466

8,601

7,403

N886 Traumatic amputation of

thumb(s)

N887 Traumatic amputation of other

Anger(s)

N888 Traumatic amputation of arm

and hand

Laceration and open wound of lower limb (N890-N898)

N890 Open wound of hip and thigh

N891 Open wound of knee, leg (except thigh), and ankle not involving tendons

N892 Open wound of ankle involving

tendons

++++

N893 Open wound of foot, except

toe(s)

------

-----

N894 Open wound of toe(s) N895 Multiple and unspecified open wounds of one lower limb

N896 Traumatic amputation of toe(s) N897 Traumatic amputation of foot...

Carried forward

| | |

| | | |

|||

| | |

27,120

38,405

1,450

6,466

8,602

7,403

Diseases

Cases

Treated 1949

Deaths 1949

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Male

27,120

38,405

1.450

6,466

8,602

Deaths 1949

Whole Colony

Female

Unknown

sex

Brought forward

+++

N898 Traumatie amputation of leg

---

Laceration and open wounds of multiple

location (N900-N908)

N900 Multiple open wounds of both upper limbs

N901 Multiple open wounds of both

lower limbs

T++++++

N902 Multiple open wounds of both upper and lower limb(s)

N903 Multiple open wounds of both

7,403

106

------

hands

N904 Multiple open wounds of both head and limb

│││││

1 1

N905 Multiple open wounds of both head and trunk

N906 Multiple open wounds of both

trunk and limb

N907 Multiple open wounds of face with other sites

N908 Multiple and open wounds of unspecified location

Carried forward

27,152

$8,536

1,453

6,466

8.606

7,404

146

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

ment

Assisted

Hospitals

Assisted

Hospitals

Male

Brought forward

Superficial injury (N910-N918)

N910 Superficial injury of face and

neck

N911 Superficial injury of trunk

N912 Superficial injury of shoulder

----------

and upper aim

N913 Superficial injury of elbow, forearm, and wrist

N914 Superficial injury of hand(s)

---------------+H

N915 Superficial injury of finger(s).

N916 Superficial injury of hip, thigh,

Deaths 1949

Whole Colony

Female

27.152

38,536

1,453

6,406

8,805

7,404

2 | | |

except fingers

25 म

leg, and ankle

N917 Superficial injury of foot and

toe(s)

N918 Superficial injury of other,

multiple,

sites

and unspecified

+++

Carried forward

~| | | | |

1 │

27,210

38,615

1,453

6.466

8,608

7,404

Unknown

sex.

147

Cases Treated 1949

Deaths 1949

Whole Colony

Unknown

sex

148

| | || || |

王

Diseases

Govern-

ment

Hospitals

Assisted

Hospitals

Assisted

Hospitals

Male

Female

Brought forward

27,210

38,615

1,453

6,466

8,608

7,404

Contusion and crushing with intact skin surface (N920-N929)

N920 Contusion of face and neck, except eye(s)

-----

N921 Contusion of eye and orbit

N922 Contusion of trunk

N923 Contusion of shoulder and upper arm

N924 Contusion of elbow, forearm,

and wrist

N925 Contusion of hand(s), except

fingers

N926 Contusion of finger(s)

N927 Contusion of hip, thigh, leg,

and ankle

N928 Contusion of foot and toe(s)

N929 Contusion of other, multiple, and unspecified sites

12 29 2

| | | |

| | |

Carried forward

27,362

38,619

1,455

6,466

8,609

7,406

Diseases

Cases Treated 1949

Deaths 1949

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

"Govern-

Govern-

ment

Hospitals

Assisted

Hospitals

Male

Deaths 1949

Whole Colony

Female

27,352

38,619

1,455

6,466

8,609

7,406

Brought forward

Effects of foreign body entering through orifice (N930-N936)

N930 Foreign body in eye and adnexa

N931 Foreign body in ear

N932 Foreign body in nose

larynx

lung

113

N933 Foreign body in pharynx and

N934 Foreign body in bronchus and

N995 Foreign body in digestive tract

N936 Foreign body in genito-urinary

tract

Burns (N940-N949)

N940 Burn confined to eye

--T--++

N941 Burn confined to face, head,

and neck

ז...

N942 Burn confined to trunk

IJLI JI

N943 Burn confined to upper limb(s), except wrist and hand

Carried forward

| _| | | | |

| | | |

|| 1

27,515

38,621

1,456

6.466

8,610

7,406

Unknown

sex.

149

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

Whole Colony

Govern-

ment

mient

Assisted

ment

Hospitals

Assisted

Hospitals

Unknown

Male

Female

sex

Brought forward

27,515

38,621

1,450

6,466

8,610

7,406

N944 Burn confined to wrist(s) and

hand(s)

N945 Burn confined to lower limb (s) N946 Burn involving face, head, and neck, with limb(8)

N947 Bura involving trunk with

limb(s)

N948 Burn involving face, head, and neck, with trunk and limb(s) N949 Burn involving other and un- specified parts

Injury to nerves and spinal cord without bone injury (N950-N959)

N950 Injury to optic nerve(s)

N951 Injury to other cranial nerve(s) N952 Injury to nerve(s) in upper arm N953 Injury to nerve(s) in forearm... N964 Injury to nerve(s) in wrist and

hand

N955 Injury to nerve(s) in thigh N956 Injury to nerve(s) in lower leg

. . г. г

------

| | | |

| | |

Carried forward

27,656

THTHITTI

38,660

1471

6,469

8,651

7,425

150

Diseases

Brought forward

N967 Injury to nerve(s) in ankle

and foot.........

N958 Spinal cord lesion without

evidence of spinal bone injury

N959 Other nerve injury including nerve injury in several parts

Effects of poisons (N960-N979)

N960 Poisoning by noxious foodstuffs

N961 Poisoning by alcohol

---------

N962 Poisoning by petroleum pro-

ducts

N963 Poisoning by industrial solvents N964 Poisoning by corrosive

aromatics, acids, and caustic

Cases Treated 1949

Deaths 1949

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Hospitals

Assisted

Hospitals

Male

Female

27,656

38,660

1,471

6,469

8,651

7,425

00-

୪

| -

alkalis

190

N965 Poisoning by mercury and its

compounds

N966 Poisoning by lead and its

compounds

N967 Poisoning by arsenic and anti- mony, and their compounds...

Carried forward

|- ||

| | ││

| | | |

Unknown

sex.

27,948

38,666

1,479

6,469

8,656

7,431

151

Cases

Treated 1949

Deaths 1949

Diseases

Govern-

ment

Hospitals

Govern-

ment

Assisted

Hospitals

ment

Hospitals

ment

Assisted

Hospitals

Male

Deaths 1949

Whole Colony

Female

Unknown

sex.

7,431

27,948

38,666

1,479

6,469

8,656

------

---------ri

* - | - | |

| |

Brought forward

N968 Poisoning by carbon monoxide.. N969 Poisoning by other gases and

vapours

N970 Poisoning by morphine and other opium derivatives

N971 Poisoning by barbituric acid and derivatives

......-T-----------

N972 Poisoning by aspirin and

salicylates

N973 Poisoning by bromides

N974 Poisoning by other analgesic and soporific drugs

--------

N975 Poisoning by sulphonamides N976 Poisoning by strychnine N977 Poisoning by belladonna, hyoscine, and atropine

N978 Poisoning by venom

N979 Poisoning by other and un- specified substances

Carried forward

28,120

38,676

1,501

6,469

8,681

7.448

152

Diseases

Cases

Treated 1949

Deaths 1949

Deaths 1919

Whole Colony

Govern-

ment

Hospitals

ment

Assisted

Hospitals

ment

Assisted

Hospitals

Male

Female

28,120

38,676

1,501

6,469

8,681

7,448

Brought forward

Effects of weather, exposure, and related conditions (N980-N989) N980 Effects of reduced temperature N981 Effects of heat and insolation N982 Effects of high altitude

N983 Caisson disease

N984 Effects of lightning

N985 Effects of hunger

N986 Effects of thirst

------

----

- ■+ + ++

N987 Effects of exposure, not else.

where classified

N988 Effects of excessive exertion N989 Motion (travel) sickness

Other and unspecified injuries and re actions (N990-N999)

1. Tele-|

N990 Drowning and non-fatal sub-

mersion

N991 Asphyxia and strangulation N992 Electrocution and non-fatal effects of electric currents

Carried forward

TETTETT │||

|-|| ||

Unknown

sex

28.169

38,678

1,505

6,470

8,789

7,494

153

Cases Treated 1949

Deaths 1949

Diseases

Govern-

ment

Govern-

ment

Hospitals

Assisted

Hospitals

ment

Assisted

Hospitals

Male

Brought forward

N993 Injury due to radiation, except

Deaths 1949

Whole Colony

Female

28,169

38,678

1,505

6,470

8,789

7.494

sunburn

N994 Other general effects of

external causes

trauma

Druk++-----------------

nature

N996 Certain early complications of

N996 Injury of other and unspecified

N997 Reactions and complications

N998 Adverse reactions to injections, infusions and transfusions

due to non-therapeutic medical and surgical surgical pro-

cedures

ruutu-

other

tions

for therapeutic purposes

N999 Averse reaction

therapeutic procedure

Y 00 Medical or Special Examina-

Total

Unknown

Sex.

28,276

38,678

1,505

6,470

8,789

7,494

154

Name

156

ANNEXURE L.

In-Patients Treated in Private Hospitals-1949.

General Cases

Infectious Tubercu-

divense

Maternity

Cases

losis

cases

Total

cases

Tai Wo Hospital

$26

122

1,048

St. Paul's Hospital

1,818

567

634

3,083

Ling Yuet Sin Infant's

Hospital

Precious Blood Hospital

1,579

147

229

1,982

Hong Kong Sanatorium

and Hospital

2,935

230

460

639

4,273

St. Teresa's Hospital... |

1,216

170

472

1,942

Tolal

8,449

419

1,466

2,073

12,407

New Cases of Out-Patients at Private Hospitals.

1949.

Name

Dressinga

Genern! Out. patienta

Children's Clinic

Ante-Natal! Post-Natal

Clinic

Gynaeco- logical Clinic

Eye

Clinic

Ear, Nose and Throat

Tuber-

Total

culosis

St. Paul's Hospital

Ling Yuet Sin Infants'

Hospital

Figures not available.

244

187

785

Hong Kong Sanatorium

and Hospital

3,293

2,013

380

St. Teresa's Hospital...

613

250

210

120

240

1,570

Total

3,770

737

602

120

罰

246

240

5,648

Total Allendances of Out-Patients at Private Hospitals

1949.

Name

Dressings

General Out- patients

Children's Clinic

Ante-Natal Post-Natal

Clinic

Gynaeco logical Clinic

Езле Clinic

Tuber- Ear, Nose and Throat culosis

Total

St. Paul's Hospital

Ling Yuet Sin Infants'

Hospital

L-

120

15,445

955

276

607

629

17,159

937

------------

Hong Kong Sanatoriumi

and Hospital

ILJILI

7,149

1,004

8,153

St. Teresa's Hospital...

150

1,840

1,240

1.470

120

620

$70

6,372

Total

297

24,710

2,802

2,486

121

520

104

1,509

32,021

156

ANNEXURE M.

Report of work in the Almoners' Department

of the Medical Department from

April 1949 to March, 1950.

1. Staff.

During this last year 1949-50, the Almoners' Department has suffered many changes, and the period has been rather a turbulent one, resulting in a great deal of hard routine work for the members of the staff. The Principal Almoner, Miss Margaret Watson, 0.8.E. left the Colony in March 1949 and the new Principal Almoner did not arrive until September. Another member of the staff went to England during this period for a course of training and the Acting Principal Almoner was forced to carry on with more responsibility than before and with a reduced staff. Nevertheless by April 1950, the Medico-Social Department was able to look back upon a year of hard work and of some achievement,

Almoners are now in attendance at the following hospitals and clinics:

Queen Mary Hospital

Kowloon Hospital

4 almoners.

Harcourt Tuberculosis Clinic

Sai Ying Pun Centre O.P.D.

Tsan Yuk and the Mental Hospital.

Violet Peel Polyclinic

נו

Ruttonjee Sanatorium,

St. John Hospital, Cheung Chau, and Lai Chi Kok Hospital

Principal Almoner

2. Training.

visiting almoners.

Medical Headquarters.

Three new student almoners were appointed to the Depart- ment in December 1949 with pay. Seven additional students volunteered to take a year's course of training under the auspices of the Almoners' Department. These trainees have attended courses of lectures given by the Supervisor and Training Officer of Health Nurses, the Sister Tutor, Queen Mary Hospital by various doctors, and by the Principal Almoner. They have also been on many visits of observation to local factories, welfare centres, orphanages and other institutions. Further experience

in home visiting and interviewing has been gained with the Family Welfare Society, with the Society for the Protection of Children and in the offices of the various Hospitals.

157

　　All these students are graduates of Chinese universities and have taken sociology or economics as their major subject.

　　The Almoners' Department, with the help of the Supervisor and Training Officer for Health Nurses, has also dealt with the appointment and training of six new Tuberculosis Workers who are attached to the Harcourt Tuberculosis clinic. There are now twelve such workers under the direction of the almoners at the Harcourt Clinic,

3. General Work.

　　Although medico-social work has, in itself, not developed greatly within the hospitals this year owing to the need for retrenchment, nevertheless assistance has been given to patients. in need in the following ways:

(a) Repatriation.

In many cases patients come from China into Hong Kong for a few years, are ill, have treatment, and then desire to return to their home village. They are, as a rule, destitute, and the almoner sees that they are either taken by police or relations to the border, and that they have enough money and clothes to travel back to China.

(b) Artificial limbs and other surgical appliances.

　　These are supplied to those patients who need them, funds being provided, where necessary, either by Government or from the Almoner's Samaritan Fund.

　　Some of the artificial limbs have been obtained from New Zealand, America and England; but orders are as a rule placed with local men, one of whom has himself lost a limb and makes surgical appliances as his only means of livelihood.

　　Recommendations for hawkers' licences are made by the almoners, and in suitable cases these licences are granted to patients. This enables many an injured or incapacitated patient to obtain a living where otherwise he would find employ- ment impossible.

(d) Maintenance of Children.

The Medico-Social Department has made arrangements during the year for the maintenance of children of patients, or of children who have been patients, in Homes and Crèches in the neighbourhood. In most cases Homes agree to have these children free of cost, but for a few the parents, if known, will pay.

158

(e) Financial assistance.

Temporary financial assistance and the supply of clothes and food is given. The almoners have a small clothing store, and also a Samaritan Fund from which money can be given, or from which goods can be bought and given to patients.

(f) Re-employment.

Many patients on their discharge from hospital are advised about future employment and how best to obtain work. Visits are made by the almoner to the factories concerned and employers are contacted. Whenever possible alternative work is found for the patient. This proves very difficult as for every vacancy in a factory or workshop there are so many healthy workers clamouring for employment.

(g) Attempted suicides.

Those patients who have attempted suicide and have been unsuccessful, who are admitted to hospital or sent to out-patient clinics because their attempt was due to some real or imaginary illness, are the responsibilty of the almoner as well as the doctor. These patients are advised and helped over their difficulties, and are kept under observation after their discharge from hospital.

(h)

Injured patients.

Advice and help are also given to those patients who are injured as a result of an accident at work or on the road. A close liaison is maintained with the Traffic Office and the Labour Office, and the almoners arrange to visit patients' employers to see what help can be given to the family.

(1) Extra Food. (0

Doctors often recommend extra nourishment for patients where the standard of nutrition is very low. These patients are given powdered milk weekly or extra money with which to buy food.

Help has also been given in a variety of other ways applicable to the cases concerned. With the co-operation of other Government departments and voluntary agencies, much has been done to help patients on their discharge from hospital.

During 1949 full statistics were not kept of all these cases- but in future years more complete records will be kept and figures will be available to show how many cases are dealt with by the Almoners' Department in the course of a year.

159

4. Tuberculosis Work.

During the last year the almoners concerned have done a great deal of work.

(a) Interviews.

An average of approximately 460 patients per month have been interviewed by the almoners at the Tuberculosis Clinic. For most of these patients arrangements are made for admission to hospital or for out-patient treatment, and for adequate follow-up by the Tuberculosis Workers of all contacts.

(b) Maintenance Scheme.

Almoners have been responsible for the continuation of the maintenance scheme for families of patients suffering from tuberculosis. This scheme has been a great success.

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　Financial help is given to families of early positive cases of tuberculosis in circumstances where the patient would be unable to take advantage of a vacant hospital bed unless some help was forth- coming. It is also helpful to patients who have been self- supporting and who could not stop work to take treatment unless they know they would have some form of financial assistance. It is hoped that this scheme is encouraging patients to take their treatment at an early stage and so aid recovery.

It has been found possible in exceptional cases to re-house tubercular patients in more healthy surroundings. The Crown Lands & Survey Office has granted land on a yearly lease to patients who have built their own huts. These patients have been helped with grants and loans from the Almoner's Samaritan Fund.

(d) Care of Children.

Schemes are being discussed with certain voluntary societies who have promised to help to house children who are in contact with direct infection until there is no further danger in the home. During the year arrangements have been made for such children to be admitted to Children's Homes and Institutions for a certain length of time.

(e) Selection of Tuberculosis Workers.

The six new Tuberculosis Workers already mentioned were appointed in January 16th, 1950. Their training consists of courses of lectures, advice and practical experience in home visiting, and visits of observation to hospitals, clinics and wel- fare centres in the Colony. Their main work is to arrange for

160

the contacts of all known cases of tuberculosis to come up for examination and x-rays. They visit and report on the home conditions of all new patients and, whenever necessary, follow up cases.

5. Mental Hospital.

In the Mental Hospital, plans have been made for a system of follow-up for mental patients. At the present time one almoner has to cope with the Tsan Yuk Maternity Hospital, Sai Ying Pun Infectious Diseases Hospital, Sai Ying Pun out- patients and the Mental Hospital, all of which are situated close to each other in a very crowded and poor area. It is hoped later in 1950 that it will be possible to appoint an almoner full time to the Mental Hospital and to make a start on the much needed social work that is waiting to be done.

6. Recreation.

(a) Occupational Therapy.

Occupational Therapy is still in its infancy and without the expert help of a trained occupational therapist it is difficult to arrange for work or recreational activity which should be selected and prescribed for each individual patient for his parti- cular needs; but a start has been made on very broad lines. A small committee has been formed to deal with an occupational therapy fund made up of voluntary grants.

(b) Teaching Trades as a form of Rehabilitation.

It is hoped during the next year that it will be possible to teach patients some form of occupational therapy, not only as a diversion when in hospital, but as a trade which will be of use to them when they are discharged. There is at present a Rattan Instructor at the Mental Hospital, and a voluntary helper at Queen Mary Hospital whose services have been most useful.

(e) Library.

A Library has been started in Lai Chi Kok Hospital with the help of Tuberculosis Workers mainly for tuberculous patients. Chinese newspapers are being sent to every ward in all the hospitals by the Secretary of the British Red Cross Committee in Hong Kong, who has also sent books for the library.

(d) Films.

The Red Cross have also started to give silent film shows at the Lai Chi Kok Hospital and Ruttonjee Sanatorium.

161

7. Samaritan Fund.

　　The Principal Almoner has control of a Samaritan Fund used to help patients who are in need and for whom there is no other provision. Grants and loans are given from this Fund which is entirely made up of voluntary contributions.

(a) Hawkers.

　　Patients who leave Hospital and who cannot work due to accident or disease may, on the advice of the almoner, be granted a hawkers licence. Several patients have had a grant from the Samaritan Fund to pay for the licence, and have been given a certain amount of capital with which to buy their goods.

(b) Re-housing.

　　Tuberculous patients have been helped with grants and loans towards the cost of building a new house or hut, in order that they may live in less crowded conditions and have as much rest and fresh air as possible.

Small grants are made from time to time for travelling expenses and meals for patients coming from a distance.

(d) Pocket Money.

Many patients have no relations to bring them extras or to buy their clothes. Long term patients, such as those in the Mental Hospital, may have small pensions or allowances from Government or private sources which can be used for this purpose. In all cases such monies are given to the Principal Almoner to administer through the Samaritan Fund.

The work of the Almoners' Department has expanded during the year, and plans have been laid for future schemes although it is always difficult in the Colony to plan for the future owing to the shifting tides of population.

A. M. BALLANTYNE,

Principal Almwoner.

7th July, 1950.

162

ANNEXURE N.

A Summary of the Work Done at the Kowloon and Hong Kong Public Mortuaries.

1949.

Total number of Post-mortem Examinations performed

during the year

No. of male bodies examined

No. of female bodies examined

Sex unknown owing to decomposition

No. of claimed bodies sent from hospital, etc.

No. of unclaimed bodies mostly abandoned No. of bodies cremated

No. of Chinese bodies examined

No. of Non-Chinese bodies examined

No. of bodies nationality unknown No. of medico-legal cases

No. of bodies under 2 years of age No. of bodies over 2 years of age

3,945

2,079

1,848

634

8,311

757

3,919

391

Female. Total.

817

1,262 1,471 2,733 1,194

377

Male. Female.

No. of bodies received from the following sources:-

(Hong Kong)

Victoria District

Shaukiwan

From hospitals

Infant convent

Total

District, Police Station, & Hospitals

Marine Police Station

"T" Land

Yaumati

Mongkok

Shumshuipo

Tsun Wan

Castle Peak

Ping Shan Hung Hom

נו

607

140

254

1,073

124

100

+ +4

450

108

163

290

י.

Kowloon City Police Station

Sai Kung Cheung Chau

Lok Ma Chau

Kam Tin

Sheung Shui

Ta Ku Ling

Tai Po

נן

Shatin

Tai O

Shataukok Hospitals

....

ננ.

Total

ין

No. of rats caught and brought to mortuaries No. of rats examined

No. of rats spleen smears taken for examination

No. of rats infected with plague

г.

1,549

2,872

196,337

14,066

Nil.

ANNEXURE 0.

Annual Report of Malaria Bureau,

Notification of Malaria.

　　The Bureau has been handicapped by the lack of notifica- tion of malaria and a condition of affairs has arisen in the last year which has made its reinstitution still more necessary. Up to this year the number of mosquitoes brought into the controlled area by vehicular traffic from the New Territories was very small and was limited to a few lorries and an hourly bus service. to Un Long. With the advent of the Army the volume of traffic of all descriptions coming into both Kowloon and the Island from the New Territories increased tremendously. In addition to this the civilian traffic has increased to 14,000 vehicles, a proportion of which returns nightly from the New Territories bathing beaches. It can be clearly seen that notification is very important to check up these imported foci of infection into the controlled areas of Hong Kong and Kowloon.

164

PALUDRINE.

Large scale observations were able to be made on the pro- tective prophylactic value of Paludrine amongst the troops situated in the New Territories who were on a daily dose of one (0.1 gramme) tablet.

Among the troops only 87 cases of malaria were notified by the Military Authorities and the majority of the cases arose either from omission to take Paludrine at all, taking it irregularly, or not taking it for a sufficient length of time. No cases of anæmia following prolonged administration of Palu- drine were observed.

Experimental control of the Seventh Day Adventist School at Hang Hau by Paludrine alone was equally successful. Here a preliminary blood parasite rate was done at the beginning of the year among the 500 pupils, and again at the end of the season. Paludrine was taken voluntarily by half the pupils and a weekly prophylactic distribution was made in the villages in the neighbourhood of the school which was supervised by the school teaching staff. The pupils on protective Paludrine came from the North and had no local immunity. No case of malaria occurred amongst them, and there was no increase in the blood parasite rate. This, in a school where malaria was rampant before this method of control was introduced, was most satisfactory.

European and Chinese Police in the New Territories had equally good results on protective Paludrine.

FIELD WORK.

Rough training of streams, stone drainage, clearing, subsoil drainage, and oiling were the methods used. In addition a cheap experimental form of rough concrete training was carried out in the Deep Water Bay Valley which proved so successful last year that it has been used on the Stanley Peninsula. In addition to these larval control measures, the Chinese villages of Sai Wan, Pokfulam, Telegraph Bay and Ngau Chi Wan, on the outskirts of the control area, were residually sprayed with DDT. A determined effort to bring down the recurrent cost of the field work by more permanent methods was commenced by an attack on the sea coast breeding places of aedes Togoi, a great pest and a good carrier of filaria. Hitherto it has been necessary to oil weekly the whole southern coast of the Island. This has been a difficult, and sometimes dangerous procedure in precipitous places.

165

Funds for cement were made available by the Public Works Department and the Prison Department provided a daily labour force of 50 from Stanley Prison. Rock pools amounting to 9,500 were cemented in, and the whole of Stanley Peninsula has been permanently cleared of this species. This work is also being carried out by the Malaria Bureau at Kennedy Town, Pok- fulam, Aberdeen, Deep Water Bay and Shek O. It is hoped in two years to rid permanently all the inhabited areas of the Island of this species; this will result in a big saving in oil, labour and supervision.

A further attempt for the purpose of increasing the efficiency of the work by cutting down the most expensive item, namely labour, is being made to find an insecticide which is efficient in uncleared water. Malariol has proved an efficient larvicide in cleared water and has the great advantage that using, as we do, unskilled labour, it is easy to apply and check by an unskilled staff, but it has the disadvantage (in local con- ditions) that the vegetation must be cleared first.

In conjunction with Imperial Chemical Industries, experiments with a new water miscible Gammexane were tried in certain uncleared streams in the New Territories. These streams which had previously been surveyed showed encouraging results with a 98% reduction of larvae after two applications.

Experiments are still going on to find a suitable dye so that the sprayer and supervising staff can check the work.

　　　　So far work has only been done in the dry season and it remains to be seen if this insecticide is equally good in heavy rain conditions.

　　　　Other work is proceeding with hormone weed killers to find a cheap method of keeping down local vegetation in streams. This is applied in the form of a spray.

NIGHT RESTING HABITS OF THE MOSQUITOES.

　　　　In order to determine the importance and value of Gammexane as a residual insecticide a series of observations on mosquito night flying habits were made during the period June to November. A Nissen hut, loaned by the Public Works Department, was sprayed on September 5th with Gammexane midway throughout the observation period. The hut, not an ideal choice, was the only one available and was sited about a mile from Castle Peak Road, and about 50 feet above sea level. The nearest inhabitants of villages or huts were about half a

166

mile away. Hill streams, paddy fields, seepage areas, irrigation channels and swampy areas were situated in its immediate night- bourhood. The fauna of the district were A. maculatus, A. minimus, A. hyrcanus, A. jeyporiensis, A. tessellatus, Â. splendidus, A. karwari, C. tritaeniorhynchus, C. bitaeniorhyn- chus, C. whitmori, C. vishnui, M. uniformis, etc.

　　One of the windows at the side of the hut was taken off, and it was replaced with a window-trap, which consisted of two parts. The top part was a box of wire gauze on wooden frameworks having a sliding pannel at the bottom to allow an entrance slit for the entry of mosquitoes and to close the slit when the box was removed in the morning. The box served as a holding-cage for the observation of mortality of mosquitoes that entered the box during the period of observation. The lower part was a supporting wooden framework mounted with wire gauze, and it was fitted to the window frames. All the other windows were fitted with black cloth curtains, so that the windows could be closed completely when required.

The human bait during the course of observation con- sisted of two caretakers of the Water Works, one trained assis- tant and one Inspector. On the 17th October, a probationer Malaria Inspector was sent there for training.

　　The following is a brief summary of the full text of the report. The points to be determined were:--

1. The time of entry of the mosquitoes and their

relating to time of biting.

Both Anophelines and Culicines entered dwellings at and after dusk, and they continued to enter dwellings at various times. throughout the night with a peak period of entry from 8.30 p.m. to 10.30 p.m. (Hong Kong summer time) Mosquitoes that entered the dwellings fed on the inmates at various times throughout the night, and the peak period of biting coincided with that of the entry. The peak period of entry and biting was prolonged on still sultry nights. There were marked differences between re- lative attractiveness of different individuals used as human bait. This preference maintained its existence throughout the period of the observation.

2. The resting position in relation to doors, walls,

windows, ceiling etc.

On 12 nights, observations were made with regard to the resting positions of mosquitoes. Mosquitoes found resting in the hut were segregated into those caught on walls, roof, screen of windows and on furniture. Of 583 anophelines caught, 113

167

were found on walls, 410 on roof, 45 on screens and 15 on fur- niture. Their resting positions are of great importance in con- sidering the application of insecticide to dwellings.

3. The length of the resting period of individual

species.

There were as many as seven species of anophelines coming into the hut. To separate them into individual species when they were resting in the hut at night was impracticable. They were, therefore, segregated into large and small species. The large species represented A. hyrcanus var. sinensis, and the small species represented A. minimus, A. jeyporiensis var. candidiensis, A, karwari, A. tessellatus, A. maculatus and A. splendidus. The minimum length of the resting period of the large species was three minutes for the fed and half-a-minute for the unfed, while the maximum length of the resting period of the fed and the unfed was 272 minutes and 89 minutes respectively. With re- gard to the small species, the minimal length of the resting period of the fed and the unfed was 2 minutes and half-a-minute and the maximal length of the resting period of the fed and the unfed was 206 minutes and 44 minutes.

4. Observed death rate before and after residual

spraying.

Before the residual spraying, only one A. hyrcanus var. sinensis and one A. karwari , both unfed and dead, were discovered oa the floor in the hut in an observation period of 14 nights, where- as 791 anophelines were collected on the floor in the same hut in an observation period of 55 nights after the residual spraying. Of 791 anophelines collected, 364 were A hyrcanus var. sinensis; 266, A. jeyporiensis var. candidiensis; 14. A. minimus; 21, A. maculatus; 106, A. karwari; 12, A. splendidus and 8, A. tessel- latus.

5. The effect of "Gammexane" in these observed

habits.

After the application of "Gammexane" Dispersible Powder, a marked reduction in number of mosquitoes was observed in the hut for 7 nights, but mosquitoes, such as A. hyreanus, A. kar- wari, and A. jeyporiencis var, candidiensis, nevertheless, entered the treated hut and fed on the inmates as early as the 1st night following the spraying. On the 15th night, the number of mos- quitoes entering the hut and feeding on the occupants was as numerous as before. During the first 14 nights after treat- ment, mosquitoes were found restless after making contact with the treated surfaces, and short flights from one spot to another were noticed. This was markedly demonstrated in the 1st week;

168

it was not so prominent in the second, and the resting in an usual manner was resumed in the third. Mosquitoes, anophelines and culicines, were seen to fall on the floor about half-an-hour after their flights in the treated hut at or after dusk in the first two weeks after the application of the insec- ticide. This period varied in accordance with the age of the

spray.

6. Confirmation of species of culicines entering a house to cause a mosquito nuisance in rural areas.

People domiciled in the New Territories suffered badly from mosquito nuisance compared with those who lived in urban areas. C. tritaeniorhynchus, C. bitaeniorhynchus, C. whitmori, C. vishnui and, sometimes, M. uniformis are the additional species causing mosquito nuisance apart from C. fatigans and Ae. albopictus. An enormous number of the above-mentioned mosquitoes were found moribund or dead on the floor in the hut after the treatment with "Gammexane" confirming our pre- vious observation that the above species are a cause of rural mosquito nuisance,

7. The residual efficacy of Gammexane as shown by the survival rate of mosquitos caught after exposure in the treated hut.

A high mortality was recorded of anopheline mosquitoes kept under observation in holding-boxes and catching bottles. No anophelines were recorded to survive forty-eight hours through- out the period of observation.

MOSQUITO NUISANCES.

Mosquito nuisances were investigated on behalf of the Urban Council at Mt. Cameron, Mt. Nicolson, the Peak, Upper Levels, Felix Villa, Hong Kong University, Pokfulam, Aberdeen, Shouson Hill, Repulse Bay, Stanley, Shek O, North Point, Cause- way Bay, Happy Valley, Kowloon Tong, Kowloon City, Tsim Sha Tsui, Yaumati, Sham Shui Po, Hung Hom and Lai Chi Kok.

　　Much time had to be spent in checking the vagaries of the ever mounting and moving squatter population, who created a large number of new breeding places.

563 cases were notified by Government Hospitals and Dispensaries and 116 deaths from malaria were recorded by the Registrar of Births and Deaths during the year 1949.

J. B. MACKIE, Malariologist.

14th April, 1950.

169

ANNEXURE P.

Annual Report of the Government Laboratory

for the year 1949.

The comparative table of samples examined (Table 1) again shows an increase over the work for the previous year.

TABLE 1.

1948

1949

(i) Waters & Waterworks Chemicals

689

722

(ii) Foods & Drugs

(iii) Chemico-legal

607

728

(iv) Commercial

1,886

2,063

(v) Biochemical

+---

3,056

4,547

(vi) Coal from Department of Supplies,

Trade & Industry

101

132

(vii) Miscellaneous from Government

Departments

173

158

+ I

6,609

8,404

(i) In addition to the routine control of the public water supply, which has shown the quality of the water to be of a uniformly high standard, a number of samples from new wells in outlying districts has been examined for the Public Works Department. Samples from waterboats supplying shipping in the harbour have been periodically checked for possible salt water contamina- tion.

(ii) Under this heading are included samples of milk for control of pasteurisation, and a number of samples in connection with minor outbreaks of food poisoning. The cause of one of these incidents was traced to the use of a mixture of tung oil and arachis oil, in mistake for arachis oil, for frying purposes.

(iii) Tables 2 & 3 give details of the variety of work under this heading. There were again no cases of homicidal poisoning, but in one murder case a revolver from which the number had been erased by filing, the file which it was alleged had been used for this purpose, and some steel filings, were examined for the Police Department.

　　　　An incident of some interest was the explosion on board the s.s. Chaksang in the harbour. (See the Annual Report of the Director of Marine.) As a result of investigations carried out in the Laboratory, in conjunction with the Police Department,

170

this was shown to have been deliberately caused, but the culprits were not traced. At the Marine Court of Enquiry, the Govern- ment Chemist sat as a member of the Court, and Mr. R. C. Terry, Assistant Government Chemist, gave evidence on the technical side of the investigations.

TABLE 2.

Chemico legal Analyses.

Toxicological Examinations (including post-

mortem materials from 52 persons) Urine and Blood for Alcohol determination Articles connected with:-

271

Acid-throwing

Arson

------

Bombs and Explosives

s.s. "Chaksang" Explosion Enquiry

Forgery

Fraud

Illegal firecrackers

Articles connected with:

Illegal practising of Western medicine Larceny

Licensing Laws

Medicines, Drugs and Poisons

Murder

TABLE 3.

Toxicological Examinations.

No poison present

Opium

Phenolic or Cresolic Compounds

Acetic acid

Acetylsalicylic acid

Alcohol

Alkalis

יז

Arsenic

Barbituric acid derivatives

Belladonna

Bromide

---- IL

Camphor

Carbon monoxide

Chloral hydrate

Coal-tar derivatives

Cyanide

Eucalyptus oil

Ferrocyanide

LII.

141

+ -

728

171

TABLE 3-(Continued).

Toxicological Examinations.

Gelsemium elegans Benth

Hydrochloric acid

Kerosene

Morphine

Methylene blue

Oil of wintergreen Potassium ferricyanide Potassium permanganate Quinine

Salicylic acid

Sodium silicate Sulphonamide Sulphuric acid Strychnine

+rh

*ANHN

271

Fees collected

Table 4 shows the

(iv) Commercial work has again increased. were $141,169 compared with $118,811. considerable range of material dealt with.

TABLE 4.

Commercial Samples.

Minerals and Metals:-

Aluminium

Antimony

Bismuth concentrate and ore

Cassiterite

Chromite

Clay and Kaolin

Coal

Copper

Copper concentrate

Fergusonite ore Ferro-manganese

Ferro-molybdenum

Ferro-tungsten

Fluorspar

Gold

Granite

Graphite Gunmetal

Iron ore

Lead

■IT 1.

1 8

· L H

гт

NONER

172

TABLE 4-(Continued).

Commercial Samples.

Minerals and Metals:-

Manganese ore Manganese dioxide

- - - -

LI- J

Manganese steel scrap

Magnesium

Magnesite

Metal files

Metal tubes

Mercury

Molybdenum Nickel bronze

Pewter

Pig iron

Plated metal sheets

Pyrite

Scheelite

Silica sand

Silver

Silver alloy

Silver lead ore

Soil

Talc

Tin

Tin concentrate

Titanium ore Wolfram ore

Zinc

TILL -- +1

Zinc concentrate

++++

314

Zinc sheets

Zirconium ore

Miscellaneous minerals and metals

Oils and Fats:-

Aniseed oil

Camphor oil

Citronella oil

Eucalyptus oil Ho oil

Peppermint oil Apricot Kernel oil

Coconut oil

Groundnut oil

Linseed oil

Palm oil

Rapeseed oil

Sesame oil

гт

· ·

H+

173

TABLE 4-(Continued).

Oils and Fats:-

Stillingia oil

Commercial Samples.

Soyabean oil

Teaseed oil

Wood oil

Diesel oil

Fuel oil Gasoline

Hydraulic fluid Lubricating oil

Varnish oil Lard

Miscellaneous:

Bone-meal

Camphor

Cassia lignea

391

182

Cements and mortars

Chinese lacquer

Copper naphthenate solution

Cotton piece goods

Derris root

Enamel frits

Fertilizers

Firecrackers

Firebricks

Foodstuffs Formaldehyde Gallic acid Gypsum

Liquid gold Menthol crystals Methylated spirit Nitric acid

Nitrogen lime

· ·

++ +7

Oil cakes

Paints

Plastics

...

Polishes and varnishes

Rosin

Salt

Sea grass

Soap

Spent Tan

Steamer tanks

Stearic acid

Toilet powder

L ·

++1

ו ז י .

+---+ +

115

99 1

174

TABLE 4-(Continued).

Commercial Samples.

Miscellaneous:

Toxicological examination

Turpentine

Water

Wines and Spirits

Waxes

гто

Drugs and chemicals, calibration of instru-

ments etc.

2,063

(v)

Biochemical work is summarized in Table 5. This also continues to increase.

TABLE 5.

Biochemical Examinations.

Specimens received:

Bile

Blood

Cerebro-spinal fluid

Gastric contents

Stool

Urine

Miscellaneous

Received from:-

Anti T.B. Clinic Kowloon Hospital

Lai Chi Kok Hospital Mental Hospital Private Practitioners Queen Mary Hospital

Ruttonjee Sanatorium Sai Ying Pun Hospital St. Paul's Hospital

Tsan Yuk Hospital

Tung Wah Eastern Hospital Violet Peel Health Centre

2,123

389

1,877

121

4,547

1,118

302

2,855

4,547

175

(vi) A large proportion of this work shown in Table 6 done for other Government Departments has again come from the Fire Brigade, chiefly in connection with the Dangerous Goods Regulations. These Regulations are now being revised by a Committee, of which the Government Chemist is a member.

TABLE 6.

Miscellaneous samples from Government Departments.

Samples from:

Agricultural Department

Commerce and Industry

Controller of Stores

Fire Brigade

Forestry Department

Kowloon-Canton Railway

Labour Office

Medical Department:

Central Medical Stores

Health Officers & Inspectors

Medical Department Headquarters

Malariologist

Urban Council

Prison Hospital

Public Works Department:

Building Ordinance Office

Electrical and Mechanical Office Electrical Workshop

Port Works Office

г.

N =

HM NNA

Social Welfare Office

Treasury

158

Drainage Office

Staff.

Mr. Shum Lau was appointed Laboratory Assistant on probation on 1st December, 1949.

J. REDMAN, Government Chemist.

- 176

ANNEXURE Q.

Annual Report--Pathological Institute,

(1) Introductory.

　　The year's activities were characterized by expansion of routine work in an endeavour to meet the demands of a greatly increased population, and by a very much larger vaccine output, which has now far outgrown the facilities provided forty-five years ago when the Institute was originally built. However, supplies of water, gas, light and power were all over- hauled by the authorities respectively concerned, and by the end of the year these were found to be much improved. Losses due to sickness among animals and contamination of vaccine batches occurred from time to time, but in spite of these and other difficulties the vaccine stocks were maintained at figures beyond all likely requirements, and in November a start was made in the production of lapinised rinderpest virus vaccine. The greatest demand was no doubt occasioned by an outbreak of rabies, fortunately restricted to the mainland. which was respon- sible for no less than twenty human deaths. Storage space for vaccines was helped considerably by the acquisition of a 100 cu. ft. refrigerator.

　　At the Kowloon branch, which is assuming increasing importance, fluorescent lighting was installed and refrigeration space was doubled; whilst at the Kowloon Mortuary the con- struction of a much needed refrigeration chamber and the installation of air conditioning were well in hand by April 1950. The Queen Mary laboratory is still cramped for space, but other- wise continues to be a useful and necessary unit of the hospital.

Experiments with the treatment of nightsoil, com- menced in 1948, continued to give interesting results, and it was found that neither 3% ammonium sulphate nor 10% calcium sulphate was able to render the nightsoil mixture relatively safe as regards ova of hookworm and other helminths in a period of three weeks.

Other minor items of some interest include the dis- covery of a typhoid carrier in Stanley Prison; a bacillary dysen- tery carrier in the Sai Ying Pun Hospital; the isolation of Ch. tetani from two powders useh for dressing the umbilical cord in two fatal cases of tetanus neonatorum; and the fact that amoebic dysentery, formerly recorded infrequently in the Colony, has now become a comparatively common disease.

177

Additions to the library included the following:-

Huddleston.

Brucellosis

----------------

Guide to Human Parasitology....Blacklock & Southwell.

Clinical Parasitology

Principles of Bacteriology

& Immunity

Atlas of Bacteriology

Gould's Medical Dictionary Histopathologic Technic

Craig & Faust.

Wilson & Miles.

Low & Dodds.

Blakiston.

.Lillie.

Staff changes Mr. W. T. Liu joined the staff in October. Following the resignation of Dr. K. T. Loke, pathologist, in January 1950, Dr. G. B. Smart was transferred from health duties to the Institute. In February, Dr. C. C. Lin was taken on to supervise activities in Kowloon during the absence of Dr. Alvares under medical treatment, and Messrs H. Y. Li and W. K. Yan were engaged to fill vacancies in the grade of Laboratory assistant, one of which was created by the resignation of Mr. K. S. Wong.

Cordial relations were maintained with colleagues in Services laboratories, and the University Department of Pathology

(2) Protozoology and Helminthology.

2. Blood films for malaria-Four thousand one hundred and thirty-six films were examined for parasites of malaria. Classification of types found and negative findings are shown in the table below. Positive findings are nearly 40% less than last year, though the total examined was approximately 20% fewer.

N. B. The figures in the following tables include those of the Kowloon and Queen Mary Hospital branches. Allocation of work performed is shown separately in the summary at the end of this report.

Bloods Examined for Malaria.

Sub-tertian...

Benign-tertian

Quartan

-- J

Unclassified

TABLE I.

Non-

Chinese Chinese

Total

200

206

195

208

• +

JLL

3,439

198

3,637

3,917

219

4,136

(type undetermined)

Multiple infection

Negative

Grand total

cases.

178

Filaria-Microfilarial parasites were found in three

　　Anthrax-Infection with B. anthracis was established in thirty-seven instances in blood films taken from sick animals.

5. Faeces Twelve thousand eight hundred and twelve stool specimens were examined for parasites, ova or cytological picture. Fgures for E. histolytica are more than double those recorded last year. An idea of the incidence of helminth in- festation among the general population may be gained from the fact that so far it has not been possible to take any specimen from a large tank containing the community's nightsoil without finding Ascaris, Clonorchis, Ankylostoma and Trichuris ova present. Some, but not all, specimens also contained Fascio- lopsis ova.

Examination of Stools for Intestinal Parasites.

TABLE II.

Non-

Chinese Chinese Total

Ascaris

Clonorchis...

Trichuris

...

Ankylostoma

Enterobius...

Taenia...

Strongyloides

Fasciolopsis

Schistosoma

E. histolytica...

Multiple infection

1,970

139

2,109

391

397

668

754

་་་

408

416

Negative

Grand total

138

1,260

1,282

6,466

1,198

7,664

---

11,283

1,529

12,812

(3) Haematology.

The majority of this work is carried out at the Queen

Mary laboratory and the Kowloon branch, as the summary shows.

Hb. percentage

Total Red Cell Count

179

Table III.

Total White Cell Count Differential Count

...

Blood Sedimentation Rate Blood Bleeding Time Blood Coagulation Time Platelet Count Reticulocyte Count

+++

TII

---

3,403 3,288

4,389

9,009

1,318

Blood Grouping...

Cross Matching...

Ground total

(4) Serology.

473

139

++ |

16,058

The Kahn reaction-Forty thousand seven hundred and thirty-five sera were tested. This figure represents roughly the maximum number that the existing racks and apparatus can deal with, and in order to ease matters the introduction of an exclusion test, such as the Berger-Kahn, for routine antenatal and cord sera is under consideration.

Examination of Blood Sera for Syphilis.

Table IV.

Chinese

Non-Chinese Total

Male Female

Male

Female

Strong Positive

3,491

2,384

5,904

Positive

LLI

1,919 1,932

2,866

Weak Positive

1,279

1,110

2,401

Doubtful

-----

968 1,019 12,165 13,762

1,999

562

76 26,565

-----

19,822 20,207 627

79 40,735

Negative

Grand total

Agglutination tests-One thousand five hundred and forty-two sera were examined for the presence of agglutinins against various organisms. During the last six months of the year a paratyphoid C suspension was included in all tests for enteric agglutinins. Positive findings for Br. melitensis and Br. abortus relate to a head of cattle in Fatshan and one local

Cow.

8. Blood Clot Culture--Bact. typhosum was isolated from the widal clot in 103 instances at the Institute and 6 cases gave a growth of Bact. paratyphosum A.

Organlams

Bact. typhosom

paraty phosum Ą.

180

Agglutination Tests,

Enteric fever, type undetermined, 26

Br. melitenzia

...............JLIJLI-----------

Br. abortus

Well Fellx reaction

LIILILILO-▬▬▬▬▬

Grand total

Table V.

Chinese

Non-Chinese

Pos.

Neg. Doubtful Pos. Nee. Doubtful Total

863

778

1,216

196

| | 7

***

218

412

003

1,642

(5) Bacteriological Examinations.

　　Faeces-One thousand one hundred and ninety-five stools were cultured for pathogenic organisms. No case of cholera was discovered.

Examinations of Stool for Organisms.

Table VI.

Chinese

Pos. Neg.

Pos.

Non-Chinese

Neg.

Total

668

735

293

364

的

Г. .

1 17

977

114

1,195

Bact. typhosum

B. dysenteriae (Group)...

Cytology typical of

bacillary dysentery..

B. dysenteriae (Plexner)

B. dysenteriae (Shiga)

V. cholerae

Grand total

10. Sputum-Eleven thousand and ninety-eight sputa were examined for the presence of the tubercle bacillus. In addition, gastric lavage from one hundred and sixty-two patients gave 8 positive results.

Examination of Spula for Tuberculosis.

Direct examination

Culture

Animal inoculation

Grand total

Table VII.

Chinese Pos. Neg.

Pos.

Non-Chinese

Neg.

Total

3,344

7,406

120

193

11,063

3,347 7,438

121

197 11.098

181

　　11. Urine-One thousand one hundred and sixty-one specimens were cultured for pathogenic organisms.

12. Urethral and cervical smears-Five hundred and fifty- three specimens were examined for the presence of the gono- coccus, with 36 positive findings.

　　13. Nasal smears, etc. for M. leprae-Three hundred and forty-four examinations gave 94 positive results.

14. Throat swabs-Two thousand three hundred and forty- three throat swabs were cultured for C. diphtheriae, and one hundred and eighty-nine were examined for the presence of haemolytic streptococci, with 24 positives recorded.

Examination of Throat Swabs for Diphtheria.

Positive Negative

Grand total

---+

Table VIII.

Chinese Non-Chinese Total

339

346

1,839

158

1,997

2,178

165

2,343

15. Cerebrospinal fluid-Nine hundred and seventy-six specimens were examined for the presence of pathogenic organisms.

Examination of Cerebrospinal Fluids for

Pathogenic Organisms.

Meningococcus...

Pneumococcus

M. tuberculosis...

Negative

· ++

TABLE IX.

Non-

Chinese Chinese Total

916

933

ITI

957

976

Grand total

16. Rat spleen smears-Fourteen thousand and sixty-six examinations were made of smears for P. pestis. In one case organisms morphologically indistinguishable from P. pestis were found, but intensified trapping in the area from which it came produced nothing further.

182

(6) Clinical Pathological Procedures.

17. Urine examinations-Twelve thousand nine hundred and fifty-three routine and microscopic examinations of urine were carried out.

18. Pregnancy tests-Sixty Friedman tests were perform- ed. Arrangements were in hand to import Xenopus frogs and institute a frog pregnancy test, but experience in twenty-four tests using the readily available local species of male frog, check- ed by the Friedman, suggests that this simple procedure is likely to become the method of choice in due course.

19. Miscellaneous tests-Nine hundred and fifty examina- tions of an unclassified nature were carried out.

(7) Preparation of Vaccine Lymph.

20. Buffalo calves were again used exclusively, and expected difficulties in supply did not materialise. Two new vaccinating tables made by the Stores Department were put into use. Con- ditions under which calf lymph is produced continue to be some- what primitive, but do not appear to have any adverse effect on the quality of the lymph.

(8) Preparation of Vaccines.

21. Cholera vaccine-Stocks were maintained in readiness for the routine inoculation campaign and the possibility of an outbreak. Refrigeration space was increased considerably.

22. Antirabic vaccine-An outbreak of rabies in the Main- land responsible for 40 known canine and 20 human cases of rabies caused vaccine demand and production to reach abnor- mally high figures, and whereas last year 56 litres of vaccine were issued, this year 185 litres were given out. The vaccine. continued to be of the Semple type in 4% and 2% dilutions, and for the greater part of the year, until sheep became available, goats were used in its production.

Of the twenty cases of rabies in humans, 15 had not received any anti-rabic treatment. Of the remaining five, one adult who had three bites on the thumb died 19 days later, three days after having completed a full course of treatment; one child of 8 years, bitten on the buttock, hand and lower lip, died twenty-three days later in spite of a full course of treatment; two cases had received only six injections at irregular intervals; and one had a break of ten days early in the course of treatment.

183

One adult patient who completed a full course of anti- rabic treatment developed three weeks later a transverse lumbo- dorsal myelitis, with sensory loss which reached to the level of the 7th dorsal segment. However, ultimate progress was good and eventually he made a complete recovery. apparently was one of the rare post-vaccinal paralyses.

Cases Treated with Anti-rabic Vaccine,

TABLE X.

Treatment

This case

not Treatment

completed completed

Total

----T

Chinese Non-Chinese

1,908

1,849

3,757

157

171

328

Grand total

+ − +

2,065

2,020

4,085

Vaccine Production.

TABLE XI.

Vaccine prepared

Vaccine issued

Anti-smallpox vaccine

Cholera

FIL-

13,570 c.c.

35,288 c.c.

T. A. B.

738,860 119,250

451,440

38,740

Plague

1,560

בל

Rabic

(2%)

153,280

1,100 116,300

(4%)

73,840

66,740

Lapinised rinderpest virus

vaccine

Grand total

460

1,100,820

709,608

(9) Examination of Water and Milk.

23. Water-Two thousand three hundred and twelve

samples of water from various sources were examined. general, it can be said that, bacteriologically the Colony's water supply is most satisfactory.

TABLE XII.

Unfiltered raw water

Filtered

Filtered and chlorinated water from

service tap

284

279

1,609

184

Well water

TABLE XII-(Continued).

Water other than public supplies

Total

132

2,312

24. Milk and other foods-One thousand and twenty-three examinations of milk were performed, largely at the instance of the health authorities. Results on the whole were very satisfactory. Eight hundred and fourteen examinations of a miscellaneous nature were also carried out as shown. The findings were usually of a reasonable bacteriological standard.

TABLE XIII.

Milks Ice-creams

Popsicles

----

TT +-

Aerated waters

Tinned foods

Total

1,023

499

161

гг.

152

1,837

(10) Morbid Histology.

　25. Four hundred and eleven tissue sections were examined for histological diagnosis. Of these, one hundred and ninety-nine were benign or malignant tumours as the table shows.

26. Negri bodies-Two hundred and twelve brains were examined for the presence of Negri bodies. There were twenty positive human cases, and forty-one in dogs. tive dogs' heads was sent from Kukong in Kwangtung Province, China.

One of the posi

Brains Examined for Negri Bodies.

TABLE XIV.

Positive Negative

Total

Human brains

Dogs' Cats'

124

165

Rats'

Total

151

212

185

Tumours Examined.

TABLE XV.

Fibroma Lipoma Fibrolipoma Angioma Angiofibroma Fibromyxoma Papilloma... Chondroma

Nasal polyp

Rectal polyp

---

+++

---

Cervical polyp...

---

TII

ITI

+++

+ L

...

---

...

יי,

---

。

---

+++

++ 4

.-.

Fibroadenoma of the breast Myxofibroadenoma of the breast Fibromyoma of the uterus... of the cervix...

Adenomyoma of the uterus Mixed salivary tumour... Sweat gland adenoma

Sarcoma

Lymphosarcoma

Myxosarcoma

Osteogenic sarcoma

Fibrosarcoma

---

- 17

TTI

---

..ז

ד..

TII

...

- J-

---

LII

---

+ ··

---

- 17

-- J

Secondary carcinoma of lymph gland (neck) Secondary carcinoma of lymph gland

(other regions)

Carcinoma of nasopharynx

ггт

...

+ I

---

lung...

scalp

neck... jaw... tongue stomach...

Ir+

---

...

---

- - -

гт-

liver (hepatoma)... colon

rectum

breast

uterus

ILI

F++

---

...

---

- IL

гт.

---

cervix " Ovary

Carcinoma of vulva

++.

ITI

prostate...

penis

testis (seminoma)..

Fibrous epulis....... Adamantinoma... Urethral car uncle... Chorion-epithelioma.. Hydatidiform molę... Cysts of the ovary

..т

+++

LLI

TII

...

ITI

LIT

TII

...

Т. .

- rr

---

+44

ILI

...

NATURE OF EXAMINATION

Agglutination

reaction

Bact. typhosum

ני

paratyphesum A

Enteric fever, type undetermined!

Br. melitensis

Br. abortus

Weil Felix reaction

Serological reaction for syphilis

Malaria

Blood smears

Filaria

B. anthracis

SUMMARY OF EXAMINATIONS.

Haematology

Cultural

examination

Faccés

Tissue section

Hb. percentage

Total Red Cell Count

Total White Cell Count

Differential Count

Blood Sedimentation Rate

Coagulation Time

Bleeding Time

Platelet Count

Reticulocyte Count

Blood Grouping

Cross Matching

----------------Crucest

Naso-pharyngeal swabs (C. diphtheriae)

Haem. Streptococci

Cerebro-spinal fluid for pathogenic organisms Faces for pathogenic organisms

Blood clot culture (enteric organisms only)

Blood

Urine

Intestinal parasites

Occult blood

M. tuberculosis

Brains for Negri bodies

Sputa

Gastric lavages for M. tuberculosis

Smears for gonococeus

Smears for M. leprae

Rat spleen smears for P. Pestis

Urine (Routine, chemical & microscopic)

Pregnancy tests

(Friedman)

(Frog)

----------T‒‒

Bacteriological examination of milk and foods

analysis of water

Miscellaneous

Grand total

Table XVI,

Pathological Institute

Queen Mary Hospital Laboratory

186

Kowloon Pathological Institute

Total

745

453

1,280

218

40,735

LJIL

1,654

832

1,650

4,136

2,634

752

3,403

2,290

977

3,288

3,142

1,221

4,389

130

1,739

1,140

3,009

1,136

175

1,318

--------.........

343

103

478

123

139

1,230

206

907

2,343

189

807

389

280

976

142

263

790

1,195

876

126

540

1,551

200

315

135

617

400

1,161

2,278

5,570

4,964

12,812

264

373

LLJIL

411

212

2,674

2,937

5,487

11,098

162

123

113

317

553

134

179

344

5,306

8,760

1-1,086

844

8,241

3,868

12,953

1,094

743

1,837

----------------------------------------------

2,312

-ILL

291

324

335

950

62,132

32,003

34,407

E. F. DUCK, M.B., B.S. (Lond.), M.R.C.S., L.B.C.P., D.P.H., D.T.M. & H. (Eng.) Government Pathologist.

128,542