醫務衛生署年報 Medical and Health Department Annual Report 1951-1952

RBB 40k

HONG KONG

13076

ANNUAL

DEPARTMENTAL

REPORTS

1951-2

PRICE: $12

RRB 40k.

LIBRARY

www.

INSTI

ลิเกม

DIRECTOR OF

MEDICAL & HEALTH

SERVICES

THE ROYAL SANITARY INSTITUTE LIBRARY

90, Buckingham Palace Road, London, S.W.I.

Class No. RBBLOK

Acc. No. ....4.3076

This book is returnable on or before the last date Marked below

11 AUG 1953

22501293016

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL

AND

HEALTH SERVICES

FOR THE

FINANCIAL YEAR 1951-2

PRINTED AND PUBLISHED BY THE GOVERNMENT PRINTER,

HÙNG FONG.

■

WELLL

NUTE

Cel:

tia:

Ann Rup

No. I WA28

JH6

LLH

1952

CONTENTS

I. GENERAL

Administration

General

Staff

Legislation

Statistics

Population

Births

J. I

Deaths

Infant Mortality

...

Maternal Mortality

Principal Causes of Death

Hospitals and Clinics

II. PUBLIC HEALTH

Introduction

Hygiene and Sanitation

Rural Health

Communicable Diseases

Anti-Epidemic Measures

Health Education

Port Health

Paragraph Number

13 - 17

19 - 20

•

26 - 30

31 - 34

---

+ ··

35 - 37

38 - 43

44 48

49 - 57

58 - 70

71 - 75

76 - 103

104 - 109

110

112

111

120

Paragraph Number

II. PUBLIC HEALTH,-Contd.

Social Hygiene

Maternal & Child Health

School Health ...

Malaria and Mosquito Control

Tuberculosis Control

121 - 129

130

139

140 - 149

150 - 166

167 218

r..

III. HOSPITALS AND CLINICS

Queen Mary Hospital

Kowloon Hospital

Mental Hospital

Sai Ying Pun Hospital

Lai Chi Kok Hospital

Tsan Yuk Hospital

Eastern Maternity Hospital

St. John Hospital, Cheung Chau

Stanley Prison Hospital

ILJ

JLI

- T

...

219 231

232 240

241 - 250

251

259

260 - 264

...

265 276

277 - 280

281 - 283

284

294

Privately Hospitals

295 - 296

New Territories Clinics,

Maternity

Homes and Travelling Dispensaries

297 305

Dental Clinics

306 - 412

Violet Peel Polyclinic

Public Dispensaries (Urban)

Midwives and Maternity Homes

413 415

416 418

419 - 426

IV. GOVERNMENT ASSISTED HOSPITALS

Tung Wah Group Hospitals ...

Nethersole Hospital

Ruttonjee Sanatorium

V. SPECIAL SUB-DEPARTMENTS

Pharmaceutical

+ I

Paragraph Number

427

428

429 - 433

434 - 435

436 - 437

Almoner

+44

Pathological-including Mortuaries

Chemical

Medico-Legal

Radiological

438 - 445

446 - 451

452 - 489

...

LT1

490 - 502

...

1 IT

503 - 504

Blood Transfusion

rri

..ז

Births & Deaths Registration

---

1 IT

Steward including Transport & Am-

bulance Services

VI. TRAINING OF MEDICAL AND HEALTH

PERSONNEL

505 - 512

513 515

516 - 518

519 521

522

530

VII. ACCOUNTS

Occupational Therapy Fund

Samaritan Fund

Nurses Rewards and Fines Fund.

VIII. MAPS

Digitized by the Internet Archive in 2019 with funding from Wellcome Library

https://archive.org/details/b3140599x

General.

I. GENERAL

ADMINISTRATION

1. In September 1951 the Director of Medical & Health Services attended the 2nd Session of the World Health Organization Western Pacific Regional Committee, which was held in Manila, as the representative of His Majesty's Govern- ment for British Territories in the Western Pacific Region, viz. Singapore, Federation of Malaya, Sarawak, Brunei, North Borneo, Fiji and Hong Kong.

　　　　2. The number of patients dealt with in every section of the department continues to increase and the plans for the proposed new hospital in Kowloon have been revised. It is now intended that a 1,000 bed general hospital, and a 200 bed children's hospital will be built to replace the existing Kowloon hospital.

　　　　　　The new block at Kowloon Hospital was opened in September 1951. This block provides an additional 72 beds, a much needed relief until such time as the hospital referred to above can be completed.

4. To cope with the increase of patients two additional evening clinics were opened at Shamshuipo Public Dispensary and Violet Peel Polyclinic as an extension of the dollar a time scheme.

　　　　5. A new maternity home of 6 beds was opened at Mui Wo (Silvermine Bay). This maternity home was built by the villagers and then handed over to this department which provided the staff and equipment.

6. A new public dispensary for the Kowloon City district was completed at the end of March 1952. Funds to construct this dispensary were provided by the local Kaifong and the Hong Kong Government, and on completion the building was handed over to this department which is now responsible for running it.

　7. For the convenience of residents of the New Territories two new birth registration offices have been opened; one in the Taipo Dispensary and the other in the Un Long Dispensary.

8. Provision has now been made for a leper colony on Hay Ling Chau formerly known as Nun Island which will replace the temporary leprosarium at Sandy Bay. Work is going ahead on the construction of buildings on the island for patients and staff. This leper colony is operated by the Hong Kong Auxiliary of the Mission to Lepers.

　9. Dr. E. D. Pridie, Chief Medical Officer of the Colonial Office, visited the Colony in June. He visited all sections of the Department and expressed himself as well satisfied with the work being done. Dr. B. Chisholm, Director General of the World Health Organization, also visited the Colony and gave the department the benefit of his advice.

　10. A certain amount of assistance was received from U.N.I.C.E.F. during the year. This took the form of the provision of equipment and a feeding programme. The most important item of equipment received was a complete mobile mass X-ray unit housed in two specially built vans. This unit has been of great assistance to the department but unfortunately the shortage of staff in the X-ray department prevented its full utilization.

11. By the end of the period under review arrangements had been completed with U.N.I.C.E.F. and W.H.O. for the provision of assistance in immunizing the juvenile population

of the Colony against tuberculosis by the use of B.C.G. vaccine. U.N,I.C.E.F. and W.H.O. will assist the Colony by the provision of the necessary vaccine and equipment and the loan of an international team to instruct and train members of this de- partment in the use of the vaccine.

12. U.N.I.C.E.F. also provided a quantity of diphtheria toxoid for use in the immunization campaign initiated by this department.

Staff.

13. On 6.7.51 Dr. I. Newton, F.R.C.S. (Edin.), M.R.C.S. (Eng.), L.R.C.P. (Lond.), left the Colony on leave prior to re- tirement and was replaced by Dr. K. C. Yeo, M.D., B.S. (H.K.), D.T.M. & H. (Eng.), D.P.H. (Camb.), who acted as Director of Medical & Health Services until 27.1.52 on which date he was promoted to the substantive post of Director of Medical & Health Services.

14. During the year under review recruiting of qualified staff continued to be a problem. Due to the lack of recruits with registrable qualifications the department had to continue to rely to a considerable extent on non-registrable doctors resid- ing in the Colony. Out of a total establishment of 141 Medical Officers and Assistant Medical Officers, 98 posts were filled with persons having qualifications which cannot be registered in Hong Kong.

15. In the case of expatriate nursing staff it has proved impossible to fill the existing vacancies for Sister Tutors due to the shortage of this type of officer; vacancies for Nursing Sisters are filled only after considerable delay so that it has been necessary to employ temporary married staff who are recruited locally, a not very satisfactory solution to the problem. Thirteen locally trained and fully qualified nurses resigned during the year; there is a steady loss of qualified nurses, in the most part due to the attractions of private nursing.

　16. Eleven local nurses were promoted to Nursing Sisters during the year.

　17. Six members of the Department were in the United Kingdom on study leave during the period under review; of these, three left the Colony during the previous year.

Establishment of Medical Department as at 31.3.52.

Director of Medical and Health Services ..

Deputy Director of Medical and Health Services

Deputy Director of Medical Services ...

Deputy Director of Health Services

Secretary

Senior Medical Officer

Senior Health Officer

Medical Specialist..

ITI

Surgical Specialist

Gynaecological and Obstetrical Specialist

Tuberculosis Specialist

Senior Port Health Officer

Senior Social Hygiene Officer

++ |

+++

Ophthalmic Surgeon

Government Pathologist

Pathologist and Assistant Pathologists.

Senior Dental Surgeon

Dental Surgeon and Assistant Dental Surgeons

Senior Radiologist

and

Radiologist

...

LII

Superintendent

Radiographer, Radiographers,

Radiographic Assistants

Malariologist

+ •

Government Chemist

Chemists and Assistant Chemist

г.т

Medical Officers, Assistant Medical Officers, Woman Medical Officers, Assistant Woman Medical Officers,

and House Officers

Principal Matron

Nursing Staff

Principal Almoner

Almoners

+..

LII

Chief Steward and Stewards

Executive Officers

155

TII

634

JIL

Clerical Staff

...

ILI

Chief Pharmacist, Pharmacists, Dispensers, and Dis-

pensary Supervisors

Physiotherapists and Assistant Physiotherapists

Senior Laboratory Technician, and Laboratory As-

sistants

г.

Health and Malaria Inspectors

Dietitian

Public Vaccinators

Other Staff

Total

ITI

---

T 1

г 1 г

---

164

1,804

2,983

MEDICAL DEPARTMENT - ADMINISTRATIVE ORGANIZATION AND

CHANNELS OF COMMUNICATION

Medical, Dental, Nurses, Midwives and Pharmacy Boards.

DIRECTOR

Registrar of Birtha and Deaths

DEPUTY DIRECTOR

-Auxiliary

Medical Services

Secretary -Accountant -Tung Wah

Hospital Group

Deputy Director of

Medical Services

-Senior Radiologist⚫ -Senior Dental Surgeon*

Government

Hospitals (includ- Ing Mental

¡Hospital)

Government Clinics -Government Dispensaries

-Consultants

Government

Pathologist

-Government

Chemist*

-Police Surgeon -Principal

Matron

-Principal Almoner -Chief Pharmacist" -Chief Steward*

Deputy Director of Health Services

Senior Health Officer

-Malariologist

Senior Port Health

Officer

Senior Social

Hygiene Officer

and S. H. Clinica Supervisor of Midwives and Maternity Homes

Schools Welfare Officer and

Clinics -Tuberculosis Specialistt

-Health Officers (Hong Kong & Kowloon)

-Medical Omeer off Health, New Territories

-Infant Welfare Clinics

-Anti-Epidemic

Office

* Deals direct with Deputy Director of Health Services where appropriate.

† Deals direct with Deputy Director of Medical Services where appropriate.

Legislation.

18. The following legislation affecting public health was enacted during the year 1951-52.

(1) Ordinances:

(a) The Law Revision (Penalties Amendment) Ordinance

No. 22 of 1950.

Item 12-Amendment to the Coroner's Abolition

Ordinance No. 5 of 1888.

Item 30--Amendment to the Midwives Ordinance

No. 22 of 1910.

Item 54-Amendment to the Nurses Registration

Ordinance No. 1 of 1931.

Item 65-Amendment to the Births & Deaths Regis- tration Ordinance No. 21 of 1934.

Item 66 Amendment to the Cremation Ordinance

No. 40 of 1934.

Item 67-Amendment to the Adulterated Food and

Drugs Ordinance No. 8 of 1935.

Item 68--Amendment to the Public Health (Food)

Ordinance No. 13 of 1935.

Item 69 Amendment to the Public Health (Animals

and Birds) Ordinance No. 16 of 1935. Item 70-Amendment to the Lepers Ordinance No. 25

of 1935.

Item 73-Amendment to the Dangerous Drugs Ordin-

ance No. 35 of 1935.

Item 76-Amendment to the Quarantine & Prevention

of Disease Ordinance No. 7 of 1936. Item 79-Amendment to the Nursing & Maternity Home Registration Ordinance No. 48 of

1936.

Item 83-Amendment to the Registration of Dentists

Ordinance No. 1 of 1940.

(b) The Law Revision (Miscellaneous Amendments)

(No. 2) Ordinance No. 24 of 1950.

PART II:

Item 45-Amendment to the Public Health (Animals

& Birds) Ordinance No. 16 of 1935. Item 46-Amendment to the Dangerous Drugs Ordin-

ance No. 35 of 1935.

Item 52-Amendment to the Registration of Dentists

Ordinance No. 1 of 1940.

Section 3 of sub-section 5-Amendment to the Births and Deaths Registration Ordinance No. 21 of 1934.

(d) The Venereal Disease Ordinance No. 1 of 1952.

(e) The Nursing and Maternity Homes

(Amendment) Ordinance No. 4 of 1952.

Registration

(f) The Mental Hospitals (Amendment) Ordinance No. 5 of

1952.

(II) Orders, Rules, Regulations and By-laws:

(a) The Public Health (Food) Ordinance 1935-Amend- ments to the by-laws under the heading "Slaughter- Houses", (G.N.A, 70 of 1951).

(b) The Law Revision Amendment Regulations (G.N.A. 79

of 1951).

Item

1-Amendment to the Adulterated Food and

Drugs Ordinance No. 8 of 1935.

Item 2-Amendment to the Cremation Ordinance

No. 40 of 1934.

Item 3-Amendment to the Dangerous Drugs Or-

dinance No. 35 of 1935.

Item 4--Amendment to the Asylums Ordinance

No. 22 of 1936.

Item

5-Amendment to the Pharmacy & Poisons

Ordinance No. 8 of 1937.

Item 7 Amendment to the Dogs & Cats Ordinance

No. 1 of 1950.

to the Market By-law. (G.N.A. 85 of 1951).

(d) The Law Revision Amendment Regulations (G.N.A. 87

of 1951).

Item

1-Amendment to the Public Health (Animais

& Birds) Ordinance No. 16 of 1935.

Item 2-Amendment to the Public Health (Food)

Ordinance No. 13 of 1935.

(e) The Births & Deaths Registration Ordinance 1934-

Amendment to the First Schedule. (G.N.A. 105 of 1951).

(f) The Nurses Registration (Amendment) Regulation.

(G.N.A. 129 of 1951).

(g) The Public Health (Animals and Birds) (Amendment)

By-laws. (G.N.A. 211 of 1951).

(h) The Quarantine & Prevention of Disease (Scale of

Charges) Regulations. (G.N.A. 215 of 1951).

(1) The Essential Services (Auxiliary Medical Services) Corps (Instruction Periods) Order. (G.N.A. 219 of 1951).

(j) The Restaurants and Food Stalls (Amendment) By-

laws. (G.N.A. 227 of 1951).

(k) The Markets and Market Areas (N.T.) Rules. (G.N.A.

21 of 1952).

(1) The New Territories (Amendment) Rules. (G.N.A. 22

of 1952).

(m) The slaughter-houses (Amendment) By-laws. (G.N.A.

51 of 1952).

(n) The Slaughter-houses By-laws-Suspension of By-law 29 in respect of the Ma Tau Kok Slaughter-house (G.N.A. 64 of 1952).

STATISTICS

Population.

19. No official census has been taken since 1931. The population estimated in the mid-year by the Department of Statistics was 2,013,000. The figure mentioned above repre- sents a little more than a quarter of a million decrease over the year 1950.

20. Table 1 below gives the population figures from 1920 to 1951 excepting the period of the Japanese Occupation.

Table 1

Year

1920

+++

1921

---

1922

1923

1924

---

1925

1926

+++

---

Estimated Population

648,150

625,116

+++

638,300

667,900

695,500

725,100

710,100

Year

1927

1928

1929

1930

1931

1932

1933

1934

1935

1936

1937

1938

1939

1940

1941

г.

т го

ח ..

...

ILI

---

PIT

TP1

...

---

· · ·

---

FIL

Estimated Population

740,300

766,700

802,900

838,800

840,473

900,812

922,643

944,492

+-+

966,341

988,190

• +7

---

1942-1945 (Aug.)

+++

1945 (Sept.)

1946

+++

1947

1948

1949

гот

++-

LII

+++

1950

1951

1г.

■++

+ T-

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-

11 -

1,600,000

1,750,000

1,800,000

1,857,000

2,265,000

2,013,000

Births.

21. During the year, 68,500 births as compared with 60,600 in 1950 were registered. The figure is the highest so far in the history of the registration of births in the Colony.

22. In addition to the 68,500 births registered, (a) 752 births as against 564 of last year were post-registered, and (b) 454 births as compared with 513 in 1950 were re-registered in accordance with the Ordinance introduced in December, 1947, which permits re-registration of births recorded in the registers which were either lost or destroyed during the Japanese Occupation.

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

Year

Table 2

Births Registered 1934-1951.

Birth rate using estimated population

No. of Births Registered

1934

1935

1936

1937

++ I

20,886

22.11

---

25,037

25.9

27,383

27.8

ILJ

32,303

25.19

1938

ILI

35,893

24.5

1939

TII

...

hot

46,675

26.7

1940

LII

45,064

24.73

1941

45,000

27,44

1942

+++

10,343

Not available (Japanese Occupation)

1943

20,732

Year

No. of Births Registered

Birth rate using estimated population

1944

13,687

Not available (Japanese Occupation}

1945

3,712

1946

31,098

20.1

1947

42,473

24.3

1948

47,475

26.4

1949

+++

F+

54,774

29.5

1950

1951

---

60,600

26.8

68,500

34.

　　　　24. The post-registered and re-registered births are not re- corded in the above table.

25. It will be seen from the Table that the highest birth rate since 1934 was recorded in 1951.

Deaths.

　　　　26. Except in outlying places in the New Territories, where deaths are recorded at the nearest Police Station as being from natural causes or otherwise, as an investigation by the Police suggests, all deaths have to be certified by a registered medical practitioner and the nomenclature adopted is that of the Inter- national Statistical Classifications of Diseases and Injuries and Causes of Death. 7.0% of the total deaths were recorded at the Police Stations as being from natural causes.

27. 20,580 deaths were registered during the year, a figure representing an increase of 2,115 deaths over the year 1950, in spite of the decrease of population. The death rate calculated by using the estimated population is 10.2 as compared with 8.2 of last year.

28. The following table shows the deaths registered and the death rate per mille from 1926 onwards based on the estimated population:

Year

No. of Deaths Registered

Table 3

Death rate using estimated population

1926

1927

1928

1929

1930

1931

--1

12,516

17.6

---

14,761

19.9

ILI

14,735

19.2

17,565

21.9

---

- JI

16,268

19.4

18,797

22.4

1932

19,829

24.7

1933

+ L

18,161

22.1

1934

---

19,766

20.9

1935

22,133

22.9

1936

---

26,356

26.6

1937

34,635

1938

1939

38,818

26.3

48,283

27.6

1940

61,010

33.5

1941

61,324

37.4

1942

83,435

Not available (Japanese Occupation)

1943

40,117

1944

1945

24,936

1946

---

+ro

23,089

16,653

10.7

Year

1947

1948

1949

1950

++.

1951

•

No. of Deaths Registered

Death rate using estimated population

13,231

7.6

13,434

7.5

16,287

8.8

18,465

8.2

20,580

10.2

　　　　29. Besides the 20,580 deaths registered, (a) 23 deaths were post-registered and (b) 4 deaths were re-registered under the Ordinance introduced in December 1947, which permits re- registration of deaths recorded in registers that were lost in the Japanese Occupation.

　　　　30. An attempt has been made this year to get an ap- proximation to a standardized death rate, based on a survey of over 40,000 squatters in a resettlement area. The figure is 17.3 per 1,000, using the British 1931 census standard million as a basis.

Infant Mortality.

31. There were 6,285 deaths of infants under one year, a mortality rate of 91.8 compared with 99.6 for 1950. Of the 6,285 deaths, 1,238 and 1,151 occupying the 1st and 2nd places were those in the 4 weeks to 3 months and 3 to 6 months age periods respectively.

　　　　32. As in previous years, the deaths in infants under one year provided almost one third of the total deaths occurring during the year.

33. Table 4 shows the number of infant deaths per thousand live births for the years 1928-1951.

Year

Table 4.

Infant Mortality.

Infant Mortality Rate

1928

1929

458

---

662.9

1930

1931

ILI

1932

1933

1934

1935

1936

1937

1938

1939

+ L

1940

1941

---

557.5

617.4

525.3

454.9

347.3

316.4

372.4

376

343

345

327

1942 to 1945

1946

1947

1948

TII

1949

1950

1951

Not available

Not available (Japanese Occupation)

89.1

102.3

91.1

99.4

99.6

91.8

34. Table 5 shows the infant and neo-natal deaths and also the neo-natal death rate per thousand live births for the years 1946-1951.

Table 5.

Neo-natal Mortality Rate.

Aged Period

1046

1947

1948

1949

1950

1951

0-1 day

1-7 days

---

174

273

221

219

308

$91

264

376

467

454

539

814

4 weeks

FIL

---

563

814

745

986

072

936

4 weeks - 8 months

771

981

900

1,136

1,264

1,238

3-6 months

---

462

760

665

925

1,025

1.151

6-9 months

$67

731

TTE

986

1,040

067

---

9-12 months

169

421

551

788

899

788

---

--T

Total under 1 year

2,700

4.346

4.324

6,444

6,037

6,285

Infant Mortality rate

89.1

102.3

91.1

99.4

99.6

91.8

No. of deaths under 4

weeks

---

LLI

Neo-natal Mortality rate

1,001

22.2

1,463

$4.4

1.438

1,509

1,819

2,141

90.2

29.4

30.0

31.3

Maternal Mortality.

　　　　35. A further drop in the maternal mortality rate was noted when 1.59 was recorded as compared with 1.7 in 1950 and 2.12 in 1949.

36. Table 6 sets out the maternal mortality rate for the years 1946-1951 with the death rate per 1,000 live and still births.

17-

Table 6.

Maternal Mortality for 1946-1951 with rates per 1,000 live and still births ascribed to:-

(a) Pregnancy & Child bearing, excluding Abortion (b) Abortion (including criminal)

Year

Live Still Births Births

Total Live and

• Pregnancy and Childbearing

† Abortion

Maternal Mortality Rate

Still Births

No. of

Rate per

Deaths

1,000

No. of Deatha

Rate peri

No. of

Rate per

Births

1,000 Births

Deaths

1,000

Birthe

1946

31,098

636

31,782

1.01

7 |

0.22

1.28

1947

42,473

1,348

43,821

1.66

0,07

1.62

1948

47.475

1,251

48,726

1.38

0.14

1.47

1949

64,774

1.321

58.096

116

2.01

0.11

119

2.12

1960

50,600

1.343

61,943

1.49

0.21

105

1.70

1951

68,500 |

1,180

69,680

109

1,66

0.08

111

1.59

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

Death.

For 1949-1951, 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 1949-1951, Nos. 650-652 of International Statistical Classifica-

tion of Diseases, Injuries and Causes of Death.

36. Table 7 gives the figures of death from toxaemias of pregnancy for the years 1946-1951:-

Year

Table 7.

Deaths from Toxæmias of Pregnancy.

Deaths from Toxaemias of Pregnancy

1946 1947 1948 1949 1950 1951

+ ||

---

LII

---

Total Births (including still births)

31,783

43,821

48,726

56,095

61,943

69,680

Death rate per 1,000

333333

0.3

0.9

0.5

37. It will be seen from these figures that if the deaths from toxaemias of pregnancy are subtracted from the total maternal deaths there is a remarkably constant maternal mortality rate, and, in view of the very rapid increase in the demands on the maternity services since 1947, this reflects great credit on those concerned.

Principal Causes of Death,

　　　　38. Table 8 shows the principal causes of death for the years 1946-1951.

Causes of death (classified by 1938 Revision of International List).

Table 8.

Number of Denths,

1946

1947

1948 1949 1950

1951

　　　Beri-beri Bronchitis

гг.

---

гги

1318

312

140

100

JLI

---

-H

---

839

620

419

$11

743

854

Irr

I Tr

011

...

rrt

100

Cancer, malignant diseases

Cerebro-spinal fever

Diphtheria

Diseases of the heart

Enteritis and diarrhoea

Influenza

Malaria

Intracranial lesions of vascular origin

---

Non-venereal diseases

system

Old age, senility

of genitourinary

Other diseases of circulatory system Other diseases of digestive system

Other diseases of nervous system and sense

Other diseases of respiratory system Pneumonia (all forma)

Premature births, congenital malformations

　　　　and diseases of early infancy Smallpox

LLI

---

ILL

Syphilitic diseases

---

Tuberculosis of respiratory system

Tuberculosis (other forma)

Violence, (accidents, suicide, homicide etc.) Other defined disenSCA

Ill-defined causes

++.

117

277

304

397

618

669

795

JJ J

PP1

+Pr

TPL

137

FFF

+tr

++*

135

121

Fro

---

379

514

672

620

$25

982

FLL

---

1235

1179

1767

2268

2574

---

243

189

264

275

294

844

410

J-I

---

765

252

193

116

226

841

---

350

843

237

328

142

101

113

114

---

174

---

122

194

154

937

361

$18

454

492

509

ז!!

132

180

197

139

125

105

248

LII

328

-JI

4129

3464

3157

4391

4425

4064

982

1289

1214

1204

1262

1644

1306

129

↑

---

JIL

---

42 !

100

120

9.5

1475

1420

1443

1712

2165

3006

843

443

618

899

1098

1184

---

631

686

781

620

718

773

786

445

517

690

722

796

---

489

522

803

839 1063

1164

Total

---

+++

18653 13231: 13434 16287 18465 20680

39. Pneumonia.

　　　　　　The principal cause of death was pneumonia, all forms, which has steadily increased in number over the last five years.

40. Enteritis.

　　　　　　　Deaths from this disease have likewise increased over the past few years, but probably both in this disease and with pneumonia the increase is roughly pari passu with the increase in the number of births.

41. Tuberculosis.

　　　　　　This disease is steadily overtaking Pneumonia as the major killing disease in the Colony.

42. Table 9 shows the number of notifiable diseases and

TABLE

Notifiable

Notifications and

Total No. of Notifications

Diseases

1946

1947

1948

1949

Amoebiasis

118

153

Cerebro-Spinal Meningitis

Chickenpox

293

556

123

116

146

195

Cholera

D+++

+++++

514

Diphtheria

Dysentery (Bacillary & elinical)

Enteric Fever

Infantile Paralysis

Malaria

161

122

140

261

++++++++++

LILIH

104

123

221

246

311

408

Measles

Plague

Puerperal Fever

Rabies Human

Animal

----

Relapsing Fever

Scarlet Fever

Small-pox

Tuberculosis

Typhus Fever

Whooping Cough

Yellow Fever

THI

317

160

190

458

ILJI

1,998

214

2,801

4,855

6,279

7,510

NOTE: Malaria was first made notifiable in June 1950,

Whooping Cough and Infantile Paralysis were made notifiable

deaths at all ages for the years 1946-51.

Diseases

Deaths 1946 to 1951.

Total No. of Deaths at all ages.

1950

1951

1946

1947

1948

1949

177

154

137

233

281

246

524

574

8 || # =

1950

1951

135

121

528

374

907

1,024

115

160

134

502

453

ཋསྟྲg |ཋ ཌ

526

765

528

་ |

253

193

116

ཚ།

ལ།ཥ|

1,306

129

9,067

13,886

1,818

1,863

1,961

2,611

3,263

4,190

306

747

100

in October 1947 and July 1948 respectively.

43. Table 10 shows the age groups of diseases notified for

TABLE

Age Group of

Under 1 year

1 year to 3 years

Diseases

Total! M.

Total

A moebiasis

Cerebro-Spinal Meningitis

Chickenpox

Diphtheria

Dysentery (Bacillary & clinical)

Enteric Fever

Cont

Human Rabies

Malaria

Measles

Poliomyelitis, Acute

---

Puerperal Fever

Scarlet Fever

Tuberculosis

Typhus Fever (scrub)

Whooping Cough

TOTAL

-----------

119

190

TULU - - -

112

146

258

----

-- JL LJ----

193 175.

368

311

790

1,601

138 159 127

286

342 313

655 1,292 1,289 2,581

Nil return for Cholera, Plague, Smallpox, Yellow Fever, Epidemic

1951.

Notifiable Diseases

1951.

4 years to 9 years 10 years to 14 years

Over 14 years

Total

F. Total

Total

M. F.

Total

141

84i

127

104

154

145

136

281

110

116,

226

24.

42.

32. 611

272

302

574

192. 62

254!

256

1181 374

50: 39

579

256

835

690

334)

1,024

0 0 0

36.

350

443

398

128.

526

165

247

281

528

0·

1' 3i

763

545! 1,298 113

206 7,017 3,396 10,418 8,887 4,999 13,886

147 142

289

111

231 401, 346

747

1,262 984 2,246|

228 178

406. 8,315; 3,959 12,274 11,439: 6,723 18,162

Typhus, and Relapsing Fever,

Hospitals

44. Table 11 gives a summary of all the in-patients treated

Name

TABLE

Inpatients admitted into Government and including cases remaining in

Beds

General

Cases

Queen Mary Hospital

574

7,490

Kowloon Hospital

Sai Ying Pun Hospital

231

4,835

777

Tsan Yuk Hospital

Mental Hospital

Stanley Prison Hospital

Eastern Maternity Hospital

140

---➖ ➖➖ ➖ ➖

794

Wanchai Social Hygiene Hospital

20+8 cots

1,074

Lai Chi Kok Hospital

St. John Hospital

Lai Chi Kok Female Prison Hospital

Total Government Hospitals

New Territories Dispensaries

Tung Wah Group Hospitals

Nethersole Hospital

470+18 cots

1,781

100

1,137

------+-

165

Ruttonjee Sanatorium

1,809+26 cots

18,053

225

1.085

22,858

186

3,211

140

Grand Total

3,266+26 cots

44,347

and Clinics.

in Government and Government assisted Hospitals in 1951:-

Government assisted hospitals 1951, hospital from the previous year,

Mental

Maternity

Tuberculosis

Infectious

Total

Cases

2,118

594

113

10,322

2,454

131

111

7,540

876

1,719

7,113

935

1 !

7,113

935

271

1,175

2,437

1│

།

2,437

1,074

623

943

3,352

412

1,657

224

979

14,552

1,583

2,381

37,548

2,994

3,223

17,560

4,683

340

45,441

1,676

5,056

383

333

982

36,782

6,748

2,792

91,651

45. Table 12 gives a summary of all new out-patients treated

Institutions

TABLE

Outpatients

New Cases at Government & Government

Hospitals:

Queen Mary Kowloon

Sai Ying Pun Tsan Yuk

Stanley Prison

St. John

Lai Chi Kok Female Prison

Clinics & Dispensaries:

Violet Peel

Harcourt T.B.

Kowloon T.B. Social Hygiene

8 Public Dispensaries

➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖ ➖

12 New Territories Dispensaries Families Clinic

Police Medical Post

Victoria Remand Prison

Mongkok Clinic

Port Health

Health Centres:

Western

Kowloon

Harcourt

Total of Government Institutions

Tung Wah Group

Nethersole Hospital

Grand Total

++ +

י.

General Children's

Dressings Out-

Clinics

patients

4,646

8,184

258,982

212,833

3,281

6,648

67,613

46,488

7,182

43,823

2,832

5,607

5,343

8,368

24,895

42,197

37,974

11,717

51,680

95,380

8,983

33,697

993

689

2,633

6,752

5,689

1,156

5,796

231

844

972

329,674 11.779

488,442

195,992

36,529

23,455

9,893

1,475

341,453

534,864

220,922

in Government and Government assisted institutions:-

-1951

Assisted Hospitals, Clinics & Dispensaries

Ante- natal

Post- Gynae- Social

natal

cological Hygiene

Eye

Ear, Nose & Throat

Tuber- culosis

Total

340

619

2,442

751

1,012

219 7,568

110 1,537

130

14,248

488,406

1,843

131

1,450

4,319

645

129,137

6,735

300

7.035

1,742

446

53,193

13,945

8,368

1,441

106,507

15,747

18,562

17,934

3,022 1,434

3,122

164,999

923

323

454

46,807

689

138

334

410

186

167

| |

མཚ། །

16,142

7,436

1,076

972

304

463

349

304

463

711

1,060

17,159

1,182

6,351 20,874

10,767

1,172

13,671 7,341

4,235 35,449

1,113,029

304

91,347

2,069

950

6,280

20,667

29,995

2,132

13,803 20,874 21,012

4,235

35,753

1,225,043

-27-

46. Table 13 gives a summary of the total attendances at

Institutions

TABLE

Outpatients

Total Attendances at Government and Government

Hospitals:

Queen Mary Kowloon

Sai Ying Pun

Tsan Yuk

----

Stanley Prison

St. John

· +

Lai Chi Kok Female Prison

Clinics & Dispensaries:

Violet Peel

Harcourt T.B.

+++

FILT

Kowloon T.B.

General Dressings Out-

patients

Children's

Clinica

4,646

9,587

289,602

247,287

3,869

38,027

101,027

72,556

18,009

53,080

5,986

9,786

8,302

8,368

44,246

66,467

58,972

Social Hygiene

+++

8 Public. Dispensaries

+++

12 New Territories Dispensaries

Family Clinic

Police Medical Post

Victoria Remand Prison

Mongkok Clinic

Port Health Clinic

Health Centres:

Western Kowloon

Harcourt

44-------

JILI

Total of Government Institutions

Tung Wah Group

Nethersole Hospital

Grand Total

47,344

80,423

130,099

32,163

58,402

2,574

7,284

4,285

9,782

9,976

++++

2,372

10,289

291

981

1,030

486,680 23,214

663,103

70,009

287,329 49.191

2,609

19,997

4,286

512,503

753,109

340,806

Government and Government assisted institutions:

-1951

assisted hospitals, clinics and dispensaries.

Ear,

Ante-

natal

Post- Gynae- Social natal cological Hygiene

Tuber-

Eye

Nose &

Total

culosis

Throat

2,049

218

2,102

223

9,168

867

2,146

12,378

4,603

272

3,797

20,303

110 3,422 2,050

130

19,065

15,980

524

2,763

125

167

|||$||

568,739

242,635

16,504

564

74,416

24,366

8,368

5,595

2,538

160

| | | | |

2,120

171,805

52,866

49,637

152,294

8,769

272,326

1,213

437

8,169

105,496

7,284

106

187

471

650

25,694

361

397

125

298

13,842

1,272

1,030

　　　1,925 2,282

1,080

1,070

| 1|

1,925

2,282

2,150

45,505 12,893 4,895

1,881 17,087 156,818 2,205

35,316 15,832

8,521

111,756 1,051

1,813,996

174,395

970

11,344

44,101

63,293

2,851

30,636 156,818 51,148

8,521 112,807

2,032,492

　　47. Table 14 gives an analysis of the cases treated in Government and Government assisted hospitals, and the total deaths in the Colony.

　　48. It will be seen from the figures quoted that there has again been a marked increase in the number of persons treat-

TABLE

Cases treated in Government and Government assisted

Intermediate

Detailed

List Number, List Number.

Cause Groups

A 1

001-008

Tuberculosis of respiratory system

A 2

010

Tuberculosis of meninges and central

nervous system

A 3

011

Tuberculosis of intestines, peritoneum and

mesenterie glands

Tuberculosis of bones and joints

A 4

012-013

A 5

014 - 019

Tuberculosis, all other forms

------

A 6

020

Congenital syphilis

-JL-

A 7

021

Early Syphilis

A 8

024

Tabes dorsalis

A 9

025

General paralysis of insane

A10

022, 023

All other syphilis

026 - 029

A11

030 - 035

Gonococcal infections

A12

040

Typhoid fever

------

A13

041-042

LLI

Paratyphoid fever

infections

and other Salmonella

Carried forward

ed. As the estimated population of the Colony in 1951 has de- creased by about 252,000 from that of 1950, and there have been no large outbreaks of infectious disease, consequently it is clear that an increasing proportion of the population is attending Government or Government assisted institutions for the treat- ment of their common ailments.

hospitals with the total deaths in the Colony for 1951,

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Sex Un-

pitals

Male

Female

Total

pitals

known

1,133

3,853

2,125

1.899

1.107

3,006

142

862

646

454

404

858

130

135

147

265

t *

126

111

237

102

10 00

164

769

549

355

།སྒྱུ

132

3,303

5.653

319

2,966

2,678

1,740

4.418

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List

Number.

Cause Groups

Brought forward

A14

043

Cholera

A15

044

Brucellosis (undulant fever)

A16(a)

045

(b)

046

(0)

047, 048

A17

050

Bacillary dysentery

Amoebiasis

Other unspecified forms of dysentery

Scarlet fever

+--

A18

051

Streptococcal sore throat

A19

052

Erysipelas

A 20

053

Septicæmia and pyæmia

-------

A21

055

Diphtheria

A22

056

Whooping Cough

A23

057

Meningococcal infections

➖ ➖ ➖ ➖

A24

058

Plague

A25

060

Leprosy

A26

061.

Tetanus

FIITI

A27

062

Anthrax

A28

080

A29

082

Acute poliomyelitis

Acute infectious encephalitis

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases Treated 1951

Deaths 1951

Govern-

Whole Colony

ment

Assisted

ment Assisted

Hos-

pitals

Hos-

Sex Un-

pitals

Male

Female

pitals

known

Total

3,303

5.653

319

2.966

2,678

1,740

4,418

229

102

488

104

121

150

ウ

129

108

4,425

5.849

526

3.032

2,855

1,897

4,752

Table 14--

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number,

Cause Groups

Brought forward

A30

081, 083

Late effects of acute poliomyelitis and acute

infectious encephalitis

LL-

A31

084

Smallpox

A32

.085

Measles

A33

091

Yellow Fever

-----

A34

092

Infectious hepatitis

A35

094

Rabies

A36(a)

100

101

(c)

104

(d)

105

Louse borne epidemic typhus

Flea-borne epidemic typhus (murine)

Tick-borne epidemic typhus

Mite-borne typhus

(e)

102, 103

Other and unspecified typhus

106-108

A37(a)

110

(b)

111

(c)

112

(d)

115

(e)

113, 114

A38(a)

123.0

116, 117

Vivax malaria (benign tertian)

Malariæ malaria (quartan)

Falciparum malaria (Malignant tertian)

Blackwater fever

Other and unspecified forms of malaria

Schistosomiasis vesical (S, hæmatobium)

Carried forward

------

---

5,003

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Sex Un-

Hos-

Male

Female

Total

pitals

known

pitals

4.425

5,849

526

3,032

2,855

1.897

4.752

258

1 I

1 1

[

122

129

221

ลง

6,266

562

3,049

2.900

1.933

4,833

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number,

Cause Groups

Brought forward

A38 (b)

123.1

(e)

123.2

(d)

123.3

Schistosomiasis intestinal (S. Mansoni)

Schistosomiasis pulmonary (S. Japonicum)

Other and unspecified schistosomiasis

A39

125

A40(a)

127

Hydatid disease

Onchocerciasis

(b)

127

Loiasis

(c)

127

Filariasis (bancrofti)

(d)

127

A41

129

A42(a)

126

(5)

130.0

(c)

130.3

Other filariasis

Ankylostomiasis

Tapeworn (infestation) and other cestode

infestations

Ascariasis

Guinea Worm (dracunculosis)

(d)

124, 128 130.1, 130.2

Other diseases due to helminths

-----

A43(a)

037

(b)

038

(c)

039

(d)

049

Lymphogranuloma venereum

Granuloma inguinale, venereal

Other and unspecified venereal diseases

Food poisoning infection and intoxication

Carried forward

-------

LI ILIJ

Continued

hospitals with the total deaths in the Colony for 1951,

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Hog-

Hos-

Male

pitals

Female

Sex Un- known

Total

pitals

5,003

6.266

562

3,049

2,900

1.933

4.839

119

234

5,191

6,672

562

3,051

2,904

1.933

4,837

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List

Number.

Cause Groups

A43 (e) (/)

071 072

SSSSSS

(g)

073

Relapsing fever Leptospirosis

disease)

Yaws

Brought forward

icterohæmorrhagica

י ח ח + F +

(Weil's

087

Chickenpox

090

Dengue

+LJLI

095

Trachoma

096.7

Sandfly fever

120

Leishmaniasis

(m)

121(a)

(b)

(c)

(n)

131

A44

བྱབྱ ཚེ

135

036, 054, 059 063, 064, 070 074, 086, 088 089, 093, 096.1

096.6, 096.8,

096.9, 122,

132-134, 136 - 138

140 - 148

Trypanosomiasis gambiensis

Trypanosomiasis rhodesiensis

Other and unspecified trypanosomiasis

Dermatophytosis

Scabies

ггт г гт

All other diseases classified as infective and

parasitics

Malignant neoplasm of buccal cavity and

pharynx

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

ment

Hos-

Assisted

ment Assisted

Whole Colony

Hos-

pitals

Hos-

pitals

Male

Sex Un-

Female

Total

pitals

known

5,191

6.672

562

3,051

2,904

1,933

4,837

100

370

दूध

| ས |

118

113

107

5,814

6,821

577

3,115

2,977

1.981

4,958

Table 14

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number,

Cause Groups

Brought forward

A45

150

Malignant neoplasm of œsophagus

A46

151

Malignant neoplasm of stomach

A47

152, 153

Malignant

neoplasm of intestine, except

A48

154

A49

161

A50

162, 163

rectum

Malignant neoplasm of rectum

Malignant neoplasm of larynx

Malignant neoplasm of trachea, and of

bronchus and lung not specified secondary

A51

170

Malignant neoplasm of breast

A52

171

A53

172 - 174

A54

177

Malignant neoplasm of cervix uteri

Malignant neoplasm of other and unspecified

parts of uterus

Malignant neoplasm of prostate

A55

190-191

Malignant neoplasm of skin

------

--------

A56

196 - 197

AST

155 - 160

164, 165, 175,

Malignant neoplasm of bone and connective

tissue

Malignant neoplasm of all other and un-

specified sites

176, 178 - 181,

192-195, 198

199.

A58

204

Leukaemia and aleukaemia

Carried forward

+++

Fontinued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Sex Un-

Hos-

pitals

Hos-

Male

Female

Total

pitals

known

5,814

6,821

577

3.115

2,977

1,981

4,958

122

133

175

134

196

173

171

253

6.474

7,545

724

3,419

3,318

2.348

5,666

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number,

Cause Groups

A59

200 - 203

205

AGO

210 - 239

Brought forward

Lymphosarcoma and other neoplasms

lymphatic and haematopoietic system

Benign neoplasms and neoplasms of

specified nature

un-

A61

250, 251

Nontoxic goiter

A62

252

A63

260

Tyrotoxicosis with or without goiter

Diabetes mellitus

LIL

A64(α)

280

Beriberi

----

י -

(b)

281

Pellagra

LILJ

(0)

282

Scurvy

(d)

283 - 286

Other deficiency states

-------

A65(e)

290

(b)

(c)

A66(a)

(b)

291.

292, 293

241

240.

254, 270 - 277

287 - 289,

242-245, 253

Pernicious and other hyperchromic anaemias

Iron deficiency anæmias (hypochromic)

Other specified and unspecified anæmias

Asthma

All other allergic disorders,

metabolic and blood diseases

endocrine.

294 - 299

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

pitals

Hos-

pitals

Male

Female

Sex Un- known

Total

pitals

6,474

7,545

724

3,419

3,318

2.348

5,666

635

183

132

1 1

135

ון

312

361

114

7,666

8,684

768

3,455

3,419

2,435

5,854

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List

Number

Cause Groups.

Brought forward

A67

300 - 309

Psychoses

A68

310-324

326

A69

325

A70

330 - 334

A71

340

A72

345

Psychoneuroses and disorders of personality...

Mental deficiency

Vascular lesions affecting central nervous

system

Nonmeningococcal meningitis

Multiple sclerosis

----

A73

353

Epilepsy

A74

370 - 379

A75

385

Inflammatory diseases of eye

Cataract

A76

387

Glaucoma

A77(e)

390

Otitis externa

(b)

391 - 393

Otitis media and mastoiditis

Carried forward

* Among these, 7 died of A 1

1 died of A20

1 died of A66(b)

2 died of A70

This one died of A 3

Tuberculosis of respiratory system. Septicaemia and pyæmia.

All other allergic disorders, endocrine,

metabolic and blood diseases. Vascular lesions affecting central

nervous system.

Tuberculosis of intestines, peritoneum

and mesenterie glands.

Continued

hospitals with the total deaths in the Colony for 1951.

Cases Treated 1951

Deaths 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Sex Un-

Hos-

Male

Female

Total

pitals

known

pitals

7,666

8,684

768

3,455

3,419

2,435

726

*16

203

122

† 1

5,854

102

330

207

248

162

410

❤ | | | |

{

8,991

9,374

872

3,665

3.705

2,620

6,325

1 died of A 81 1 died of A 89 1 died of A108

Arteriosclerotic and egenerative heart disease.

Lobar Pneumonia. Acute nephritis.

15175

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number

Cause Groups.

Brought forward

A77 (c)

394

Other inflammatory diseases of ear

A78(a)

380 - 384

(b)

386, 388, 389

341 - 344 350 - 352

All other disease and Conditions of eye

All other diseases of the nervous system and

sense organs

-JJL

354-357

360-369

395-398

A79

400 - 402

A80

410-416

A81

420 - 422

A82

430 - 434

A83

440 - 443

A84

444 - 447

Rheumatic fever

Chronic rheumatic heart disease

Arteriosclerotic and egenerative heart disease

Other diseases of heart

Hypertension with heart diseases.

Hypertension without mention of heart

---------

A85

450 - 456

Diseases of arteries

A86

460 - 468

Other diseases of circulatory system

A87

470-475

A88

480-483

----

A89

490

A90

491

Acute upper respiratory infections

Influenza

Lobar Pneumonia

Bronchopneumonia

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951,

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

ment Hos-

ment

Assisted

ment Assisted

Hos-

Sex Un-

pitals

Hos-

pitals

Male

Female

known

Total

pitals

8,991

9,374

872

3,665

3.705

2,620

1 1 1

6,325

111

137

207

514

152

121

166

287

732

291

311

262

573

127

228

122

287

372

452

260

683

166

940

375

465

272

737

442

3,595

124

1,877

2,054

1,998

4,052

11.086

16,999

1.118

6.391

6,876

5,453

12.329

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number.

Cause Groups.

A91

492, 493

A92

500

A93

501, 502

A94

510

Brought forward

Primary atypical,

atypical, other and unspecified pneumonia

Acute bronchitis

Bronchitis, chronic and unqualified

Hypertrophy of tonsils and adenoids

A95

518, 521

Empyema and abscess of lung

A96

519

A97(a)

523

(b)

511-517 520, 522 524-527

A98(o)

530

(b)

531-535

A.99

540

Pleurisy

Pneumoconiosis

All other respiratory diseases

Dental Caries

All other diseases of teeth and supporting

structures

Ulcer of Stomach

A100

541

Ulcer of duodenum

A101

543

Gastritis and duodenitis

A102

550 - 553

Appendicitis

A103

560, 561, 570

A104(a)

571.0

Intestinal obstruction and hernia

Gastro-enteritis and colitis, between 4 weeks

and 2 years

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Hos-

Assisted

Hos-

Sex Un-

pitals

Hos-

pitals

Male

Female

Total

known

pitals

11,086

16,999

1,118

6,391

6,876

5,453

12,329

520

104

115

175

246

120

101

197

641

157

226

112

| 88 |

121

184

134

120

116

215

367

137

273

571

320

353

229

537

2,940

110

1,313

978

1,041

2,019

13.903

22.784

1.283

7,904

8,406

7,007

15,413

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number

Cause Groups,

Brought forward

A104(6)

571.1

Gastro-enteritis and colitis, ages 2 years and

Over

A104(c)

572

A105

581

Chronic enteritis and ulcerative colitis

Cirrhosis of liver

A106

584, 585

Cholelithiasis and cholecystitis

A107

536 - 539

542, 544, 545

Other diseases of digestive system

573 - 580

582, 583

586, 587

Acute nephritis

Chronic, other and unspecified nephritis

Infections of kidney

Calculi of urinary system

Hyperplasia of prostate

Diseases of breast

A108

590

A109

591 - 594

A110

600

A111

602, 604

A112

610

A113

620, 621

A114(a)

613

(b)

634

Hydrocele

(e)

601, 603 605 - 609 611. 612 614-617

622 - 633 635 - 637

Disorders of menstruation

+++

All other diseases of the genito-urinary

system

- IIT-IT--

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Hos-

Assisted

Hos-

pitals

Hos-

pitals

Hos-

Male

Female

Sex Un- known

Total

pitals

13.903

22.784

1,285

7.904

8,406

7,007

15.413

381

604

132

295

216

511

104

224

124

165

116

587

759

101

162

122

576

129

180

100

280

في

215

150

764

1,000

16,475

26,454

1,393

8,381

9,172

7,467

16,639

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number

Cause Groups,

Brought forward

----

A115

640 - 641, 681, 682,

684

A116

642, 652 685, 686

Sepsis of pregnancy, childbirth and the

puerperium

Toxaemias of pregnancy and the puerperium.

A117

643, 644

Haemorrhage of pregnancy and childbirth

670 - 672

A118

650

A119

651

A120(c)

645-649

673 - 680

683 687 - 689

A120(b)

660

Abortion without mention of sepsis от

toxaemia

Abortion with sepsis

Other complications of pregnancy, childbirth

and the puerperium

Delivery without complication

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

A121

690 - 698

A122

720 - 725

Infections of skin and subcutaneous tissue

Arthritis and sponeylitis

A123

726, 727

Muscular rheumatism and rheumatism, un-

specified

A124

730

Osteomyelitis and periostitis

-----

A125

737 745-749

A126(a)

715

Ankylosis and acquired musculoskeletal de-

formities

Chronic ulcer of skin (including tropical ulcer)

Carried forward

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Sex Un-

pitals

Male

Female

Total

pitals

known

16,475

26,454

1,393

8,381

9.172

7.467

16,639

433

126

320

203

435

965

3,009

1,278

10,320

18,025

425

1,002

313

133

420

1 | 1

31.718

48,949

1.417

8,452

9.181

7,594

16,775

Table 14-

Cases treated in Government and Government assisted

Intermediate List Number.

Detailed List Number

Cause Groups

Brought forward

A126(6)

(c)

700 - 714

716

731-786 738 - 744

A127

751

A128

754

A129

750, 752

753 755-759

A130

760, 761

A131

762

A132(a)

764

(b)

765

(c)

763,766 - 768

A133

770

A134

A135

A136

A137(a)

788.8

(b)

793

(c)

769, 771, 772

773-776

794

780-787

788.1788.7

788.9 789-792

All other diseases of skin

All other diseases of musculoskeletal system.

Spina bifida and meningocele

Congenital malformations of circulatory

system

+----11-

All other congenital malformations

Birth injuries

Postnatal asphyxia and atelectasis Diarrhoea of newborn (under 4 weeks) Ophthalmia neonatorum

Other infections of newborn

Haemolytic disease of newborn

+++

---

All other defined diseases of early infancy Ill-defined diseases peculiar to early infancy. Senility without mention of Psychosis Pyrexia of unknown origin.

Observation, without need for further medical

care

All other ill-defined causes of morbidity

·· + --+

795

Total

Continued

hospitals with the total deaths in the Colony for 1951,

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

Hos-

Assisted

Sex Un-

Hos-

pitals

Male

Female

Total

known

pitals

31,718

48.949

1.417

8,452

9,181

7,594

101

434

16,775

บริ

158

219

104

107

173

105

625

603

119

424

580

425

1,014

249

108

101

174

391

141

།ལ

600

588

1,197

33,655 50,668

1,663

9,147 10,777

9,016

19,802

Table 14-

Cases treated in Government and Government assisted

"E" Code. Alternative Classification of

Accidents, Poisonings, and Violence (External Cause).

Intermediate Detailed List

List Number.

Number,

Cause Groups

Brought forward

AE138

E810 - E835

AE139

E800 - E802

Motor Vehicle Accidents Other transport accidents

+++

E840 - E866

AE140

E870 - E895

AEll

E900 - E904

AE142

E912

AE143

E916

AE144

E917, E918

Accidental poisoning Accidental falls

Accident caused by Machinery

Accident caused by fire and explosion of

combustible material

---

HIHI

Accident caused by hot substance, corrosive

liquid, steam and radiation

AE145

E919

Accident caused by firearm

AE146

E929

Accidental drowning and submersion

AE147

E923

Foreign body entering other orifice

E920

Foreign body entering eye and adnexa

E927

E928

AE148

E910, E911,

Accidents caused by bites and stings of

venomous animals and insects

Other accidents caused by animals

All other accidental causes

E913 - E915,

E921 - E922

E924 - E926

E930 - E965,

E970 - E979

AE149

E980-E985

AE150

E990 - E999

Homicide and injury purposely inflicted by

other persons (not in war)

Injury resulting from operations of war

GRAND TOTAL

Continued

hospitals with the total deaths in the Colony for 1951.

Cases

Treated 1951

Deaths 1951

Govern-

Whole Colony

ment

Hos- Assisted

Assisted

Hos-

pitals

Hos-

Sex Un-

pitals

Male

Female

Total

pitals

known

33,655

50,668

1,663

9,147

10,777

9,016

19,802

895

106

294

848

163

147

{ | 1

100

196

116

ཁྲ༅།།

| │

888

│*

180

118

298

231

37,548

50,880

1,932

9,151

11,310

9,261

20,580

Table 14

Cases treated in Government and Government assisted

"N" Code. Alternative classification of Accidents,

Poisonings and Violence (Nature of Injury).

Intermediate Detailed List

List Number.

Number.

Cause Groups

AN188

N800 - N804

Fracture of skull

AN189

N805 - N809

Fracture of spine and trunk

AN140

N810 - N829

Fracture of limbs

AN141

N830 - N839

AN142

N840 - N848

Dislocation without fracture

Sprains and strains of joints and adjacent

muscle

AN143

N850 - N856

Head injury (excluding fracture)

AN144

N860 - N869

AN145

N870 - N908

AN146

N910 - N929

AN147

N930 - N936

Internal injury of chest, abdomen and pelvis.

Laceration and open wounds

☐ 1

Superficial injury, contusion and crushing:

with intact skin surface

Effects of foreign body entering through

orifice

AN148

N940 - N949

Burns

AN149

N960 - N979

Effects of poisons

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

AN150

N950 - N959

N980 - N999

All other and unspecified effects of external

causes

TOTAL

Contd.

hospitals with the total deaths in the Colony for 1951

Cases

Deaths 1951

Treated 1951

Govern-

Whole Colony

ment

Assisted

ment Assisted

Hos-

pitals

Hos-

pitals

Male

Female

pitals

Sex Un- known

Total

302

137

181

271

832

620

553

126

189

1 │

289

431

128

164

252

3,893

212

269

533

245

778

II. PUBLIC HEALTH

INTRODUCTION

49. The Director of Medical & Health Services is respon- sible for public health administration throughout the Colony. However an Urban Council exercises control over matters of general sanitation in the urban areas of Hong Kong and Kowloon. Senior public health personnel of the Medical De- partment are seconded to the Urban Council for duty in the urban areas over which the Urban Council has jurisdiction.

50. A medical officer of health advises the District Adminis- tration in the New Territories which is substantially a rural area containing several small townships.

Urban Areas.

51. Under the control of a Senior Health Officer, two Health Officers, seconded to the Urban Council, have respon- sibilities on Hong Kong Island and in Kowloon. Also in those areas are Senior Health Inspectors and Health Inspectors em- ployed by the Urban Council. This staff is generally supervised by the Deputy Director of Health Services.

52. For purposes of public health administration the urban areas are divided into districts and these in their turn into sub- districts each of which is the responsibility of a Health In- spector. In Hong Kong there are sixty-two sub-districts and in Kowloon twenty-five. The Health Inspector is responsible for the general sanitary supervision of his sub-district, the investi- gation of infectious disease and the carrying out of disinfection and disinfestation.

53. Other duties of Inspectors include the supervision of dairies, milk and food inspection and sampling, control of wet cultivation, and the supervision of hawkers, markets, abattoirs, cemeteries, etc.

　　　　54. A pest control officer is responsible for anti-rodent measures in the urban areas.

55. The department is also responsible for anti-epidemic work, health education of the public, port health work, the opera- tion of maternal and child health services which includes a school health programme, social hygiene work, tuberculosis and malaria and mosquito control.

Rural Areas.

56. The Medical Officer of Health, New Territories has under his jurisdiction an area of some 350 square miles which includes numerous islands and has a population of about 200,000.

57. His staff consists of a Senior Health Inspector and five Health Inspectors each of whom is responsible for a district of the New Territories wherein he supervises all public health matters.

HYGIENE & SANITATION

Refuse Removal & Conservancy Services.

　　　　58. Refuse removal and conservancy services in the Urban Council area are the responsibility of a Superintendent of Sanitary Services under whom a Chief Health Inspector directly superintends the work.

　　　　59. Two systems of night soil disposal are in operation, (a) a water carriage system with sewers serving part of the City of Victoria and discharging directly into the harbour and (b) bucket conservancy which is necessitated in certain areas by the old type of premises prevailing. It is the single bucket system which operates generally but the two pail pilot scheme initiated in Kowloon in the previous year to serve 320 houses was extend- ed to serve 100 floors on Hong Kong Island. This worked very

satisfactorily but general introduction of the system was not practicable on account of high cost of plant.

60. Night soil disposal is effected partly by dumping at sea and partly by treatment in maturing tanks in the New Territories. After treatment it is disposed of for fertiliser through various distributing depots in the New Territories.

61. Domestic refuse is removed daily from the urban dis- trict by refuse lorries and then by specially designed barges to Kuntong, on the north east side of the harbour, where it is used as filling for reclamation.

62. The pilot scheme for composting night soil and refuse, referred to in the previous report, continues. Following the visit of an expert in this matter from England, consideration is being given to developing this activity on a considerable scale.

Water Supplies.

63. The main water supply of the urban area is a piped one. Its source is from controlled catchments on the Island and in the New Territories which drain into large reservoirs. The water is then filtered and chlorinated.

64. Qualitatively it is excellent but quantitatively it is in- adequate and water restrictions are necessary for a substantial part of the year.

65. Because of this water shortage additional casual supplies, such as streams, wells etc., are made use of by the urban people.

66. In the New Territories wells constitute the source of supply to the greater part of the population.

Housing.

67. There was again considerable building activity throughout the year but the housing erected was largely of an

expensive type. In one area of the Island, however, a number of houses, suitable for workers of the lower income groups, was erected.

　　　　68. A considerable amount of new housing resulted from the general scheme for the resettlement of squatters.

Squatters.

　　　　69. This remains Hong Kong's major sanitary and social problem. It is estimated that some 350,000 persons occupy un- authorized huts of the poorest type.

　　　　70. Early in 1952 resettlement of these squatters com- menced in approved areas where the people were permitted to build their own huts to approved specification, conforming to a planned layout which provided fire lanes. Piped water supply was led to these areas and latrines were erected. Health educa- tion of the squatters was carried out extensively by the health inspectorate, and extensive preventive inoculations were carried out.

RURAL HEALTH

　　　　71. The work of the Department in the New Territories is similar, in most respects, to that in the urban area, but is con- trolled by separate legislation made under the New Territories Ordinance (Cap. 97).

　　　　72. The control of building standards, both in permanent and temporary buildings, is a matter which requires constant at- tention. Conditions are rather different from those in urban districts where space is limited. The type of building is often simple, but it has been possible, in several cases, to achieve buildings which are cheap and simple while being of substantial construction and far more healthy than the tin shacks they replace.

　73. Buildings erected to house labourers on temporary pro- jects are a serious problem. Most prominent among these are the appalling shacks put up by illegal miners working the scattered wolfram deposits throughout the New Territories. These have not only risked their own health by their insanitary mode of living, but have also caused a serious danger to the health of others through the contamination of water supplies and interference with irrigation in general. The scattered situation of these mines and the lack of firm financial prospects for the miners are two of the reasons which make control extremely difficult. At the moment, however, the position is generally im- proving.

74. Considerable work has been done to keep the areas around military establishments free from fly and mosquito nuisance and fair success has been attained. The problem is not eased by the fact that many of the nuisances arise from con- tractors working in connexion with the camps themselves.

75. A new market has been built by private enterprise at Shatin and is a great benefit to the community.

COMMUNICABLE DISEASES

　76. In 1951 there was no case of cholera, plague, smallpox, epidemic typhus or yellow fever.

77. Only 2 cases of scrub typhus fever were notified from among the troops but the disease is neither epidemic nor endemic.

78. For the fifth year in succession the Colony has been free from any major epidemic.

　79. During the year 1951, there was no case of rabies, human or animal. The case registered in March 1951 actually occurred on the 24th of December 1950 in Tai Po, N.T., and the laboratory test was not confirmed until the 16th of March 1951.

　　　　80. Pulmonary tuberculosis increased both in cases (50%) and in deaths (30%), the former being due partly to better noti fication.

are:

81. The leading causes of deaths by communicable diseases

Cases

Diseases

Chinese

Non- Chinese

Total

Deaths

Fatality

rate

1. Tuberculosis...

2. Enteric fever..

13,855

13,886

4,190

30.2%

1,015

1,024

134

13.1%

3. Diphtheria

569

574

121

21.1%

4. Measles

390

138

528

7.4%

5. Malaria

482

526

6.7%

6. Bac.

Dysentery

318

371

7.5%

---

82. Enteric fever.

Notifiable diseases

　　　　　　　There were 1,024 cases with 134 deaths, in 1951 as against 907 cases with 160 deaths, in 1950. The incidence of the disease has been steadily rising since 1946.

　　　　83. In spite of repeated efforts, no focus of infection could be found. It is believed that carriers are the source of infection. Data showed that squatter populations had a higher percentage in both incidence and deaths than the community at large. The disease continued to be particularly fatal to young male adults.

84. Dysenteries.

　　　　　　While bacillary dysentery showed a 47% increase in incidence, amoebiasis registered a 13% decrease. There were 154 cases of amoebiasis with 9 deaths and 371 cases of bacillary dysentery with 28 deaths during the year, as against 177 cases

of amoebiasis with 10 deaths, and 253 cases of bacillary dysentery with 14 deaths.

　85. As usual the non-Chinese population showed a relative- ly greater susceptibility than the Chinese population.

86. Poliomyelitis.

　　　This disease has become more serious in this Colony as elsewhere throughout the world in recent years. There were in 1951, 28 cases with 3 deaths as against 16 cases with 3 deaths in 1950. The non-Chinese population appeared to be dis- proportionally susceptible.

87. Diphtheria.

The incidence of this disease showed a 10% increase but the fatality rate decreased markedly.

88. There have been 574 cases with 121 deaths as against 524 cases with 135 deaths in 1950.

　89. The disease mainly affects children in the second and third years of life (60%) but the fatality rate is very high among infants below 1 year of age,

　90. An absence of immunization of infants and youngsters is the cause of the high incidence, and a preference for Chinese herbalist treatment rather than for early scientific treatment is responsible for the deaths of the infected.

91. Cerebrospinal Meningitis.

　　　There have been 26 cases with 13 deaths, as against 49 cases with 26 deaths in 1950.

　92. The disease affects Chinese children almost exclusively and the incidence has fallen markedly during the last few years,

93. Measles.

There have been 528 cases with 39 deaths.

　　　　94. The cause of death among children of poor and ignorant Chinese families was invariably Pneumonia.

　　　　　95. About 11% of the cases occurred in non-Chinese without any deaths.

96. Pertussis.

　　　　　　　There is evidence that the marked increase in the in- cidence of this disease during the last 2 years is largely due to better notification. This incidence in the Colony is greatest during the summer months.

　　　　97. There have been 747 cases with 20 deaths against 306 cases with 16 deaths in 1950.

98. Puerperal fever.

In 1951 there were 7 cases without deaths.

99. Tuberculosis.

The incidence of pulmonary tuberculosis increased 50%

as compared with the preceding year.

Better service and active

propaganda certainly ushered in more cases.

　　　　100. In 1951 there were 13,886 cases with 4,190 deaths, as against 9,067 cases with 3,263 deaths in 1950.

　　　　101. A separate report on tuberculosis will be found in paragraphs 167-218.

102. Malaria.

In 1951 there were 526 cases with 35 deaths as against 502 cases with 89 deaths in 1950. There was less subtertian malaria than previously.

January

February

March

103. Table 15 gives the number of vaccinations and

TABLE

Inoculations and Vaccinations

Anti-

smallpox

cholera

typhus

telanus

MONTH

vaccina-

inocula-

tions

192,535

7,137

1,285

1,054

124,977

5,013

808

1,002

H++

136,230

6,589

1,227

1,101

83,863

47,250

1,196

1,053

28,183

133,164

900

1,397

18,434

132,463

1,158

1,477

13,535

107,027

1,029

1,580

12,283

74,007

880

1,484

-----

12,723

58,338

790

1,467

124,571

18,106

745

1,506

167,375

6,288

712

1,375

127,988

5,141

575

1,291

April

--T---+

May

June

July

---------------T-utharutthull++

August

September

October

November

December

TOTAL

----

1,042,697

600,5 23

11,311

15,787

inoculations done each month:

done during 1951

Anti-diphtheria inoculations

Anti-typhoid inoculations

Anti-plague inoculations

Anti-rabies inoculations

1st

2nd

1st

2nd

ist

doses

2nd doses

1st

Other

doses

1,953

9,080

2,841

305

1,461

808

972

2,139

308

1,360

932

919

3,034

240

1,477

629

811

4,449

293

261

1,772

952

493

5,233

628

300

2,177

095

482

3,235

32G

278

1,887

898

673

3,544

1,931

320

2,153

670

427

3,162

370

269

1,784

461

378

2,602

129

241

1,701

653

545

2,341

957

300

1,698

1,226

461

2,886

498

1,931

2,741

417

2,405

239

1,580

12,918

15,658

37,871 4,741

3,565

20,981

ANTI-EPIDEMIC MEASURES

　104. Anti-epidemic measures are under the control of an Epidemiologist but early in 1952 the Senior Port Health Officer took over this work in addition to his own duties.

　105. His staff consists of 11 Public Vaccinators and 19 Inoculators who are trained nurses.

106. A new form for the notification of infectious disease was introduced last year and has proved satisfactory.

　107. The anti-epidemic work consists mainly of immuniza- tion against smallpox, cholera, and diphtheria. The staffs of all food establishments are inoculated and vaccinated in due season. Also all staff of Government departments and the larger com- mercial firms are dealt with by teams which visit their offices. In addition the great body of squatters is given prophylaxis early, as it is there that the most explosive source of epidemics lies. This year a new scheme was adopted to allow a greater stress of anti-diphtheria prophylaxis-the year being divided into 3 periods of 4 months January to April-diphtheria; May to August-cholera; September to December-smallpox.

　108. For the 5th year in succession there was no case of cholera. Plague remains absent, but continuous attention was paid to the examination and control of rats and preparation of flea indices in view of proximity to the hinterland where plague has been reported.

　109. R. norvegicus is the more common type of rat found in the tenement houses. R. rattus is more common in ships but is also found in tenement houses. Final disposal of all rats is by burial.

HEALTH EDUCATION

110. No further progress has been made with an actual Health Education programme for the Department itself, as all publicity work has been taken over by the Public Relations Officer. Nevertheless a considerable amount of teaching is done by lectures and demonstrations particularly in the Infant Wel- fare Section. Vaccinations and immunization campaigns are usually preceded by radio talks given in English and Chinese. Anti-spitting propaganda is well publicised by a film, prepared by the Cinema Association which is shown in over 40 picture houses. A special film on venereal diseases, prepared locally by this Department has been shown to male audiences. It is a film which has received special commendation, and may give some real results in the prevention of the disease, and the seeking of treatment at an early date. A specially fitted cinema van for the showing of pictures on hygiene and health problems has been a success throughout the year.

111. Series of lectures on hygiene have been given to the teachers in training at Northcote Training College who will thus be in a position to pass on this knowledge to pupils in due course.

PORT HEALTH

112. The main administrative officers of the Port Health Office are accommodated in the Marine Department Building. Three inoculation centres cater for the travelling public, two on the Hong Kong side, and one at Kowloon. The Airport section is housed in the Terminal Building at Kai Tak. At Lo Wu, the Port Health team is responsible for the quarantine inspection of travellers from Canton. The two quarantine anchorages at Kowloon Bay and Stonecutters Island are made use of through- out the year by vessels of all tonnages and flags.

　　　　113. During the year under review, the establishment of Assistant Port Health Officers remained constantly at seven,

　114. A Senior Port Health Inspector assisted by two Health Inspectors dealt with all deratting and disinsecting aspects of Port Health work. Cyanide and sulphur fumigation were undertaken by the port. 19 vessels were fumigated with cyanide, 72 with sulphur, and 152 exemptions were granted for 1951.

　115. The port was free of any epidemic of quarantinable disease during the year. However, one imported case of small- pox, and one local case of smallpox, which was notified on 17th January, 1952 and 18th February, 1952 respectively, were recorded.

　116. Due to the absence of accurate epidemioligical intelli- gence from the Chinese mainland all cargo originating from areas in China where plague is endemic had to be disinsected as a precaution against the introduction of plague-infected fleas in the cargo.

　117. 82,816 passengers, 191,838 crew, and 3,742 vessels were inspected during the year 1951 as against 731,148 passengers, 537,991 crew and 13,781 vessels in 1950. (The 13,781 included small craft which arrived from Macao and the river ports in the Kwangtung Province).

　118. Due to travel restrictions and the limitation on the quota permitted for contracted labourers, the total number of emigrants inspected during the past year was 13,487 as against 25,038 for 1950.

119. The number of Bills of Health issued during the calendar year 1951 was 2,769.

　120. Although air passenger traffic had not increased much, 32,669 passengers as compared with 32,177 in 1950, were medically inspected. All passengers and crew of arriving air- craft were medically inspected, and the International Civil Avia- tion Organization's recommendation regarding the routine spraying of aircraft was insisted upon.

SOCIAL HYGIENE

　　　121. For the greater part of the year there were 7 Doctors, one Technical Assistant, 12 Nurses, and 6 Dressers on this work. In the early part of 1952, 4 Social Hygiene Health Visitors were recruited for contact tracing as a result of the Venereal Diseases Ordinance.

　　　　122. There is one Hospital for female patients with 20 beds and 8 cots, and 6 clinics of which 3 are for males and 3 for females. The clinics run full time and evening sessions are arranged for office workers.

　　　　123. In addition a great amount of work has been done in improving the control of venereal disease in the prisons; with the newer drugs giving more rapid results there is real hope for clearing up this problem.

　　　　124. As a result of the presence of large numbers of Army personnel in the New Territories it has been necessary to develop anti-venereal disease work in this area and special clinics have been set up.

125. A close link has been established with ante-natal, infant welfare and maternity services. Blood specimens are taken as a routine at these clinics. 24,375 specimens were examined last year, and 7.5% were positive to the Kahn Test and this may be assumed to be a fair sample of incidence of venereal disease. One disturbing feature is that of the positives only 31.8% came for adequate treatment.

　　　　126. Home visits are being increased to educate and per- suade infected mothers to attend for treatment.

　　　　127. A record number of 17,934 new cases of which 40% were females, was recorded in 1951 as compared with 13,524 in 1950. The total attendance of all patients was 152,294.

128. Only 19 cases of Ophthalmia neonatorum were reported last year.

129. Venereal disease must reach a high percentage in the Colony, reckoned to be about 7 to 8% with such figures as are available, because the Colony possesses all the factors which are conducive to the disease and its spread. In particular it is a busy port, within easy reach of other maritime towns, there are many refugees both rich and poor, it is crowded with sly brothels, and private consorts are easily available in the cabarets or hotels and other places of amusement which abound in the Colony, thus making contact and contraction of venereal disease an easy matter.

MATERNAL AND CHILD HEALTH

130. There has been a steady increase in interest in this subject among the Chinese population, as is shown by the well attended clinics that are run both in urban areas and in the villages. A practical approach is maintained by an attempt to meet the social, physical and mental health needs of the families and to educate the mothers in such a way as to stimulate their interest.

131. At present there is a gap in respect of the pre-school child and post-natal care in Maternal and Child Health Centres, but plans are in hand to attempt to meet this need.

132. There are three main centres with doctors in charge, Harcourt and the Western Infant Welfare Centre on the Island, and Tsim Sha Tsui Centre in Kowloon. Besides this, there are four subsidiary Infant Welfare Centres staffed with Health Nurses at Stanley, Aberdeen, and Shaukiwan, on the Island, and Shamshuipo in Kowloon.

133. During the year, 11,646 home visits were made by the Health Nurses in connexion with Infant Welfare work.

134. The number of attendances at the clinics was as

follows:-

Table 16

Attendances at Infant Welfare Clinics.

New

Revisits

Total

2.980

33,654

36,634

+++

2,952

29,802

32,754

2,310

21,942

24,252

258

2,209

2.467

157

LIL

--L

+44

++.

1,923

2,080

---

1,130

8,352

9,482

382

---

2,903

3,285

Harcourt Centre

Kowloon Centre

Western Centre

Aberdeen

Stanley

Shaukiwan

---

H+

Shamshuipo..

+ru

+--

+74

Grand Total

10,169

LIL

100,785

110,954

　　　　135. Congee and UNICEF milk were given to the ill nourished. Mothers have a growing appreciation of the benefits of a balanced diet, the need for hygiene in preparing and serving food, and they respond well to the friendly atmosphere of the clinics.

　　　　136. Health sessions continued to be adapted to the cultural levels of the participants. During the year study and observa- tion groups included medical, midwifery, social science and social welfare students, school teachers and school girls for mother- craft, anti-tuberculosis trainees and welfare workers from official and voluntary organizations.

　137. Arrangements are under way to teach midwives in active practice how to instruct the mother in the care of herself and her child. As there are about 900 midwives registered in Hong Kong, their health educational activities backed by such improvement as is possible in housing conditions, will help sub- stantially in the reduction of infant mortality rates and in the promotion of child and family health.

New

TABLE

State of Health of Attendances at

Under 1 year

Over 1 year

Total

Centres

Without Defect

Some Abnorm-

Without

Some Abnorm-

Defect

ality

Harcourt

2242

593

2980

Kowloon

2086

787

2952

Western

1829

431

2310

Total:

----

6157

1811

180

8242

SCHOOL HEALTH

　140. On the 1st April, the services provided in the School Health Scheme were made available to private schools resulting in an additional 25,528 pupil participants.

　　　138. Early in 1952 doctors in the maternal, infant, and school health programmes commenced the preparation of joint educa- tional sessions including the care of the pre-school child.

139. Table 17 shows the state of the health of the patients attending the main Infant Welfare Clinics.

the Main Infant Welfare Clinics

Revisits

Under 1 year

Over 1 year

Grand

Total

Some

Without

Abnorm-

Defect

Without Defect

Some Abnorm-

ality

24785

2176

6152

541

33654

36634

20187

2281

6858

476

29802

32754

16069

759

4938

176

21942

24252

61041

5216

17948

1193

85398

93640

　　　141. In the year under review 314 schools participated in the School Health Scheme, the parents contributing fees on a voluntary basis. The total school population was 187,032 of whom 40,048 participants in the Scheme were specially covered.

142. The system of routine medical inspection of new en- trants, periodic examination of pupils and teachers and special observation of participants in the School Health Scheme re- quiring special attention continued.

143. 56,186 medical examinations were made and it was found that dental caries remained as formerly the largest single defect in all schools. Errors of refraction constituted the main sight defect. Only 19.6% of children from private schools were appraised as having no apparent defect.

144. The following tables (18-22) give an indication of the nutritional standard of school children according to age groups. The letters A, B, C and D refer to different types of schools as follows:

A-Government schools which are directed, maintained and

staffed by Government personnel;

B Grant-in-aid schools which are operated by missionary bodies with the assistance of a Government grant; C-Schools of primary standard subsidized by Govern-

ment;

D-Schools maintained entirely from their own resources.

145. 417 cases of infectious diseases were notified from pupils and school staff in all schools. The cases were scattered and there were no epidemics in schools.

146. Table 23 shows the defects found in schools.

147. Table 24 gives the results of medical inspection of pupils.

148. Table 25 gives a summary of the infectious diseases during the year in the schools.

149. Table 26 gives the number of pupils treated in clinics and hospitals.

Number

inspected.

Normal

Age Groups

Table 18

Types A, B, C and D Schools.

Standard of Nutrition

Slightly below

normal

Poor

1st.

Re-

examina- | examina

tion

1st. examina- examina-

Lion

Re-

tion

lat. examina- examina-

tion

Re-

Ist.

Re-

examina- | examing-

tion

1990

185

1655

169

306

2552

641

1977

519

515

115

2354

1182

1777

909

530

258

2600

1720

2009

1369

538

324

1958

1812

1622

1535

304

248

873

643

713

579

149

Total 12327 6183

9753

5080 2342

1021

232

Table 19

Number inspected.

Normal

Type A Schools.

Standard of Nutrition

Slightly below

Poor

Age Groups

normal

1st.

Re-

examina- examina-

tion

1st.

Re- examina- examina-

tion

1st.

Re-

1st.

Re-

examina-examina-

tion

cxamina- | examina-

tion

Total

153

197

149

192

Number

Table 20

Type B Schools.

Standard of Nutrition

Slightly below

normal

inspected.

Normal

Poor

Age Groupa

Ist.

Re-

examina- examina-

tion

1st. examina- examina-

tion

Re-

1st. examina- | examina-

tion

Re-

1st

Re-

examina- | examina-

tion

167

208

101

161

128

401

128

305

209

656

156

530

116

120

920

109

765

136

457

412

Total

747

2654

591

2185

147

428

Number Inspected.

Normal

Age Groups

Table 21

Type C Schools.

Standard of Nutrition

Slightly below

normal

Poor

lat.

Re- examina- examina-

lat. examina- examina-

Re-

1at.

examina-

Re- examina-

1st. examina- examina-

tion

362

173

289

157

587

398

413

323

155

528

729

382

556

135

165

563

1,008

410

783

138

208

266

852

212

731

111

172

153

Total 2333 3,332

1732

2703

545

588

Table 22

Type D Schools.

(New Entrants).

Standard of Nutrition

Age Groups No. inspected

Normal

Slightly below normal

Poor

1476

1237

218

1817

1443

336

1625

1236

356

1811

1426

349

1554

1283

243

811

656

144

Total

9094

7281

1646

167

Schools

Government

No. of School Premises

TABLE

DEFECTS FOUND

No. with Defects

Defects

Lighting Defects

in Latrines

Grant-aid

---

Subsidized.

Hong Kong .

Kowloon

Private.

Hong Kong

248

Defects in doors & windows

Kowloon

185

LII

Total

533

115

IN SCHOOLS.

Details of Defects

Water

Blackboards

Windows

Seats

White-

General

Closets

Not Matt

requiring

without

washing

surfaced

glazing

backrests

required

repairs required.

repairs.

―

Schools

Number of medical inspections undertaken.

Number of pupils with no apparent

defect.

TABLE

Results of Medical

Observation

Treatment at General Clinics.

Type

No.

"A"

894

411

467

45.97%

52.24%

1.79%

"B"

11305

3791

5516

1687

33.53%

48.79%

14.92%

"C"

17247

5577

7481

4067

32.34%

43.38%

23.58%

"D"

213

26740

5241

15625

12002

19.60%

58.43%

44.88%

Total

314

56186

15020

29089

- 84

17772

26.73%

51.77%

31.63%

inspection of Pupils.

Number of Pupils with Defects Requiring Attention.

Treatment at Eye Clinics.

Treatment at E.N.T.

Clinics.

Treatment at Dental Clinics.

Treatment at Surgical

Clinics.

152

7.61%

1.01%

17%

1338

141

2739

Treatment at T.B. Clinics.

11.83%

1.25%

24.22%

0.01%

1189

217

5812

6.90%

1.26%

33.70%

0.05%

3196

615

11085

11.95%

2.29%

41.45%%

0.004%

0.04%

5791

982

19788

10.31%

1.75%

35,22%

0.001%

0.035%

Diseases

Table 25

Infectious Diseases.

Cerebro-spinal meningitis

Chickenpox

-- J

■ + I

Diphtheria

+1 +

Dysentery, Amebic

Dysentery, Bacillary

Measles

Mumps

Poliomyelitis, acute

Pulmonary tuberculosis...

Typhoid fever...

Para-typhoid 'A'

Whooping-Cough

Leprosy

+ I

...

+++

...

+ 1 +

Cases

+++

+ I

+++

++1

...

- - -

+++

+ I

++ I

- I

| +-

179

1. General Clinic

Table 26

Curative Care.

New Cases

Revisits

32,564

12,944

Total

ILI -

45,508

2. Dental Clinics

New Cases

Revisits

Total

14,981

5,412

20,393

3. E. N. T. Clinics

New Cases

1,411

Revisits

656

Total

2,067

80 cases were given operative treatment in hospitals.

4. Eye Clinics

New Cases

Revisits

Total

3,204

1,219

4,423

18 minor surgical cases were done at the clinic and 5 cases

operated in hospital,

2330 pairs of spectacles were issued during the year.

―

MALARIA AND MOSQUITO CONTROL

Control of Breeding.

150. The larval control programme covers the whole of the inhabited area of Hong Kong island, and in Kowloon, an area from Lai Chi Kok in the west to a mile beyond the Airport in the east, and extending as far north as the Kowloon Reservoir. In addition, the area from Lyemun to Rennie's Mill, and Cheung Chau Island are also included.

151. With the setting up of a squatter resettlement camp at Ngau Tau Kok, the larval control programme has been extended beyond that area since the beginning of 1952. The camp includes a large population with infected people, and in the interest of the nearby Kai Tak Airport, this extension of work was essential.

152. Another new commitment at the beginning of 1952 is the malaria control work at the Tai Lam Chung Reservoir site. While preliminary construction work is in progress, the place is to be made safe from malaria for the occupation of a large labour force. Vigorous initial work in the form of canalizing and training of streams, has now been done.

153. Since May, the use of malariol as a larvicide has been entirely discontinued; its replacement by water-miscible gammexane brought numerous advantages, the chief being the saving of transport, labour, expense, and its harmlessness to vegetation with the dosage that was employed. The use of gammexane bricks (25% gammexane and 75% plaster of Paris) which was introduced last year on suitable potential breeding places like tanks and small pools, continued to prove very effective in controlling breeding.

　　　　　154. Where possible, permanent work in the form of cement filling of rock holes was continued along the sea-coast at Shek-0, Stanley and Green Island. This work brought excellent results as it has permanently cleared the breeding places of Aedes togoi.

155. The fact that gammexane miscible powder leaves no readily discernible trace after having been applied, calls for even closer and stricter supervision of labour. Numerous check- ing catches and surveys were done in the controlled area of Kowloon and Hong Kong Island, but no anophelines, either larval or adult, could be found. Constant vigilance, however, is being maintained, as there is no satisfactory natural barrier between the controlled and uncontrolled areas, and the condition is made worse by heavy land and sea transport between these places.

Imagocides.

　　　　156. Quarterly residual D.D.T. spraying was undertaken during the warmer months at Sai Wan, Lyemun, Shek-O, Tele- graph Bay and Pokfulam, as a supplementary barrier check in villages on the perimeter of the larval controlled area, and in all Government buildings in the New Territories.

Mosquito nuisances.

　　　　157. Mosquito nuisances were investigated on behalf of the Urban Council at various districts. As a result, 93 legal notices were applied for, and 15 prosecutions conducted during the year.

　　　　158. In Cheung Chau Island, good results were achieved in regard to mosquito infestation since the extended programme was undertaken.

Malaria Incidence.

159. During 1951, a total of 526 cases of malaria with 35 deaths were notified, comprising 340 cases of benign tertian, 140 subtertian, 18 quartan and 28 clinical malaria. Of these cases, 44 were Europeans, the majority belonging to the armed forces. Almost invariably, the infection was contracted outside the larval controlled area.

Malaria surveys.

160. Adult anopheline mosquito catching was carried out during the year in different parts of the New Territories, which were not included in the larval control programme, namely Woo Li Hop, Tai Po, Fanling, Sek Kong, Ma On Shan and Tai Shui Hang. A total of 16802 mosquitoes were caught and 12432 examined. It is rather perplexing to note that from dissections made, no infective mosquito was encountered. Frequent larval surveys were carried out during the year.

161. Since July 1951, blood smears have been obtained from children in different parts of the New Territories. 858 smears were thus examined, with 37 positive for malaria infection, giving a parasite rate of 4.31%.

162. In a separate survey conducted in July and September, 5 out of 187 blood smears taken from Cheung Shu Tan Village, Kam Chin Village and Woo Li Hop Village were found infected.

163. The spleen index and parasite rate of the children at Tai Lam Chung Village were taken in February 1952 when anti- malarial measures had just commenced. Of the 36 children examined, 9 were found with palpable spleens (spleen rate 25%). 2 out of 48 blood smears taken were found positive with malaria infection.

164. A malaria survey was also undertaken at Hay Ling Island (Leprosarium) during the year.

Other work.

165. In addition to the routine work, much consultative work was carried out with the Royal Navy, Army and Air Force. At Sek Kong, New Territories, where the Army has started a big building project, much time has been taken for preliminary surveys on the spot.

166. Advice was given on the abatement of the fly nuisance at the Dairy Farm, Pokfulam.

TUBERCULOSIS CONTROL

167. The relative importance of tuberculosis in the mor- tality statistics of the post war years has continued to grow at an alarming rate. For the year 1951 this disease accounted for more than 20% of deaths from all causes as compared with the figure of 14.6, 16 and 17.7 per cent recorded from the years 1948-50 respectively. The mortality rate has increased by 44% over the 1950 figure and is almost double the rate recorded in 1947. It must be pointed out however that the 1951 figures probably represent a more accurate picture of the true situation than any of the figures since 1945 as the common practice normally adopted by the chronic sick, of returning to their native village is not now easy in view of the present restrictions at the Chinese border. At the same time economic conditions have recently deteriorated with an increase in the cost of living and a definite rise in the number of persons not in employment. Over-crowding has been materially alleviated although there has been a fall of more than 11% in the estimated total population.

168. Tuberculosis notifications show an increase of 53% over the 1950 figure. Some part of this increase is undoubtedly due to several factors an increase in the diagnostic facilities available to the general public by the opening of the new Tuber- culosis Clinic in Kowloon, an intensification of the search for

disease among contacts and the introduction of X-ray surveys in factories made possible by the gift by UNICEF to the Medical Department of a mobile X-ray unit. The true increase in morbidity is difficult to assess.

169. The facilities available for the institutional treatment of the disease remain pitifully inadequate with little prospect of improvement for those in the lower income groups and with the existing conditions; the general emphasis must remain on out- patient treatment which is even under the best of circumstances a very poor second best, particularly if the unfortunate in- dividual must remain at work during the period of treatment.

170. The available figures are as follows:

Tuberculosis (all forms)

Notifications and Deaths.

Death rate

Year

Estimated population

Notifica- tions

Deaths

D/N Ratio

per 1,000,000 estimate

population

1920

648,150

2082

321.2.

1921

625,116

1894

303.1

1922

638,300

2096

328.3

1923

667,900

2108

315.6

1924

695,500

2358

339.0

1925

725.100

2291

315.9

1926

710,100

1912

269.2

1927

יוויוי

740,300

2123

286.7

1928

766,700

2637

330.9

Year

Estimated population

Notifica- tions

Deaths

D/N Ratio

Death rate

per 1,000,000 estimate population

1929

802,900

2158

268.7

1930

838,800

1994

237.7

1931

יזי

840,473

1983

235.9

1932

900,812

2042

226.6

1933

922,643

2225

241.2

1934

-----

944,492

2179

230.7

1935

966,341

2237

231.5

1936

988,190

2416

244.5

1937

1,281,982

4028

314.2

1938

1,478,619

4920

332.7

1939

1,750,256

7591

4443

1 to 1.7

253,8

1940

1945

1946

1,600,000

2801

1752

1 to 1.6

109.5

1947

1,750,000

4855

1861

1 to 2.6

106.3

1948

1,800,000

6279

1961

1 to 3.2

108.9

1949

1,857,000

7510

2611

1 to 2.8

140.6

1950

2,265,000

9067

3263

1 to 2.8

144,0

1951

2,013,000

13886

4190

----

1 to 3.3

208.0

171. It will be seen that the unfavourable post war trend in the morbidity and mortality statistics is continuing at an accelerated pace and that the effect of the influx of refugees is now becoming apparent.

Mortality.

172. The rise in the tuberculosis death rate has occurred at all ages, but is slightly greater in the adult groups, particu- larly in males. Deaths from tuberculous meningitis, more than 85% of which occurred below the age of 5 years, account for 20% of the total tuberculosis deaths, and despite a fall in the total population of more than 11% show a gross increase of 30%. Deaths attributable to forms of tuberculosis other than respiratory and meningeal show a marked drop.

173. Respiratory tuberculosis continues to dominate the tuberculosis picture, accounting for 3,006 deaths, a gross in- crease of almost 39% over the year 1950, the death rate per 100,000 showing an increase of 56%.

Deaths from Tuberculosis of the Respiratory

System by Age and Sex 1949- 1951.

_____

Age Group

1951

1950

1949

Male Female Persons Male Female Persons Male Female Persons

Under 1

57 105

111

104

5-9

10-14

15 - 19

1951

1950

1949

Age Group

Male

Female Persons

Male

Female Perводв

Male

Female Persons

20-24

139

209

57 152

54 117

25-29

209

107

316

128

205

160

30-34

236

123

359

166

100

266

132

226

35 - 39

252

124

376

158

240

150

240

40-44

201

288

162

220

130

197

45 - 49

172

219

122

177

137

50 - 54

147

219

101

156

114

162

55-59

¦ 100

143

112

121

60 - 64

125

65 - 69

70-74

→

75-79

البعي

80 - 84

85 & over

▸

Unknown

Total: 1,899 1,107 3,006 1,333 832 2,165 1,013 699 1,712

　　　　　174. On the assumption that the age and sex distribution of the population has remained relatively unchanged, the tuber- culosis deaths have been standardized against a fixed unit of population in a sample of population which is thought to re- present a fair average of the age and sex distribution of the whole population in order to provide a comparative mortality figure for the various age groups in each sex above 15 years. The findings are reproduced herewith together with the findings based on the same comparative figures for 1950.

Number Per Unit Of Population (See Context)'

Number Per Unit of Population (see Context)

800

600

400

200

AGE

400

200

MORBIDITY RESPIRATORY

TUBERCULOSIS-1950 & 1951

•

1954

30 $5 40

GROUPS.

MORTALITY RESPIRATORY

TUBERCULOSIS-1950 & 1951

45 50

AGE GROUPS

　　　　　175. It will be seen that the mortality figures for males are considerably higher in males at all ages than for females, the disparity increasing with age. In comparing the 1951 figures with those recorded in 1950, deaths in females are slightly in- creased, but in males there has been a marked increase in the deaths above 30 years of age.

Morbidity.

176. Notifications of tuberculosis show a marked increase over last year's figures. The comparative figures for the two years are set out below and shown according to origin:-

Government Tuberculosis (Harcourt)

Government Institutions

1950 1951

2,959 3,858

Clinics

(Kowloon)

3,038

2,339

5,522

Non-Government Institutions

■

3,202

524

567

944

Total:

9,067 13,886

Private Practitioners

　　　　　177. Respiratory tuberculosis notifications are set out below according to age and sex for the year 1949-1951:

Notifications of Respiratory Tuberculosis by Age and Sex for the year 1919 to 1951.

1951

1950

1949

Age Group

Male Female Persons Male Female Persone

Male Female Persona

Under 1

80 178

59 118

163

132 295

156

177

182

359

156

קים

189 168

357

124

177

143

320

62 126

1951

1950

1949

Age Group

Male Female Persons

Male Female Persona

Male Female Persons

5-9

435 303 738

75 172

125

10-14

101

87 188

34 100

15 - 19

349

206 555

199

115

314

167

111

278

20-21

1,089

406 1,495

706

246 952

630

220 850

25-29

1,279

481 1,760

888 377

1,265

787

310 1,097

30-34

1,216

543 1,759

803

403

1,206

707

343 1,050

35-39

98.5

453 1,438

665

313

978

607 319 926

40-44

732

409 1.141

480

225

705

362

237 599

45 - 49

479

235 714

321

177

498 254

136

390

50-54

361

239

600

217

163

380 191

116

307

55-59

206

148

353

114

205

117

214

60 - 64

111

113

224

140 |

112

65-69

102

70-74

75-79

80-84

85 & over

Unknown

0 0 0

Total

8,268 4,439 12,707 5,046 2,695 7.714 4,194 2,219 6,413

　　　　　178. The notifications of respiratory tuberculosis show a very marked increase over last year's figures. The notification rate for 100,000 population has risen from 341 to 631, an in- crease of 85%. While this alarming increase must be in part due to the increased diagnostic facilities, it is very doubtful if this is the whole explanation.

Diagnostic Facilities.

179. The only large Government centres occupied full time in the diagnosis and treatment of pulmonary tuberculosis are the two Tuberculosis Clinics, one of which has been in operation since 1947, the second having been opened in Kowloon in February 1951, each holding daily sessions. It was anticipated that this second clinic would considerably relieve pressure on Harcourt, the original clinic, but the total fall in attendances at Harcourt was just over 11% while the attendances at Kowloon almost equalled the Harcourt attendances. Four smaller clinics are held weekly in outlying districts.

180. All diagnosis and treatment is free and all comers are dealt with daily irrespective of number and origin. The amount of out-patient treatment has shown a substantial increase and the number of out-patients treated with P.A.S. has been increased also. Domiciliary treatment is possible to a very restricted extent only. An increasing amount of survey work is being undertaken by the clinics on behalf of private firms in conjunc- tion with the medical officers of the firms,

181. Details of the combined attendances are as follows:-

First Visit

Return Visit

34,838

69,596

Total ...

104,434

Origin of New patients:

Attending Voluntarily

Contact

Referred by

Government

Servants

Private Practitioners

Hospitals...

---

Routine

Voluntary attenders

Survey

28,459

1,801

530

1,472

483

1,894

+ I

128

Non-Government School Teachers

Conditions of new patients on first attendance.

(1) Examination not completed:

(a) Attended but did not wait to

be examined

PIL

(b) Examination incomplete as

at 31/12/51

+ I

(2) Examined and found non-tubercular

(3) Examined and found to be suffering

from tuberculosis:

4,681

1,637

6,318

16,984

Active Tuberculosis

7,286

Quiescent Tuberculosis

2,968

Arrested Tuberculosis

IHI

1,282

11,536

Total attended for the first time

34,838

100

　　　　　182. It is of interest to note that 2,980 of the cases of tuber- culosis who attended had minimal disease in an active easily. treatable state. Considerably less than one quarter of this number were able to secure admission to hospital.

Bacteriological Examinations.

　　　　　　183. Examinations are carried out on behalf of the tuber- culosis clinics by the Government Pathological Institute. Details are as follows:--

Sputum

Materials tested.

Gastric content

Pleural Fluid

Blood for Kahn Tests

Positive

Negative

Total

2,965

10,420

13,385

101

➖ ➖ ➖ ➖---

สล

Radiological Examinations.

　　　　　184. Radiological examinations are carried out on behalf of the clinics by the Radiological Department, at Queen Mary Hos- pital in the case of Harcourt Clinic, and in the same building in the case of Kowloon Tuberculosis Clinic. First examinations are normally done on 35 mm. film and positive cases confirmed on full size picture-normally papers. Clear films are used most sparingly.

Out-patient Treatment.

185. The following treatment was carried out on out-patients at the Clinics:

101

Number treated (specifying forms of treatment)

Initial treatment

A.P.T.-Refills

Unsatisfactory (abandoned)

Completed treatment

Initial treatment

A.P.P.-Refills

Unsatisfactory (abandoned)

Completed treatment

++ · L

ד.

546

873

Specific drug treatment

(a) Streptomycin (not used in out-patient work)

(b) P. A. S.

215

Pleural Aspiration

Hospital Treatment.

186. Hospital admissions for the treatment of pulmonary tuberculosis were arranged as follows:

Ruttonjee Sanatorium

Government Hospitals

Total

241

483

724

T-

187. Ruttonjee Sanatorium, an institution operated solely for the treatment of pulmonary tuberculosis by the Hong Kong Anti-Tuberculosis Association admits a proportion of its patients

102

through the Government Tuberculosis Clinics. It has expanded during the year to 163 beds. Details of the admissions were as follows:

(a) Priority patients (direct admission)

(b) General public (non-priority from

Government clinics)

г. . . . r

189

241

　　　　　　　These patients subsequent to discharge become the responsibility of the Ruttonjee Sanatorium After-care Clinic.

188. The beds available in Government Hospitals are located as follows:

Queen Mary Hospital

Lai Chi Kok Hospital

3. St. John's Hospital, Cheung Chau

(Convalescent Ambulant cases only)

202

The admissions to Government Hospitals were as

follows:-

Government Servants

Other priority

General public

++ +

159

273

483

189. The number of admissions during the year was sub- stantially increased as compared with last year's figure, prin- cipally because of the reduced number of advanced cases under treatment resulting in the more economical use of beds.

103

190. The details of treatment in Government Hospitals were as follows:

1951

1950

(a) Number of patients remaining in hos-

pital at last day of previous year... 293 291

(b) Admissions

483

400

(A) Completed Treatment--

(i) Improved 351 269

(ii) In same

condition 62

(iii) Worse

(B) Discharged against medical advise 27

...

398

(D) Transferred to other hospitals.

Total discharges during the year 491

(d) Number of patients remaining in hospital as at last day of the year

285 293

Apart from the substantial drop in the average dura- tion of treatment there is little of note in comparing the two

years.

191. During the year a satisfactory start has been made in the establishment of major surgical treatment for pulmonary tuberculosis. The results have been eminently satisfactory as re- garded from an immediate standpoint but the long term results will have to be awaited. In all 10 thoracoplasty operations have been completed without untoward result and the further exten- sion of these activities is restricted not by the demand but by the shortage of beds.

101

192. In addition the following collapse measures were

carried out:-

A. P. T.

Phrenic Operations

A. P. P.

Bronchoscopy

Thoracoplasty

Induction

Refills

Pneumolysis

Abandoned

306

LILJ

L J · +

Induction

➖➖➖➖ IL J

Refills

351

...

　　　　　　　　Streptomycin was administered to 136 patients, in all cases with P.A.S.

Social Work.

　　　　　193 All patients on first diagnosis are interviewed in the Almoners department where detailed records of the social con- ditions of all tuberculous patients are prepared and retained for future reference. Such problems as exist are dealt with accord- ing to the extent of the available facilities and every effort is made to ensure that the patient, if he is fortunate enough to secure admission to hospital can do so free of anxiety.

　　　　　194. As there is no general social security scheme the need for an efficient and well provided Almoners department is of paramount importance. Few tuberculosis sufferers can afford to give up work for the length of time necessary to effect reasonably satisfactory treatment. Some employers, mainly the larger firms, are prepared to grant prolonged sick leave with

105

pay to their tubercular employees. In other cases a promise. from the employer to keep the job for his worker until he is again fit to work is all that can be obtained but to the majority the possibility of prolonged sick leave with or without pay is an almost unrealizable dream. In the absence of any financial scheme to assist the tubercular household there follows the in- evitable train of plunging the already miserable family into the depths of despair, adding further to the burden of sickness and aggravating the social and environmental conditions which pre- cipitated the first case with the almost certain occurrence of further cases in the same household.

195. Fortunately it has been possible to assist such unfor- tunate cases by the provision from government sources of funds to assist families who are deprived of their sources of income by the occurrence of tuberculosis. Such assistance may be provided where it proves impossible owing to the age of the family, to help the family to help themselves by obtaining em- ployment, or other means of subsistence for a fit member of the household. In this connexion mention must be made of the excellent cooperation of the Sanitary Department who have been most helpful in not only providing employment, but in granting hawker's licences.

196. The almoner also assesses the hospital maintenance charge, if any, to be made to the patient during his stay. Only a small proportion of the general public cases are in a position to contribute to their up-keep. The maximum charge in the general wards is HK$1.50 per day, all investigation and treat- ment being included in this sum. Higher charges are levied in the special accommodation in Queen Mary Hospital-only a very small proportion of which is occupied by patients other than Government Servants or other government responsibilities.

197. Other duties of the almoner include the distribution of milk powder to cases under special treatment and to contact chil- dren, distribution of P.A.S. to out-patients, admission of children

106

to the Contact Home at Shatin and all the multifarious work necessary in looking after the welfare of the tubercular house- hold.

　　　　　198. Some details of the work carried out by the almoner's department are as follows:

Total number of interviews

11,933

Admissions to hospital f Government Hospitals

483

arranged

Ruttonjee Sanatorium

241

Transfers between hospitals

111

Numbers of families granted financial assistance

132

$ 26

L L

Average weekly grant approximately

Number of patients (or relatives) placed in

employment

Hawkers' licences obtained

Milk powder issued (one pound per week per

patient)

Number of home visits.

Repatriations

14,980 lbs.

723

гт

　　　　　199. In addition the almoner is responsible for directing the activities of the Tuberculosis Workers.

Tuberculosis Workers.

　　　　　200. These workers, nine in number and in process of in- crease to 24, are responsible for maintaining contact between the clinic and the patient. They educate the patient in the simple measures possible to prevent spread of infection, en- courage the patient to keep in touch with the clinic, bring the social problems to the notice of the almoner and arrange contact examination of cases notified from all sources.

107

201. A summary of the work done is as follows:-

Total number of home visits made.

Addresses not found

Contact examinations arranged

11,069

608

+ 1 +

13,420

9,663

Contact examinations carried out

Contact Examination.

202. Examinations of contacts is so arranged that only contacts under 8 years of age need attend the clinic for tuber- culin test. Older members of the family go straight to the hospital for X-ray and need attend the clinic only if the X-ray shows evidence of pulmonary tuberculosis.

203. The results of contact examination were as follows:

Tuberculin Test of contacts 8 years and under

X-ray findings of chidren 8 years and under, sub- sequent to positive tuberculin test

Active tuberculosis Inactive or healed

Suspicious of tuberculosis Free of tuberculosis

2,025

188

Total

Active tuberculosis

X-ray findings of contacts

over 8 years

Inactive or healed

Suspicious of tuberculosis Free of tuberculosis

Total:

L +

213

420

878

623

232

558

6,199

.7,612

8,490

ILI

1,147

9,663

Total of contacts, all ages, X-rayed

Contacts 8 years and under, tuberculin test negative

Examinations incomplete

Grand total of contacts examined

108

204. The high incidence of pulmonary tuberculosis in con- tacts will be seen from the above figures. Expressed as a per- centage the following results are obtained:

Contacts less than 8 years of age examined and found to have active pulmonary tuberculosis

Contacts over 8 years of age examined and found to have active pulmonary tuberculosis

9.2%

8.2%

205. These results amply justify the large amount of time and labour expended on contact examination.

206. At the same time much valuable educational work is being done by the tuberculosis workers in the home, the value of which cannot be set out statistically.

B.C.G. Campaign.

207. Preliminary work is already far advanced in the organi- zation of this campaign which is expected to start on 1st April, 1952 and to continue for about 3 years, and thereafter to pro- ceed on a maintenance basis.

Surveys.

　　　　　208. Many employers, for various reasons are learning to appreciate the value of X-ray surveys and more and more re- quests are reaching the department to have such examinations carried. Under present conditions such surveys are carried out free of charge provided the firm concerned is prepared to make adequate social and medical provision for positive cases found. In some cases surveys are carried out by one of the two fixed 35 mm. X-ray units, in others for convenience, the surveys are carried out by the mobile X-ray unit given by UNICEF to the Hong Kong Government,

109

209. Subsequent clinical examinations present a consider- able difficulty since the tuberculosis clinics, already overloaded, are the only organized units available for diagnosis and assess- ment on a large scale. As a result some assessment is carried out by medical officers engaged by these firms, but the majority is done by the tuberculosis clinics.

Future Outlook.

210. A new clinic is now being planned to take the place of the existing clinic in Harcourt Health Centre which is quite un- suitable by reason of size and layout for a tuberculosis clinic and which possesses no X-ray department or even space to install a machine. This new clinic when completed, will ease the pro- blem of dealing with the large numbers of patients who attend yearly.

211. When one considers that during 1951 only 462 hospital vacancies could be allocated to the general public while 2,980 mininal active cases attended the clinics, the need for a sub- stantial increase of sanatorium beds needs no emphasis. At the same time the deteriorating economic conditions indicate a pro- bable further deterioration in the position regarding pulmonary tuberculosis.

212. The infant death rate from tuberculosis which con- stitutes 34% of the total may in due course yield at least in part to the B.C.G. vaccination campaign if this should reach a sub- stantial proportion of the infant population. On the other hand one can hold out little hope of a substantial improvement in the position of adult disease for many years to come unless new methods of treatment become available in quantity at a reasonable price.

110

　　　　　213. The overcrowding problem is at present under review and a first step is being undertaken to provide additional hous- ing for the working classes at an economic rent. This scheme is being operated privately and is being sponsored by the Government. This if extended will do much to improve the tuberculosis position but like all other known methods will benefit the next rather than the present generation.

X-ray Survey of Government Servants.

　　　　　214. The total number of individuals surveyed was 19,611 as compared with the total of 22,688 surveyed in 1949-1950 which included about 2,000 teachers from private schools. The overall figure constitutes not less than 95% of Government servants. Much of the survey work was done on the mobile X-ray unit which resulted in a more complete examination of departments. There was a considerable fall in the total number of police personnel X-rayed. The fall in the number of Marine Department employees is to some extent accounted for by departmental changes. No other significant changes in totals were observed.

　　　　　215. As a result of the survey 2,640 individuals were called for examination at the tuberculosis clinics as compared with the previous survey total of 1,430, 628 of whom, on further examination, were found to be non-tubercular. 20 were found to be suffering from other disease and referred to appropriate clinics. In all 68 new active cases of pulmonary tuberculosis were discovered, more than half of which were minimal cases.

　　　　　216. Analysis by departments is summarized herewith, only departments of 500 or more being recorded and the comparative figure for the previous survey being set out alongside for con- venience.

111

Active Tuberculosis

Departments

1949-50

Government Stores

P.W.D.

G.P.O.

Medical

Marine

Urban Council

K.C.R.

Police

Education

0.98%

----

1951-52

2.38

1.36

2.2

1.11

1.74

1.11

1.4

0.9

1.05

0.0

0.9

0.78

0.7

* 1.83

0.66

0.56

0.18

* 1.32

The overall incidence of active disease was found to be

217. One hundred and fifty-nine of these cases were admitted to hospital for treatment during 1951 and 893 were kept under supervision at the clinics.

218. The overall drop in percentage of active cases from 1.13 to 0.98 and the discovery of 68 new cases of active disease fully justified this survey. What cannot be easily recorded

The two departments annotated thus show a marked increase over the previously recorded percentages. K.C.R's total examined increased from 568 to 763 which may account for the increase. Particularly disturbing is the rise in the figures recorded for the Education Department but investigation has shown that the high figure is made up principally of non-teaching staff. The General Post Office which was the subject of a special report and investigation following the previous survey has shown a marked drop in the figures for active disease although the quiescent cases necessarily remain high.

112

　　　statistically at this stage is the difference in the type of case being found. While the advanced cases must continue to remain on the books until they are, for one reason or another, written off, the new cases coming forward are much less extensive and with better prognosis, likely to yield more satisfactorily to treatment in a shorter period, a considerable advantage not only to the unfortunate individual but also to the employing authority and to the tuberculosis problem as a whole.

III. HOSPITALS AND CLINICS

QUEEN MARY HOSPITAL

219. This modern and well equipped hospital is the largest in the Colony.

220. It has 574 beds for the treatment of all types of cases other than infectious diseases.

221. It serves as the teaching hospital for the Hong Kong University Medical Faculty and it maintains a Nursing Training School.

222. The work done by the hospital during the year has continued to expand in relation to previous years-each depart- ment recording an increase in the number of patients treated.

　　　　　223. The medical staff totals 36 full time doctors-about half of whom are employed by the Hong Kong University; in addition, there are 10 House Officers.

224. Nursing staff at present numbers 173 of which 37 are Nursing sisters, 110 nurses, and 26 dressers a nursing staff/ patient ratio of 1: 3.3.

113

225. 10,322 inpatients were treated during the year as com- pared to 9,819 in 1950.

226. There were 629 deaths, 221 (over one third) of which occurred within 24 hours of admission. Of the deaths occurring within 24 hours of admission, 69 were children under 2 years of

age.

227. The Maternity Wing of 37 beds continued to be in- creasingly busy as the following figures for the year show:-

Total cases treated

Live births

2,118

1,910

Still births

Neonatal deaths

Maternal deaths

3 (2 of which had never

attended ante-natal

No. of Caesarian Sections

Statistical rates were:

Maternal Mortality

Still births

Neonatal Mortality

clinics)

1.4 per 1,000

19.9 **

18.3

}}

228. The yearly increase in maternity work is shown in the following figures:

Year

No. of Live births

1948

719

1949

➖➖➖ ➖ ➖ ➖ ➖

IL FIILI-

1,164

1950

1951

1,580

1,910

114

229. Operations performed in the Surgical operating theatres numbered 5190; the annual increase is indicated in the following yearly figures:

Year

No. of operations

1948

4259

1949

JIJLO

4460

1950

1951

4563

5190

230. The Blood Bank arranged over 1,000 transfusions dur- ing the year and continues to be increasingly used.

　　　　　231. Attendances at casualty and hospital clinics in 1951 were 19,065 of which 14,248 were new cases.

KOWLOON HOSPITAL

282. Kowloon Hospital is the only emergency hospital for the mainland; its 231 beds are quite inadequate for dealing with the amount of work it is called upon to meet, but Kowloon will have to await the new hospital before it can be considered to be supplied with an adequate number of beds.

　　　　　233. During 1951 there has been a further considerable in- crease in the amount of work done by every department of this hospital as compared with previous years. The problem of dealing with all the medical demands of Kowloon and the New Territories increases each year and throws a very great strain on the existing medical facilities.

　　　　　234. In order to ease the pressure of in-patient accom- modation, a new block was built during the year, this gave a further 72 beds bringing the total of beds up to 231.

115

235. During the year 7,540 in-patients were treated as com- pared with 6,285 in the previous year and there were 480 deaths, 264 of these occurring within 24 hours of admission. 3,006 operations were done as compared with 2,277 in 1950. There were 2,210 maternity cases delivered with 2,175 live births dur- ing the year.

　　　　　　There were 35 stillbirths and 34 neo-natal deaths giving stillbirth rate of 15.8 per 1,000, and a neo-natal death rate of 15.6 per 1,000.

236. In addition to the building of a new block another important improvement was the extension to the existing Physiotherapy Department, enabling hydrotherapy to be used for anterior poliomyelitis and similar conditions.

237. The large and very busy Out-Patient Department where general and special clinics are held, worked at full pressure throughout the year. The department works in two sessions from 9 a.m. to 5 p.m. and from 6 p.m. to midnight. The day session is attended to by 10 doctors and the evening session by 4 doctors. Plans have been made for considerable structural improvements in this department which will lead to improved conditions for the patients and will also supply a much needed large casualty department in this block.

238. There has been a great increase in the number seen in the Out-Patient Department; 488,406 new cases were dealt with as compared with 284,280 in 1950 and 94,009 in 1949. The total number of attendances throughout the year reached the figure of 568,739.

239. It says much for the administration of the hospital that the organization and direction of these vast crowds was carried out day after day quite smoothly, and much of the credit for this must go to the Almoner's Department.

240. No less credit is due to those doctors who made no serious mistakes while working at high speed for long hours in the out-patient department with the ever present fear that they might miss some serious condition.

116

MENTAL HOSPITAL

241. The Mental Hospital is an old building, and is now not only inadequate in size, but ill-adapted to modern methods of treating mental patients, and plans have been approved for replacing it during the next five years building programme. This hospital has official accommodation for 140 patients, but the daily average number of patients in recent years has been as follows:

1948

1949

1950

1951

119

156

201

242. Owing to the difficulties in ingress and egress existing between Hong Kong and China, there is a greater tendency than was the case in previous years for families to send their mentally afflicted relatives to the Mental Hospital rather than back to the native village. This change is shown, in part, by the increase in cases of senile dementia now being admitted to the hospital.

243. Rattan work, needlework and a library, provide the patients with some diversional therapy.

244. The following statistics cover the year 1951:

Remaining in from the previous year

1st admissions

Re-admission

Total Treated

163

550

222

935

117

Discharged home

Discharged to other hospitals Died

Remaining at end of year

Total

Daily average number

+ +

651

+ + ++

224

935

201

Total No. discharged or transferred

Of these, No. fully remitted

No. partially remitted

No. unchanged

יז

ז .

No. with 'No Psychiatric diagnosis'

676

401

170

245. Although the rates of 1st admissions and re-admissions as well as the rate of discharge were similar to that of the previous year, over-crowding annually increases because un- recovered cases do not necessarily die. At the end of the year there was an excess of admissions over discharges totalling 61, compared to 63 of the previous year.

246. A serious problem was the lack of a place for effective- ly isolating cases of infectious disease.

Notifiable Diseases:

The following cases were notified:

Tuberculosis, mainly phthisis

Dysentery

Typhoid Malaria

+++ +++

+++

r +

N = ∞

118

There were 35 deaths from causes as follows:

Tuberculosis

General Paralysis of the Insane

+ ·

Insulin Coma

Leucotomy

Other causes

Out-patients:

247. 193 new cases and 285 old cases were seen.

Forensic work:

248. The following were dealt with:

(1) Police cases sent in for observation

(2) Remand Prisoners sent in for observation

(3) Prisoners found guilty but insane.

(4) Sentenced prisoners becoming insane

Voluntary Patients:

· ·

249. Patients admitted on a voluntary basis or gaining voluntary status after admission numbered 64 males and 51 females.

Legislation:

　　　　　250. An amendment to the Mental Hospital Ordinance was made concerning the conditional discharge of insane criminals who had recovered.

119

SAI YING PUN HOSPITAL

251. This hospital is the infectious disease hospital for the island with a normal capacity of 88 beds. In the hot weather extra camp beds have to be provided on some of the enclosed verandahs.

252. During the year a total of 1,719 patients were treated with 278 deaths which compares with 1,207 with 196 deaths in 1950.

Diphtheria.

253. 240 cases occurred with 44 deaths, giving a case mortality rate of 18.3%.

Enteric Fever.

254. There were 138 cases with 19 deaths giving a case mortality rate of 13.7%.

Whooping Cough.

255. 110 cases were reported with 14 deaths giving a case mortality rate of 12.7%.

Measles.

256. 108 cases were reported with 14 deaths giving a case mortality rate of 12.9%.

Out-patients Department.

257. Under the same administration, but in a separate build- ing not associated with the infectious diseases hospital, there is an out-patient department.

120

258. General clinics are held in the mornings and evenings.

In the afternoons only special teaching clinics are held by the

University Clinical staff and Government Honorary Consultants.

Day Clinic. Night Clinic.

Dressings:

General Out-patients:

Children's Clinics:

Ante-Natal Clinics:

... ..

35,482

2,545

48,836

50,588

38,222

34,334

4,603

272

J L +

Post-Natal Clinics:

Gynæcological Clinics:

Eye Clinics:

Ear, Nose & Throat Clinics:

Vaccinations

Inoculations:

Diphtheria

Rabies

+ +

1 ·

291

2,672

Tetanus

519

Cholera

Typhoid

Skin Diseases Clinics:

Orthopedic Clinics:

Total

421

3,797

20,303

LILI

2,050

7,371

3,917

1,391

212

121

166,456

87,467

259. The total attendances at this out-patient department amounted to 242,635 as compared with 192,534 in 1950 and 164,676 in 1949.

LAI CHI KOK HOSPITAL

260. This hospital consists of 2 sections, The lower section, containing 310 beds, is the infectious diseases hospital for the mainland, and the upper section, a convalescent hospital, has 180 beds. No out-patients were seen other than members of the staff of the hospital.

261. In the infectious disease section, 208 beds are set aside for pulmonary tuberculosis cases. Since the beginning of this year, 10 children's cots were added for tuberculous children. A total of 507 tuberculous patients were treated during the year 1951, 304 of which were new admissions. There were 30 deaths. The new policy of admitting fairly early cases after careful selection in the Harcourt and Kowloon Tuberculosis Clinics resulted in an increased use of active treatment and a quicker turnover of cases.

262. There were 102 beds in a separate building reserved for general infectious diseases. During the year a total number of 993 infectious disease cases were treated with 193 deaths. Temporary asylum was also afforded to a few lepers until they could be taken over by the proper authorities. 5 leper women were admitted from Sandy Bay Leprosarium as maternity cases.

263. Diversional therapy for the tuberculous patients was carried out throughout the year by the Hong Kong Branch of the British Red Cross Society. An additional rattan class provided a very useful form of rehabilitation for the patients in teaching them a new trade.

122

　　　　　264. The upper section of the hospital is used as an over- flow for Queen Mary Hospital and Kowloon Hospital. Here convalescent cases are housed and attended to until fit for dis- charge. During the year 1,852 patients were treated, the majority of which were orthopedic cases.

The following are the cases treated during the year:

Tuberculosis

Typhoid fever

Diphtheria

Measles

Meningitis:

+++

-H

...

Meningococcal

Tuberculous

Others

Dysentery-bacillary

-amoebic

Chickenpox

Whooping Cough

Tetanus

Rabies

Poliomyelitis

Leprosy

Cases.

Deaths.

507

345

203

117

...

ILI

- 123

TSAN YUK HOSPITAL

265. While this hospital is administratively under the care of a Government Medical Officer and is staffed with Govern- ment nurses and midwives, the University Obstetrical Unit is responsible for the clinical work.

266. The following is the report by Professor Gordon King of his Unit's activities in the hospital during 1951.

267. The year 1951 is outstanding on account of the fact that the record number of 6,199 patients were admitted to the hospital of whom 5,819 were delivered of babies. This exceeds by over 800 the record of admissions of any previous year in the history of the hospital.

Hospital admissions since 1946.

268. The following figures illustrate the post-war growth of the work of the hospital:

Total Admissions.

Year

1946

1947

...

1948

1949

1950

1951

3,012

4,176

4,830

4,572

5,385

6,199

269. In interpreting these figures it is necessary to remem- ber that although the Tsan Yuk Hospital is the largest maternity hospital in the Colony, it only possesses 85 beds. It is clear therefore that the average stay of the patient in hospital

124

is unduly short, and it has only been possible to handle such large numbers since a scheme was introduced during the summer of 1951 whereby many normal patients were sent home by ambulance within one or two days of delivery and were then given further care by visiting midwives. Experience has shown that this scheme is not an ideal one and that the only satisfactory solution to the present problem is to rebuild or enlarge the hospital so that it will accommodate 200-250 patients.

Ante-natal Care.

270. A very satisfactory feature of the year's work was that 92% of the patients delivered in the hospital had received ante- natal care. This contrasts very favourably with the figure of 30% in 1941 and reflects the opinion of the patients themselves as to whether ante-natal care is worth while or not.

Maternal Mortality.

　　　　　271. Seven deaths occurred during the year, giving a mortality rate of 1.2 per thousand. The causes of death were as follows:-

Eclampsia-3 cases.

Post-partum hæmorrhage and shock-2 cases,

Acute cardiac failure-1 case.

Hypertension with cerebral hæmorrhage-1 case.

Infantile Mortality.

　　　　　272. The figure shows that there was a stillbirth rate of 15.7 per thousand and a neo-natal death rate of 16.7 per

125

thousand (the great majority of which were in premature in- fants weighing less than 5 pounds at birth.) These figures are the lowest that have been recorded in the history of the hospital.

Eclampsia.

273. There were 18 cases of eclampsia during the year, many of which were of a very severe type, reminiscent of the form of the disease which was encountered in 1940-1941.

Ante-partum Hæmorrhage.

274. There were 46 cases of placenta prævia during the year and 16 cases of accidental hæmorrhage without any death in either group.

Operative Delivery.

275. The hospital has maintained its conservative tradition in regard to operative delivery as it will be seen by reference to the tables which follow. The operative delivery rate was only 3.4%. This included 91 forceps deliveries and 51 Cæsarean sections. 5 of the Cæsarean sections were of the extra- peritoneal type.

Training of Medical Students and Midwires.

276. The hospital continues to hold its place in the Colony as the chief centre for the training of medical students and midwives. Over 60 medical students from the University of Hong Kong, in groups of 5 or 6, passed through a period of one month's resident training during the year and there were 28 pupil midwives undergoing a two-year period of instruction.

126

Table 27

TSAN YUK HOSPITAL

Report for the year 1951

Numerical Summary

Booked Non-booked Total

Delivered in Hospital:

a. Discharged well

Transferred

Admitted after delivery

Died:

Discharged undelivered

C After delivery

Undelivered

Abortion

Total

5,350

463

5,813

292

354

LON

5,668

531

6,199

Of the 5,668 booked cases, 1,459 were primigravidae and

Of the 531 non-booked cases,

Total number of deliveries:

Booked

Non-booked

Total

4,209 were multigravidae.

129 were primigravidae and 402 were multigravidae.

IL -

5,356

463

5,819

127

Table 28

Numerical summary of Cases delivered in the Tsan Yuk Hospital

admitted for treatment or udmitted after Delivery.

Booked Non-booked Total

PRESENTATIONS (EXCLUDE TWINS) :-

Anterior Position of Occiput

4.930

392

5,322

Posterior Position of Occiput

256

279

Breech

114

144

Face

Transverse

ז...

Compound

Undetermined

TWINS PRESENTATIONS:

Occiput Anterior

Occiput Posterior

Breech

Transverse

Compound

Undetermined

TRIPLETS:

Occiput Anterior

Compressed foetus.

5,356

463

5,819

PATIENTS DELIVERED IN HOSPITAL

PREGNANCY TOXAEMIA:

Pre-eclampsia

117

137

b. Eclampsia

C. Essential Hypertension

PRESENTATION & PROLAPSE OF CORD

HYDRAMNIOS

TUMOURS ASSOCIATED WITH

PREGNANCY

PRIMARY UTERINE INERTIA

128

INDUCTION OF LABOUR

LABOUR FOLLOWING PREVIOUS

CAESAREAN SECTION

FAILED FORCEPS

CONTRACTED PELVIS

OPERATIVE DELIVERY:

Q. Forceps

Booked Non-booked Total

b. Version in labour

JILJILJ

છે કે

Willets Forceps Application

Craniotomy

JLLE

Caesarean Section

ƒ. Laparotomy and Hysterectomy

OPERATION FOR POST-PARTUM

STERILIZATION

2nd & 3rd DEGREE LACERATION AND

EPISIOTOMY

377

416

ANTE-PARTUM HAEMORRHAGE

Accidental Haemorrhage

b. Placenta Praevia

POST-PARTUM HAEMORRHAGE

121

133

MANUAL REMOVAL OF PLACENTA

MATERNAL MORBIDITY

Cases (1) Puerperal Infection

(ii) Other Causes

b. Percentage

MATERNAL MORTALITY

Cases

.78%

1.08%

.81%

E-

Per Thousand

1.3

1.2

129

INTERCURRENT DISEASES.

Cardiac Disease

Avitaminosis B

Booked Non-booked Total

협집

Oedema (uncomplicated)

165

172

Cheilosis and Glossitis

Varicose Veins

Cellulitis of legs

૩

Pyelitis

Bronchial asthma

Bronchitis

Pneumonia

Pulmonary Tuberculosis

Tuberculosis hip

Right Pleural effusion

Malaria

Flexner Dysentery

Anaemia

Indirect inguinal hernia

Urethritis

Carbuncle of sacral region

---- IJTI➖➖‍ ➖

Fibroid of uterus

Prolapse of cervix

Right ovarian dermoid cyst

LIJLIIL

Ruptured bladder

Ruptured uterus

Haematoma of right lateral wall of

perineum

Engorgement of breast

Breast abscess

130

ን

Table 29

Infant's Report

Booked Non-booked Total

MATURE INFANTS,

Born alive and survived

4,869

371

5,240

Stillbirths (including macerated foetus)

Neo-natal Deaths

Total

4,922

391

5,313

PREMATURE INFANTS.

(Birth weight 2,500 grams or 53 lb. and

under)

Born alive and survived

385

433

Stillbirths (including macerated foetus)

Neo-natal Deaths

Total

469

550

TOTAL NUMBER OF INFANTS

DELIVERED

5,391

472

5,863

Stillbirth rate (including macerated

foetus)

Neo-natal death rate

Combined Stillbirth and Neo-natal

Morality rate

1.21% 5.72% 1.57%

1.33% 5.51% 1.67%

2.54%

11.23% 3.24%

EASTERN MATERNITY HOSPITAL

277. This hospital consists of 24 beds, but canvas beds have frequently to be used as well because of the over-crowding.

278. During the year, 2,331 cases were admitted to the hospital with 2,288 deliveries and one death, giving a maternal mortality rate of 0.44 per thousand.

131

279. There were 13 stillbirths and 27 neo-natal deaths, giving a stillbirth rate of 5.7 per thousand and a neo-natal death rate of 11.8 per thousand.

280. The number of admissions to this hospital created a new record since the hospital was first opened, and indeed many patients had to be turned away. In addition to this, the stay in hospital of normal cases was reduced from 5 to 3 days.

ST. JOHN HOSPITAL, CHEUNG CHAU

281. This hospital of one hundred beds, which is the property of the St. John Ambulance Association, is being administered by Government under a five year agreement. It serves a large territory. Patients, apart from those of Cheung Chau and the floating population, come for treatment from all the villages on southern Lantau, Pingchau and the neighbouring islands.

There was an all

282. The year 1951 was a crowded one. round increase in the total number of inpatients and outpatients treated as is indicated by the following figures:

Total number of inpatients

Total number of outpatients

Maternity cases

1951

1950

1,657

1,193

24,366

18,133

412

319

283. The beds in the tuberculosis wards were increased from The tuberculosis cases were in a convalescent stage

31 to 42.

and no special treatment was given to them.

STANLEY PRISON HOSPITAL

284. This hospital which is incorporated in the prison itself. has 3 wards of 16 beds each, and 6 isolation cells.

132

　　　　　285. The total admissions to the prison during the year 1951 was 7,495, all of whom were examined by the Medical Officer.

286. The following principal diseases were found amongst prisoners on admission to prison:·

Chronic tuberculosis

Chronic opium smokers

Skin diseases

112

· C

L J

1,873

863

Venereal diseases

497

　　　On admission to prison, 73 prisoners were admitted direct to the hospital, 346 were found unfit to perform any labour, and 410, being unable to carry out hard labour, were put to half labour.

　　　　　287. All prisoners were inoculated against cholera in Summer, and every prisoner vaccinated against smallpox on admission.

288. The total admissions to the hospital during the year 1951 was 1,136: the daily average being 37. Of these patients:

771 were general cases.

264

infectious cases.

tuberculosis cases.

mental cases.

　　　　　289. The total number of prisoners reporting sick was 53,193, the daily average being 145.

290. 15 deaths occurred in the hospital, representing 0.2% of the total admissions to prison.

133

The causes of death were as follows:-

Pulmonary tuberculosis

JJ ---

Epilepsy

Ruptured aortic aneurysm

Lobar pneumonia

IL J

Chronic nephritis

Deaths due to judicial hanging

291. 3,094 examinations and tests were carried out in the prison laboratory. 989 prison staff were given treatment for minor ailments during the year.

292. In a test survey, 2,700 specimens of blood and smears from prisoners on admission to the prison were sent to the Pathological Institute. Of these 16.1% were found to be suffering from one or more forms of venereal disease:

Syphilis

Gonorrhoea

Syphilis & Gonorrhoea

15.2%

0.75%

0.15%

293. Dental treatment was carried out by the Government Dental Surgeon who visited the prison twice a month. During the year 626 extractions were carried out.

294. During the year 6,249 prisoners were X-rayed by the Mobile X-ray unit, and 129 were found to be suffering from pulmonary tuberculosis requiring treatment.

134

PRIVATE HOSPITALS

　　　　295. The following table shows the cases treated as in- patients in the private hospitals of the Colony:

Table 30

Inpatients Treated in Private Hospitals 1951

No.

Infectious Tuber Mater-

Name of Hospital

Beds.

General Cases

disease culosis

nity Hentat

Total

Cases

Tai Wo St. Paul

Ling Yuet Sin

　　　　　　Infants Precious Blood Hong Kong

　　　Sanatorium Hospital

+ +

938!

154

776

114

1,096

588

1,086 2,574

120:

387

459

114

1,794

171

116

190

2,271

235❘ 4,245

159 !

546

768

5,769

St. Francis

יי

1,014

335

1,405

St. Teresa

----------

71 1,256.

161

350

1.852

Hong Kong Central

885 | 12,062

1,652

115

327

2.170

689 2,365 2,419

51 17,586

296. The following table gives an analysis of the total attendances of out-patients at the private hospitals:-

Table 31

Total Attendances of Out-patients at Private Hospitals, 1951.

Name of Hospital

Dres- ¦sings

General

Chil- Ante- Post- dren Natal Natal

Gynae-

culo- Eye gical

Ear, Nose

Tuber. culosis

Total

Throat

St. Paul

48 13,847

676

1,088 16,054

St. Francis

Hong Kong

236

850

1,086

Precious Blood

Central

Hong Kong

Sanatorium and Hospital

1,004

368

177

1,649

4,923

4,361

6.769

St. Teresa

Ling Yuet Sin

Infants

120

1,885

2.241 1,965 1,300 1,450

9,010

135

546

ཝཱ|

9:0

900

6.530

3,763

2,950

8.672

Grand Total... 2,298 28,178 : 9,517

3,981 194

545

90 1,982 46,861

135

NEW TERRITORIES CLINICS, MATERNITY HOMES

AND TRAVELLING DISPENSARIES

297. The clinical work in the New Territories is under the control of the Medical Officer of Health New Territories, enabling close co-operation to be maintained between the curative and preventive branches of the work.

298. There are ten establishments in the New Territories. Two are hospitals with general and maternity beds and resident doctors (Cheung Chau and Tai 0). Two clinics have maternity beds with resident doctors (Taipo and Un Long), and at the other six clinics there are resident midwives with a small number of maternity beds, namely Ho Tung, Shataukok, Shatin, Saikung, Sanhui and Silver Mine Bay. At Ho Tung Clinic there are also four beds for minor ailments among the Police force.

299. In addition there are two vehicles which are based at Taipo and Un Long and provide Travelling Dispensary services among the smaller villages, one working on the west and one on the east side of the mainland. A weekly outpatient service is also carried out at the island of Ping Chau by launch.

300. Of the above mentioned clinics, that at Silver Mine Bay was built and handed over to the Medical Department by the local community.

301. The Ruttonjee Clinic at Sham Tseng was closed down in the course of the year.

302. Infant welfare, ante-natal and venereal disease clinics are held at Taipo and Un Long by the medical officers in charge, Leprosy cases are seen at special sessions from time to time.

303. Medical officers from Hong Kong and Kowloon also visit Taipo, Un Long and Cheung Chau to hold dental, tuber- culosis and eye clinics.

136

　　　　　304. Vaccinators are posted to Taipo and Un Long to assist in routine work and additional staff are provided from time to time by the anti-epidemic office to cope with additional demands.

　　　　　305. The following table shows the details of the cases treated at the dispensaries in the New Territories.

Table 32

Medical Centres-New Territories

Out-patients

Deliveries

Dispensaries

New Cases

Total Attendances

In-patients Domiciliary

Tai Po

Ho Tung

Shataukok

Un Long

Sun Hui

14,257

33,700

766

г..

T+

1,181

3,296

253

529

1,595

115

11,488

26,592

950

1,428

2,968

204

Sai Kung

PILL ----

2,112

4.442

Shatin

2,016

3,707

127

113

Tai O

т..

6,650

16,022

367

Silver Mine Bay

Ping Chau

2,302

4,814

1,745

3,566

Travelling (East)

1,656

2,849

Travelling (West)

JOJ LJ

1,443

1.945

46,807

105,496

2,900

459

137

DENTAL CLINICS

306. The Dental Sub-Department is responsible for the provision of dental treatment under 2 heads: --

A. General Dental Service.

(i) Government servants and pensioners.

(ii) Families of Government servants and pensioners. (iii) General public poor persons.

(iv) Referred in-patients of government hospitals

including Mental Hospital.

(v) Prisoners.

B. School Health Service.

(i) Government and Government aided schools.

(ii) Private schools.

307. In all, eight full time dental clinics and one dental laboratory were operated during the year under review.

308. Full dental treatment for government servants and their families was available at Sai Ying Pun Hospital after a waiting period which varied from 2 to 6 months at different times of the year. The high standard of treatment carried out was maintained, but with the staff and facilities available it was impossible to eliminate the waiting list of government servants and families requesting full treatment. Emergency treatment was always immediately available.

309. For the emergency treatment of poor persons, four regular clinic sessions were operated each week-two at Sai Ying Pun Hospital and two at Kowloon Hospital. In addition, a monthly clinic at Cheung Chau Hospital was maintained, and

138

　　　regular fortnightly clinics for prisoners at Victoria Remand and Stanley Prisons were continued. Nearly 12,000 treatments were performed on these classes of patients during the year 1951.

　　　　　410. With regard to dental treatment in the School Health Service, a substantial year's work has been carried out. Unfortunately, the statistical summary reveals the heavy weighting on the side of extractions as against fillings. In the case of government and government aided schools, this has been so because the facilities available for the treatment of their pupils have been so limited that for the most part only children specially referred by the school medical officers because of pain or gross dental caries could be treated. Nevertheless, more than 2,000 fillings were inserted which must be reckoned as a good year's work considering the enormous volume of emergency work additionally necessary. In the case of private schools, treatment consisted mostly of extractions because the patients were participating in a new scheme, and were mostly receiving dental treatment for the first time. Necessary extractions were carried out for all participants in the scheme before attention could be given to conservative treatment.

　　　　　411. The Hong Kong Dental Society has continued to supply dental clinics for the treatment of poor persons, especially children. This most laudable effort on the part of the dental surgeons of the Colony (who include government dental surgeons and dental officers of Her Majesty's Armed Forces, as well as private practitioners) has been a most valuable addition to Government's arrangements for providing dental treatment for the poor.

Dental materials for these clinics and for the dentists working with the St. John Ambulance Brigade Penetration Parties visiting outlying districts of the New Territories have been supplied from government stocks without charge.

139

412. In spite of the inadequacy of clinic facilities, a satisfactory year's work is reported. When the planned new dental clinic is opened in Hong Kong it will be possible to effect a considerable improvement in the amenities available for patients and in the conditions of work of dental staff.

Statistical Summary of Dental Treatment

Carried out during 1951.

Surgical

Class of Patients

No. of Visits for Treatment

Extractions

Other Operations

School Children

Non-Govt.

School Children

Govt, Schools

11,894

11,182

203

9,217

7,330

311

Govt, Servants

6,635

2,127

211

Govt Families

4,518

1,430

General Public

Grand Total

11,835

11,586

298

44,099

33,655

1,090

Conservative

Paradontal

Prosthetic

Class of Patients

Scaling &

Dentures,

Fillings

Temporary

Orthodon-

Dressings

Gum Treatment

tics & Splints

School Children

Non-Govt.

2,071

579

257

School Children

Govt. Schools

2,228

1,034

Govt. Servants

Govt. Families

General Public

Grand Total

2,411

421

661

315

1,389

279

340

➖ ➖ ➖ ➖---- ■

163

+++

8.099

2.319

1,334

489

140

VIOLET PEEL POLYCLINIC

　　　　　413. This clinic is the third largest outpatient department in the Colony, and is situated in a very congested part of the island.

　　　　　414. The medical staff consists of four doctors, with weekly or twice weekly visits from specialists in medicine, surgery, chest and ear, nose and throat diseases.

415. The clinic is very well attended and the number has increased from 99,482 in 1949 to 126,804 in 1950 and 171,805 in 1951. The overcrowding necessitated a night clinic which was started in June, 1951, in order to relieve the congestion. The night clinic is staffed with two doctors, and is open from 6 p.m. to midnight. In six months they had seen over 30,000 cases.

PUBLIC DISPENSARIES, URBAN

　　　　　416. There are 8 public dispensaries (apart from those in the New Territories) where a charge of $1 is made for each visit, as in the case of the polyclinics. Authority is, however, given to the attending doctors to waive this fee in cases of the very

poor.

　　　　　417. There has been a considerable drop in the numbers of attendances at these dispensaries. This may be in part due to the introduction of the $1 fee, but it is possible that there has been a drift of patients to the more fully equipped poly-clinics, where the number of attendances had increased so much as to outbalance the decrease in these dispensaries.

　　　　　418. Midwives are attached to 5 of these dispensaries for district domiciliary deliveries, and in one case there is a small maternity hospital.

141

Table 33

Attendances at Public Dispensaries.

Out-Patients

Deliveries

Public Dispensaries

Children

Adults

Vacci-

Inocu-

nationa

lationa

Inpati- Domici-

New

Cages dances Cases

Total Atten-

New

Total Atten- dances

ents liary

Central

Eastern

Shaukiwan

12,952 21.608

10,497 14,116

19,009 26,887

8,262 ᅡ 18,947

8,102

679

8,760 21,083

11,026

926

11,146!

20.497

617

5,111

1,724

Aberdeen

4.410

6,108

4.692 I

8,221

461

3,240

395

Shamshulpo

24,512

33.719

18.785

86,787

GOR

23,488

2,006

Youmati

12,965

15.946 |

9,431

20,294

238

9.116

3.276

Hung Hom

10.218

11,914

7.666

12.761

4.777

129

Stanley

$17

1,301

978

3,637

269

1,157

Total

---------

95,380 130,099 69.619 142,227

269

1,903 66,016

10,012

MIDWIVES AND MATERNITY HOMES

419. There were 22 Government midwives employed in 16 district centres during 1951. 11 of these district centres have. small maternity homes attached, and a total of 6,417 deliveries was carried out during the year by these midwives, 2,873 being domiciliary cases and 3,544 being delivered in these maternity homes.

420. 122 private maternity homes were registered during the year; 56 of these being in Hong Kong and 66 in Kowloon and New Territories. There were 22,338 cases delivered in these private maternity homes in 1951. This number constituted about one-third of the total deliveries of the Colony.

1.12

　　　　　421. Visits of inspection are paid to all private maternity homes by the Supervisor of Midwives, and 876 visits were made during the year, 450 of these being in Hong Kong and 426 in Kowloon and the New Territories.

　　　　　422. Table 34 below shows the size and site of these private maternity Homes.

Size of Home

Table 84

Private Maternity Homes.

Number of Homes in!

Hong Kong

Number of Homes in

Kowloon

Total number of

Homes

Total number of beds

available

bed

3 4 bed bed bed bed

Total

bed

121

18 20

30 10

28:

48 30

8 3 3

122

2 56

144 120

40 18

401

423. 903 midwives were registered in 1951, 54 of these being new graduates.

　　　　　424. Of the midwives on the register, 215 were in active private practice. Regular inspection of their records and equip- ment were made by the Supervisor of Midwives.

143

125. Table 35 shows the number of patients attended by a doctor or midwife in the various institutions in the Colony from 1946 to 1951. In view of the large numbers of newcomers to the Colony it is surprising that they should have learned so quickly to appreciate the value of the maternity service provided.

Table 35

Births attended by a doctor or a midwife.

1946 1947 1948 1949

1950

1951

Queen Mary Hospital

LJLJ

Kowloon Hospital

Tsan Yuk Hospital

-----------

Eastern Maternity Hospital

Lai Chi Kok Female Prison

Hospital

Private Hospitals

St. John Hospital

Government Dispensaries

(Attended by Midwives)

Private Maternity Homes

Total births delivered

hospitals and maternity homes

Domiciliary cases delivered

by Midwives

Total Number of Births

attended

117 398

719

1.164

1,580

1,910

979 1,261:

1,189

1,287 1,576

2,175

2,645

868

3,826 4,458 1,633 1,831

4,223 5,012:

5,781

1,783, 1.995

2,254

379

4,058 9,066 12,161 15,387 16,333′ 20,002

640 1,260 1,582 2,013 2.633 3,544 9,586 13,150 14.324) 18,730 21.226 22,338

18,893 30,594 36,2641 44,587 50,355 58,390

5,628 9.237 10.120| 8,991 9.125 9,054

24,521 39,831 46,384, 53,578) 59,480 67,444

426. The Supervisor of Midwives, who is a senior doctor in the department, combines her supervisory duties with the secretaryship of the Midwives Board, and this close liaison between the supervisory staff and the Board is an important factor in the efficiency of the maternity service.

144

IV. GOVERNMENT ASSISTED HOSPITALS

427. There are five hospitals in the Colony run by charitable institutions which receive A considerable grant from Government. Three of them, known generally as the Chinese hospitals, and comprising the Tung Wah Hospital with 495 beds, the Kwong Wah Hospital with 340 beds, and the Tung Wah Eastern Hospital with 250 beds, are part of the charitable work carried out by the Tung Wah Board of Directors. The actual administration of the hospitals is under the control of the Tung Wah Hospital Medical Committee comprising the three Principal Directors for the year with the three Medical Superintendents and two advisers, and is under the chairmanship of the Director of Medical and Health Services.

　　　　　428. The two other assisted hospitals are the Nethersole and Affiliated Hospitals, associated with the London Missionary Society, with 185 beds, and the Hong Kong Anti-Tuberculosis Association's Ruttonjee Sanatorium with 163 beds.

TUNG WAH GROUP HOSPITALS

　　　　　429. Treatment in these hospitals is for the benefit of the poor, but there are a small number of private wards.

430. During the year the total number of cases treated in the three hospitals was 45,441 as compared with 40,909 in the previous year and the combined attendances at the out-patient department amounted to 174,395 which compares with 139,616 in 1950.

431. The official bed accommodation is somewhat misleading in these hospitals, as they endeavour to meet with any demands made upon them, and the number of patients in both the Tung Wah and Kwong Wah Hospitals often exceeded by two hundred or more the official number of beds.

145

432. During the year a much needed new nurses home, Selwyn Clarke Nurses Home, was almost completed at the Kwong Wah Hospital.

433. The statistics for these hospitals are seen in the tables on pages 24 - 29 giving the data of in and out-patients treated in Government and Government assisted hospitals.

NETHERSOLE HOSPITAL

434. This hospital which is under the control of the Senior Missionary in Hong Kong of the London Missionary Society receives an annual grant from Government. During the year the accommodation for general patients has been increased to 145, and for maternity patients to 40. Both the numbers of in-patients admitted and numbers of births in the hospital during 1951 have been higher than ever before in the hospital's history.

435. The statistics for this hospital are seen on the tables on pages 24 - 29 giving the data of in and out-patients treated at Government and Government assisted hospitals.

RUTTONJEE SANATORIUM

436. This hospital which is operated by the Hong Kong Anti-Tuberculosis Association also receives a subvention from Government. During the year the number of beds has been increased to 163, and an out-patient department has been built to serve as a "follow-up" clinic.

437. The statistics for this hospital are seen on the tables on pages 24 - 29 giving the data of in and out-patients treated at Government and Government assisted hospitals.

146

V. SPECIAL SUB-DEPARTMENT

PHARMACEUTICAL

438. During the year medical supplies were issued to 131 Government institutions as against a total of 113 for 1950. Costs showed a sharp increase during this period, in many cases as high as 50% over the 1950 figures.

　　　　　439. The new Central Medical Store was occupied in May 1951. These premises are a great improvement on the old store in the Fire Brigade Building, although not all the fittings and fixtures have been completed. With the installation of an electric tablet machine, large quantities of tablets have been made.

　　　　　440. The production of sterile parenteral solutions has proceeded very satisfactorily. All such preparations for use within the department are now produced at the Central Medical Store with the exception of those required for Queen Mary Hospital. With the installation of a new sterile-product room at Queen Mary Hospital, sufficient of these products to meet that hospital's needs are now made there. It has been possible to produce a satisfactory anti-coagulant solution for the storage of blood. The following figures are quoted for comparison: -

1950

1951

Bulk Intravenous Fluids: Litres

5,568

19,648

Injections, various, in 20 ml, bottles 12,428

22,135

441. The following figures showing issues of licences, etc.,

are tabulated with the corresponding figures for 1950.

147

TYPE

1950

1951

Wholesale Dealers' Licences Listed Sellers' Licences Registration of Pharmacists

Registration of Premises Premises visited

ILLI

287

424

197

218

356

328

442. In addition to the above licences, 241 penicillin permits were issued during the year.

443. It was not possible during 1951 to carry out as many inspections of premises as was desirable. With the issue of new penicillin permits during the year, it is estimated that no less than 600 visits would have been a satisfactory minimum. While the Chief Pharmacist was out of the Colony, the only pharmacist normally available for routine visits of inspection was in the acting post. During this period offences involving poisons and antibiotics became numerous. Mention should be made of the excellent cooperation from the Director of Criminal Investigation and his staff in the control of poisons, and more particularly, the antibiotics. 42 cases were prosecuted under the Pharmacy and Poisons Ordinance and the Penicillin Ordinance.

444. During the year dangerous drugs resulting from 2,389 seizures by police and revenue officers were received. With the exception of the relatively small number of items suitable for conversion to medicinal preparations, these were destroyed by dumping at sea.

Chemists and Druggists Classes.

445. Final examinations were held twice during the year. A total of 5 students presented themselves for examination. 4 passed, and one was referred for re-examination in 1 subject.

148

　　　Of the 5, 2 were pharmacists holding qualifications not recognized by the Hong Kong Government, who had been directed by the Pharmacy Board for examination in forensic pharmacy only.

ALMONER

446. The year 1951-1952 was a difficult one for the almoner's department. Increasing unemployment and a rising cost of living made greater demands on the social service work of the department, and at the same time the staff were widely made use of by the medical staff inside the hospitals, by those at clinics as well as by patients in the community. It was unfortunate that at the same time the department was understaffed the whole year, there being three almoners absent for a large part of the time.

Medical-Social Work.

447. Assistance has been given to patients in the following

ways:-

(a) Artificial Limbs and other Surgical Appliances:

　The supplying of hearing aids, surgical boots, walking calipers, a hernía support, and dentures, to the patients who could not afford to meet the expenses themselves.

(b) Repatriation:

　The number of Chinese patients who could be repatriated was smaller this year than formerly, because of political reasons. Four European mental cases were sent back to England and two elderly European ladies evacuated to Hong Kong from Amoy,

149

With the opening of a new Kowloon Branch of the Society for the Protection of Children, one more place to which children of poor patients can be sent for maintenance is now available.

(d) Financial Assistance:

Financial assistance can be given to needy patients or their families from two sources, (a) the Samaritan Fund and (b) the After-care of tuberculous patients Vote for maintenance while the bread winner of the family is unable to work on account of sickness; these sources also provide patients with extra nourishment and clothing, small capital for buying hawkers licences, or for setting up as hawkers and so on.

The almoners' department can often make arrangements for a patient to learn a trade when his last employment is found to be unsuitable or should he be unable to go back to his old job on account of his disability. With the co-operation of the Labour Department it is sometimes possible to secure from their former employers light work or alternative employment for patients.

(f) Attempted Suicide:

Medical treatment and hospitalization if necessary is frequently arranged by the almoner for attempted suicide cases, accommodation being found either in a government hospital, or at the Tung Wah group of Hospitals.

150

(g) Injured Patients:

　The almoners' department works closely with the Labour Department and Traffic Office on every industrial and traffic case, very often being able to obtain reasonable compensation for the patients.

(h) Extra Food:

　Milk powder is being given to tuberculous patients weekly at the two tuberculosis clinics. At the beginning of the year, milk powder from the United Nations International Children's Emergency Fund was given to expectant mothers and children in the outpatient departments.

Tuberculosis Work.

　　　　　　448. The Aftercare of Tuberculous Patients Vote has been well planned and carefully spent by the Tuberculosis Almoner. 132 families received financial assistance. The Children's Home for Contacts in Fanling run by the Mennonite Mission has proved to be a valuable service, and at the same time a happy home for many of these unfortunate children.

Mental Hospital.

449. Psychiatric social work has been developed in this institution since a full time almoner was posted there. She is able to follow up most of the patients after discharge or to expedite a patient's discharge,

　　　　　　　　　　patient's discharge, and make accommodation available for new admissions.

Occupational Therapy.

450. There is no trained occupational therapist in the Medical Department. The Physiotherapist and the Principal Almoner with the help of the Committee Members of the Occupational Therapy Fund are doing their best to arrange occupational therapy for the long term cases. The Hong Kong

151

Branch of the British Red Cross for several months provided voluntary instructors for Lai Chi Kok Hospital and Mental Hospital to teach the patients reading, knitting, sewing, etc. There is also a Chinese lady who has been doing similar voluntary work at the Queen Mary Hospital and the Mental Hospital. During the last two years she has done very valuable work.

451. There are two rattan instructors giving classes to patients at the Mental Hospital and the Lai Chi Kok Hospital. One is being paid by the Government and the other from the Occupational Therapy Fund. Throughout the year, the Secretary of the British Red Society has helped to dispose of the finished rattan articles-a very necessary function.

PATHOLOGICAL (INCLUDING MORTUARIES)

452. The Pathological Institute under the direction of the Government Pathologist, consists of a main building where a large amount of diagnostic work and vaccine production is carried out. In addition to this there are two branches, one at the Kowloon Hospital which is responsible for most of the diagnostic work in Kowloon, and one at the Queen Mary Hospital which is mainly concerned with clinical pathology.

453. Routine work continued to grow in volume, and showed an overall increase of 39% as compared with the records for the previous year. This was due mainly to the greater number of Kahn tests carried out at the Institute and to a general expansion at the Kowloon branch, where the numbers of specimens dealt with now exceed the prewar figures for the whole Colony. At the Queen Mary Laboratory, where only one Senior Assistant can be spared, work has remained steady.

454. Other items of interest or significance during the year included the following:

Kahn tests numbered 95,547-an increase of over 40,000: the frog test for pregnancy proved increasingly

157

popular and requests for the Friedman test are becoming more and more infrequent: potency tests on samples of penicillin, introduced during the year, were both numerous and time consuming: and in an investigation of an out- break of abortion in the herd of a local dairy, Vibrio foetus was found in the foetus in 27 instances, and was also isolated in culture from the semen of a bull.

455. The figures in the following tables include those of the Kowloon and Queen Mary branches.

Table 36

Annual Number of Specimens Examined.

Year

1930

8,721

1931

11,632

1932

17,208

1933

16,918

1934

22,271

1935

27,463

1936

38,797

1937

42,096

1938

44,710

1939

60,790

1946

51,957

1947

107,335

1948

120,775

1949

128,542

1950

149,259

1951

207,646

153

456. Protozoology and Helminthology-Blood films for malaria-4,511 films were examined for the parasites of malaria. Classification of types and negative findings are shown in the table.

Table 37

Blood Examination for Malaria,

Subtertian

186

376

JI+

ILI

JIJ

Benign-tertian

Quartan

Unclassified (type undetermined).......

Multiple infection

Negative ...

JL.

ILI

3,985

4,511

Grand total

457. Filaria-Microfilarial parasites were found in two

cases.

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

459. Faeces-13,887 stool specimens were examined for parasites, ova, or cytological picture.

Table 38

Examination of Stools for Intestinal Parasites.

Ascaris

Clonorchis

Trichuris...

Ankylostoma

Taenia

...

г. г

1,954

486

927

432

154

Hymenolepis nana

Schistosoma Fasciolopsis

Oxyuris

E. histolytica

Balantidium coli

Multiple infection Negative

+ ||

---

Grand total ...

---

109

177

т..

1,016

-+ |

8,771

...13,887

　　　　　460. Haematology-Most of this work is carried out at the Kowloon branch, activities at the Queen Mary Laboratory remained greatly restricted owing to shortage of trained staff.

Table 39

Haemoglobin percentage

Total Red Cell Count

Total White Cell Count ........

Differential Count

Blood Sedimentation Rate

Blood Bleeding Time

Blood Coagulation Time

Platelet Count

Reticulocyte Count

...

++.

Blood Grouping

Cross Matching

Grand total

155

1,306

1,304

1,910

1,799

г.

1,219

ITI

---

875

235

8,464

461. Serology-The Kahn reaction-95,547 sera were tested, representing an increase of 73% over last year's figures. The Berger-Kahn modification was used in all ante-natal cases.

Table 40

Examination of Blood Seru for Syphilis.

Strong Positive

Positive

Weak Positive

ILI

2,677

6,745

2,938

Doubtful

3,591

Negative

..79,596

Grand total ...

...

..95,547

All the

462. Agglutination tests-2,812 sera were examined for the presence of agglutinins against various organisms. positive findings for Br, abortus occurred in pigs.

Table 41

Agglutination Tests.

Organisms

Positive Negative

Doubt- ful

Total

Bact. typhosum

Bact. paratyphosum A

820

1,186

118

2,124

| |

LILI

112

240

150

352

153

Enteric fever (type undetermined)

Br. melitensis

Br. abortus

Weil-Felix reaction

Grand total

1.114

1,579

119

2,812

156

　　　　463. Bacteriological Examniations-Blood clot culture-- Bact. typhosum was isolated from the Widal clot in 152 instances, paratyphoid A 45 times.

　　　　464. Faeces--6,270 stools were cultured for pathogenic organisms.

Table 42

Examination of Stools for Organisms.

Positive

Negative

Total

Bact. typhosum

4,017

4,103

Bact, paratyphosum A

B. dysenteriae (Group)

1,325

1,330

Cytology typical of bacillary

dysentery

121

B. dysenteriae (Flexner)

478

B. dysenteriae (Shiga)

B. dysenteriae (Sonne)

Salmonella group

153

198

יזז

V. cholerae

[

Grand total

751

5,519

6,270

465. Sputum-22,705 sputa were examined for the presence of the tubercle bacillus. In addition, gastric lavage from 287 patients gave 21 positive results.

167

Table 43

Examination of Sputa for Tuberculosis.

Direct examination

Culture

Grand total

Positive

Negative

Total

4,473 13

17,901

22.374

318

331

4,486

18,219

22,706

466. Urine-2,213 specimens were cultured for pathogenic organisms.

467. Urethral and cervical smears-309

　　　　　　　　　　　　　　　　　　　　　　　-309 smears were examined for the presence of the gonococcus, with 61 positive findings.

468. Nasal smears, etc. for M. leprae-418 examinations gave 82 positive results.

469. Rat spleen smears-15,475 examinations were made of smears for P. pestis, with no positive findings.

470. Throat swabs--5,029 throat swabs were cultured for C. diphetheriae; and 2,881 were examined for the presence of haemolytic streptococci, with 166 positive recorded.

Table 44

Examination of Throat Swabs for Diphtheria.

Positive

504

Negative

4,525

Grand total

+ F

5,029

471. Cerebrospinal fluid-1,011 specimens were cultured for the presence of pathogenic organisms,

158

Table 45

Examination of Cerebrospinal Fluid for Pathogenic Organisms.

Meningococcus

Pneumococcus

M. tuberculosis

Negative

Grand total

993

1,021

472. Clinical Pathological Procedures

Urine examinations

-15,625 routine and microscopic examinations of urine were carried out.

　　　　473. Pregnancy tests-There were 47 Friedman tests, and 547 frog tests, using the local male frog.

　　　　　474. Miscellaneous tests-748 examinations of an unclassi- fied nature were carried out.

　　　　475. Preparation of Vaccine Lymph-Cow calves had to be used for this work as buffalo calves were unobtainable. In consequence yields were much smaller and less satisfactory.

476. Preparation of Vaccines Production remained much the same as last year. No plague vaccine was called for but 124 litres of T.A.B. vaccine were manufactured. ·

　　　　477. Rinderpest vaccine, using a lapinised strain, has now become a routine activity, and is prepared for the Agriculture Department throughout the year as required.

478. Antirabic vaccine-Only one human case of rabies occurred, consequently fewer cases applied for vaccine treatment and production of vaccine dropped, compared with the previous

year.

159

Tuble 46

Cases Treated with Antirabic Vaccine.

2,216

655

2,871

Treatment completed

Treatment not completed

Total

Table 47

Vaccine Production,

Vaccine prepared

Vaccine issued

Anti smallpox vaccine

24,030 ml.

31,042 ml.

cholera T.A.B.

524,550

430,130

124,270

36,250

Plague Rabic

Nil

200

...

(2%) (4%)

80,850

80,410

Rinderpest

54,320 52,260

58,100 52,260

860,280

688,392

Grand total

479. Examination

of Water and

Milk-Water-2,105

samples of water from various sources were examined. The Colony's water supply continues to be most satisfactory bacteriologically.

Table 48

Unfiltered raw water

Filtered

222

225

Filtered and chlorinated water from

service tap

Well water

1,465

Water other than public supplies

179

Total

TII

IT I

2,105

160

480. Milk and other foods-1,213 examinations of milk were carried out, and 695 samples of ice-cream, popsicle, and aerated water were tested. Results in each category were good on the whole.

Milks

Ice-creams

Popsicles

Aerated waters

Table 49

Grand total

1,213

368

139

188

1,908

481 Morbid Histology-Negri

bodies-32 brains were

examined for the presence of Negri bodies. One human and one dog brain proved positive. The positive dog's head was sent by the Macau Government.

Human brains

Dog's

Cat's

Monkey's

LJL-

Total

LLI

Table 50

Positive

Negative

Total

　　　　482. 284 tissue sections were examined for histological diagnosis. Of these, 116 were benign or malignant tumours.

161

Nature of Examination

TABLE

SUMMARY OF

Agglutination reaction

Bact. typhosum

-------¶¶.........-----------------------------▬▬▬▬➖➖

paratyphosum A

Enteric fever, type undetermined

Br. melitensis

Br. abortun

Weil Felix reaction

Serologics) reaction for syphilis

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

Blood ymesra

Malaria

Filaria

B. anthracis

Hb.

percentage

Haematology

Tatul Red Cell Count Total White Cell Count Differential Count

Blood Sedimentation Rate Blood Coagulation Time Blood Bleeding Time Platelet Count

Reticulocyte Count

Bloot Grouping

Crans Matching

--------

IPLLE

----------LJ

----------------............tTubunitatu++++

➖➖➖➖➖➖➖➖➖➖➖-----------------------

-------.........nd++++++++++++

Cultural examination

Nuvo-pharyngeal swabs (C, diphtheriae) Huem. Streptococci

------

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

Cerebrospinal fluid for pathogenic organisma Fueces for pathogenic organisms

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

Blood clut culture (enteric organisms only) Blood

Bone marrow Urine

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

Intestinal parasites

Occult blood

{

tuberculosis

Foeces

Tinue section

----

Braine for Negri bodies

Sputa

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

JILLI.

Gastric Invages for M. tuberculosis

Smear for

Smear for M. leprae

Rat spleen smears for P. pestis

Pus & body fluid

11--11

Urine (Routine, chemical & microscopic)

-----

וויrrrrrוו...

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

Pregnancy teals

{

(Friedman)

(Frog)

Bacteriological examination of milk and foods

analysis of

Water

Miscellaneous

Grand total

162

Andeer-------

----------------------------|-+-+-+-

EXAMINATIONS.

Pathological Institute

Queen Mary Hospital Laboratory

Kowloon Pathological

Total

Institute

950

222

9.52

350

ENNG![/

101

95.547

Dellai

2,124

2 81

5 352

163

96,547

2.302

319

1,990

4,611

108

120

1,072

1,306

174

763

1.034

212

1.614

1,907

500

1.164

1,799

987

179

1.219

85H

875 235

2.851 2.851

103

2,073

5,029

2,881

266

283

523

1.021

2.462

1,023

2,785

6,270

1,569

336

300

2,304

294

264

378

936

122

▬▬

299

421

620

2,335

910

4,928

683

2,213

5,980

13,643

221

331

284

7,502

2,975

12,228

22,706

10%

176

287

109

180

309

158

264

ALX

6.716

8.760

877

8.422

362

852

2,293

642

134,876

21,527

།།།སྐུ

132

148

4,326

795

168

51,243

15,475

556 15.625

547

1.720

2,293

748

207,646

163

Victoria Public Mortuary.

483. 1,036 post-mortem examinations were carried out during the year. This figure includes 157 medico-legal cases, of which 24 were examined by the Police Surgeon.

484. 31 specimens of post-mortem materials, chiefly stomach and contents, were sent to the

　　　　　　　were sent to the Government Chemist for toxicological examination in cases of suspected poisoning.

485. 115,124 rats and 6,715 rat spleen smears were examined for evidence of plague. No positive cases were found. Of late, special attention was paid to rats and mice collected from steamships after sulphur dioxide fumigation.

486. Specimens of pathological interest are still being collected by the School of Pathology, University of Hong Kong, for teaching purposes.

Kowloon Public Mortuary.

487. 3,196 post-mortem examinations were carried out during the year. This figure includes 328 medico-legal cases, of which 45 were examined by the Police Surgeon.

488. 30 specimens of post-mortem materials, chiefly stomach and contents, were sent to the Government Chemist for toxicological examination in cases of suspected poisoning.

489. 106,739 rats and 8,760 rat spleen smears were examined for evidence of plague. No positive cases were found.

Of late,

special attention was paid to rats and mice collected from steamships after sulphur dioxide fumigation.

164

A summary of the work done at the Hong Kong and

Kowloon Public Mortuaries.

1951.

Total No. 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

J.L

--J

No. of Chinese bodies examined...

No. of Non-Chinese bodies examined

No. of bodies, Nationality unknown No. of Medico-Legal Cases

...

LIL

4,232

2,461

IL J

1,762

ILJ

875

3,357

1,209

4,200

472

Male

Female

Total

No. of bodies under 2 years of age No. of bodies over 2 years of age No. of bodies received from the following sources:

1,207

1,044

2,251

ILI

1,256

716

1,972

(Hong Kong)

Victoria District

Shaukiwan

Infant Hospitals

486

181

Other Hospitals

Marine Police Station

Total

ILJ

165

LLI

266

1.036

...

- г

...

(Kowloon and New Territories)

Marine Police Station

Tsim Sha Tsui

Yaumati Police

Mongkok

Shamshuipo

Kowloon City

Hunghom

Tsun Wan

}}

ILI

Sheungshui

]]

Shataukok

Taipo

Shatin

Takuling

Castle Peak

Pingshan

Lok Ma Chau

124

107

594

+ tr

17+

47+

+++

17+

530

134

ITI

Kam Tin

Tai Q

Cheung Chau

Railway Hospitals

Total

יז

L+ -

+++

ILI

+ ··

гт.

г.

1 г

TII

1,433

3,196

---

...

221,863

15,475

Nil.

No. of rats caught and brought to mortuaries

No. of rats examined

No. of rats' spleen smears taken for examination

No. rats infected with plague

166

CHEMICAL LABORATORY

　　　　490, The Government Chemist, with a staff of two chemists and one assistant chemist to help him, is in charge of the chemical laboratory, where commercial, medico-legal and biochemical work is carried out.

Analysis.

　　　　491. The comparative table of samples examined (Table 52) shows a considerable overall increase from the figures for the year 1950. This is to a great extent accounted for by the fact that this was the first full year's working since the amalgamation of the Department of Commerce and Industry Laboratory with the Government Laboratory.

Table 52

1950

1951

(i) Waters & Waterworks Chemicals

(ii) Foods & Drugs

(iii) Chemico-legal

619

654

628

700

ין

L +

+ ·

г ·

1 T ·

(iv) Commercial

1,309

1,841

(v) Biochemical

5,658

7,608

(vi) Coal from Department of Commerce &

Industry, Supplies Branch

Departments

■ - - -

(vii) Miscellaneous from Government

(viii) Work under Dangerous Drugs Ordinance, Dutiable Commodities Ordinance and

165

256

Importation/Exportation

(Prohibition)

(Specified Articles) Order, 1951

167

670

6,400

9,147

17,568

492. In addition to the routine control of the public water supply, samples from wells and streams have been examined for Government, the Services, and private interests. The continued

shortage of water has encouraged owners of property to seek other sources of supply, particularly for use for sanitation and air-conditioning, and the Laboratory has been able to advise on the suitability of these supplies. Samples from the harbour water-boats, from vessels in port, and from local swimming pools have been submitted. Various chemicals used in the treatment of the water supply have also been analysed for the Water Authority.

Table 53

Waters & Waterworks Chemicals,

Tap Samples

243

Samples from Filter Beds

340

г г

Water from other sources

.т...

Waterworks Chemicals

654

493. The food samples consisted mainly of milk, for control of pasteurisation. Other samples examined were locally canned fish for possible metallic contamination, and flour and soya beans for the Department of Commecre & Industry. The drugs under this heading were submitted by the Chief Pharmacist for control of certain preparations.

168

Samples from:

Table 54

Foods & Drugs.

Department of Commerce & Industry 8

Medical Department:

Central Medical Store

Health Offices

Prison Department

494. Chemico-legal investigations form a

considerable

proportion of the work of the Laboratory. The Tables below show the number and variety of the cases dealt with.

　　　　495. In the murder cases, articles of clothing were examined for identification of ink stains, and for presence of sea water. The large number of forgery exhibits is derived from one case, in which spurious American gold coins had been made from an approximately correct gold alloy, the value of these coins. apparently being above that of the contained gold.

496. There were no cases of homicidal poisoning.

Table 55

Chemico-legal Analyses.

Toxicological examinations (including post-mortem

materials from 110 persons)

Urine & Blood for Alcohol determination

205

-11

169

Articles connected with:

Abortion

Acid-throwing

Arson

Assault

ILI

Bombs & Explosives...

Breach of Export Control

Dangerous Goods

Death enquiries...

Firearms & ammunition

Forgery

++ I

ITI

TII

...

· L+

106

Fraud

IT I

Illegal practising of western medicine ... 40

Larceny

Medicines & drugs

Murder

Poisoning

Suicide

-. r

Traffic accidents

· +

---

Unlawful possession of ores

Miscellaneous

..ז

т..

TII

700

170

Table 56

Toxicological Examinations.

No poison present

Adalin

Acetic acid...

Alcohol

TII

Alkalies

Arsenic

---

Barbituric acid derivatives

Carbon dioxide

Codeine

Cyanide

---

LIL

D.D.T.

IT I

LIL

+1.

Gelsemium Elegans Benth

Hydrochloric acid

Lead

Methyl salicylate

Opium

Oxalic acid

+ L

| TI

ז..

Phenolic or cresolic compounds

Procaine

Quinine

Sea-salt

г.

IT I

Soap

---

+ P

יז.

כים

■T

205

497. Commercial samples are shown in Table 57, which adequately demonstrates the range and quantity of material dealt with. The fees collected amounted to $100,747.00.

171

Minerals & Metals:

Table 57

Commercial Samples.

Aluminum & Aluminium

ore

Iron ore

J-

Barium ore

1 T

Brass & Brass Scrap

137

Calcite

Lead & Lead ore

Magnesium

Manganese ore

Nickel & Nickel ore

J-L

ITI

Iron, Steel, & Ferro-alloys 19

Pewter

Chromite

Realgar

Claps, Kaolin, & Sand

Sodium Silicofluoride ...

Coal

Tin

ANT LA

Cobalt

Wolfram

Copper & Copper Scrap 40

Felspar

Fluorspar

Zinc & Zinc ore.

metals & ores ...

Miscellaneous alloys,

++ I

+++

Soyabean oil

1 Teaseed oil

ILI

Graphite...

Oils & Fats:

Aniseed oil Camphor oil Cassia oil

Citronella oil Peppermint oil

Castor oil

Cottonseed oil Groundnut oil

Linseed oil

Mustard seed oil Rapeseed oil

Wood oil

Cylinder oil Diesel oil

126

J+

جن جن -1-

HAN

Fuel oil..

Gasoline

9 Motor oil

172

Paraffin oil

Transformer oil

Valve oil

Miscellaneous : ----

Drugs D.D.T.

Foodstuffs

Sulpha-drugs

138

Chemicals, dyestuffs etc. 501

141

1,841

264

498. The biochemical work, as shown in Table 58, again.

increased during the year.

Table 58

Biochemical Examinations,

Specimens received:

Bile

---

Blood

Cerebrospinal fluid

4,257

1,054

Gastric contents

1,908

Stools

Urine

218

Miscellaneous

100

7,608

Received from :-

Families Visiting Medical Officer

Harcourt Health Centre

Kowloon Hospital

1,359

173

Kwong Wah Hospital

Lai Chi Kok Hospital

191

Medical Post, Central Police Station ...

Mental Hospital

Nethersole Hospital

IIL

Private Practitioners

Queen Mary Hospital

Royal Naval Hospital

Ruttonjee Sanatorium

Sai Ying Pun Hospital ...

Tsan Yuk Hospital ...

185

LLI

-- J

5,143

Tung Wah Hospital

Tung Wah Eastern Hospital...

Violet Peel Health Centre

221

266

7,608

499. Other Departments of Government made considerable use of the facilities provided by the Laboratory, as shown in Table 59. The large number of items submitted by the Fire Brigade is in connexion with the Dangerous Goods Ordinance. The land storage of these commodities requires continual supervision. Samples of coal shipments to the Colony were received from the Supplies Branch of the Department of Commerce & Industry.

174

Table 59

Miscellaneous Samples from Government Departments.

Samples from:

Agricultural Office

Controller of Stores:-

Controller of Stores

Sand Monopoly Office

Co-operative & Marketing Department:

Marketing Section ...

District Commissioner, New Territories

156

Kowloon Canton Railway

Fire Brigade

Labour Department:

Superintendent of Mines

Marine Department:

Government Slipway.... Marine Department

Medical Department

Public Works Department:

Architectual Office

TII

- JL

Crown Lands & Surveys Office

Drainage Office

Port Works Office

00 - 10

+++

256

Coal samples from Department of Commerce

& Industry, Supplies Branch

175

500. Table 60 shows the considerable development of work already referred to under this heading.

Table 60

Analytical work under Dangerous Drugs Ordinance, Dutiable Commodities Ordinance and Importation/Exportation (Prohibition) (Specified Articles) Orders.

(a) Dangerous Drugs Ordinance.

Illicit possession, etc.

Certificates of Contents issued

1,436

(b) Dutiable Commodities Ordinance.

Certificates of Contents issued

(a) Illicit possession, Smuggling, etc.

(b) Examination for duty assessment and export

on drawback.

1,164

Samples examined:

Cigarettes

884

Paint

438

Beer

125

Brandy, Port, Whisky, Gin & Liqueur

126

Chinese Liquor

672

Perfume

---

■TI

1,237

Table Water

Denaturation of Alcohol

Miscellaneous

(Specified Articles) Orders, 1951 Certificates of Contents issued

176

· +

129

ILJ

6,400

Equipment.

501. The Laboratory is now well equipped, and the equipment has been maintained in good condition where practicable.

General.

502. The somewhat bare recital of figures upon which a report of this nature must necessarily rely, gives an inadequate picture of the work of the Laboratory as a whole. In addition to the figures quoted, which for the most part refer to actual samples, the Laboratory is in continual demand, from both Government and private sources, for technical advice and assistance. Recent controls on trading in particular have greatly increased the work and responsibilities of the sub- departments.

MEDICO-LEGAL DEPARTMENT

　　　　503. The Medico-legal work continued under the direction of the Police Surgeon, and consisted of forensic work, laboratory work, lectures and demonstrations to police officers and medical students.

504. The work done consisted of the following:

(a) Examination of victims and suspects totals

(b) Attendance at scenes of crimes totals...

(d) Medico-legal Post Mortems:

91 cases

135

144

1. Hong Kong

2. Kowloon ...

177

(e) Assisting in raids on:

1. Unregistered Medical Practitioners, and

abortionists

2. Illegal sale and possession of poisons

3. Illegal sale and possession of penicillin

substances

...

4. Manufacture of fake medicines

(f) Examination of weapons including daggers,

knives, axes, etc.

(g) Examination of articles including beddings,

furniture, linen, etc. totals ...

(h) Examination of hairs and fibres totals

+-+

511

(4) Examination of clothing connected with crimes 533

(j) Examination of Powder-marks in shooting cases

(k) Medico-legal Blood-grouping

724

(1) Blood-grouping of Police Personnel

951

+17

(m) Examination of motor vehicles in accidents

(n) Examination of counterfeit coins.

RADIOLOGICAL

505. The work in the X-ray Department continued to increase, as was only to be expected, in view of the great increase in in-patient and out-patient demands on the medical service.

506. The work of the Radiological Department may be divided into the following sections:

178

Radiodiagnostic.

507. The total number of X-ray investigations carried out was 157,552, which was an increase of 54 per cent over that of the preceding year. This was due to the opening of the Kowloon Tuberculosis Clinic and the Evening Clinics, the increased attendance at the Government out-patient clinics in general, the expansion of the School Health Service, the working of the Mobile Mass Radiography Unit given by the United Nations International Children's Emergency Fund, the examination of Essential Services' Personnel and, lastly but not the least, to the greater realization of the medical profession and the general public of the value of X-ray examinations in the diagnosis of diseases.

508. In connexion with these investigations 103,277 minia- ture films and 87,829 large ones, (films and X-ray papers) of various sizes were used.

Radiotherapeutic.

509. The total number of cases treated was 259. Of these 183 were treated by deep X-rays, 56 by superficial X-rays and 20 by radiocobalt or radium. This represents an increase of 85

per cent over that of the preceding year.

Physiotherapeutic.

　　　　510. This section extended its activities in the Lai Chi Kok and the Mental Hospitals and widened the scope of occupational therapy available in the Colony.

　　　　511. In all 5,486 persons of which 781 were in-patients and 4,705 out-patients, were given 47,557 treatments.

179

Training.

512. On the radiodiagnostic side 8 probationer radiographic assistants, and on the physiotherapeutic side 5 probationer assistant physiotherapists, were being trained.

BLOOD TRANSFUSION

513. The blood bank is centralized on the Queen Mary Hospital and obtains blood from voluntary donors. During the year, 988 transfusions were given, every effort being made when a patient needed a transfusion to get a relative as a donor.

514. The department prepares its own receiving bottles for use and these have proved very satisfactory, allowing blood to be kept in refrigerators up to one month after being taken from a donor.

515. Plans are in hand for an extension of the service during the next year to Kowloon Hospital, and for the assistance of the British Red Cross Society (local branch) to help in the obtaining of donors and blood.

BIRTHS AND DEATHS REGISTRATION

516. The legislation for the registration of births and deaths is provided by the Births and Deaths Registration Ordinance which is under the control of the Director of Medical and Health Services who is the Registrar of the Births and Deaths. There is a central registry and a number of branch registries in different parts of the Colony and New Territories.

517. The volume of work done during the year has considerably increased in comparison with the preceding year, due mainly to the increase in applications for birth certificates. 46,616 birth certificates were issued in 1951 as against 17,334 in 1950.

180

　　　　518. Micro-filming of birth and death registers for all years prior to 1951 was completed during the year. A total of 619 birth registers and 621 death registers were micro-filmed and the films forwarded to the Colonial Office for safe custody.

STEWARD. (INCLUDING TRANSPORT AND

AMBULANCE SERVICES)

　　　　519. The provision situation relative to equipment has again become difficult. There has been some considerable delay in supply of certain items from the United Kingdom, particularly enamelware. Attempts have been made to interest the local enamelware industry in the supply of surgical enamelware but with little success. It has also been found that the quality of some of the local enamelware bears poor comparison with that obtained from Europe. Attempts were made to replace enamel- ware with stainless steelware in operating theatres, but the supply of these items was frustrated by certain regulations being promulgated in the United Kingdom forbidding the further use of this strategic material for the manufacture of such items. The principle of make and mend, so successfully adopted since the Liberation is still being applied with much saving of public money. Every possible piece of equipment which, on becoming unserviceable, can be cannibalized is so dealt with and the resultant pieces used for the manufacture of serviceable items. The maintenance staff has performed invaluable work in this connexion and has made a large number of items of equipment as well as repairing many hundreds of items of furniture and equipment. The fitter section of the maintenance staff has also assisted in the rehabilitation of the steam installation at the Queen Mary Hospital, most of which had of necessity to be done between midnight and dawn of many nights. This staff is a great asset to the Department and has saved a considerable amount of public money.

181

520. The transport situation within the Department is still very difficult by reason of the considerable demands made upon it. The situation has been further complicated by the arrival of two large X-ray vans which constitute a Mobile X-ray Unit presented by U.N.I.C.E.F.

521. The Ambulance Service has dealt during the period under review with 26,085 calls, has carried 27,907 patients and has covered 16,128 miles. No new ambulances were made available during the year, the work having to be continued with the ambulances supplied in 1948 (six in number) and the War Department ambulances made available during the Military Administration.

VI. TRAINING OF MEDICAL & HEALTH

Doctors.

PERSONNEL

522. The Hong Kong University trains medical students and its degree is recognized by the General Medical Council, United Kingdom,

Nurses & Dressers.

523. The Government trains nurses (female and male) up to British standards, the local diploma being recognized by the General Nursing Council. Suitable local nurses, after necessary experience, can be appointed as nursing sisters.

Midwives.

524. Full midwifery courses are supplied both in Government and in other hospitals. The local qualification is not recognized outside the Colony.

182

Almoners.

525. The department trains local girls as almoners but they cannot yet obtain reciprocity with Great Britain.

527. Dispensers,

Radiographic Assistants

Asst. Physiotherapists.

The department trains young men and women for these posts, but the local diploma is not recognized elsewhere.

Laboratory Assistants.

Tuberculosis Workers.

　　　　528. Young ladies of secondary school leaving standard are trained in home visiting, health work etc. After a year's course they are transferred to work under the Tuberculosis Specialist.

529. The following table shows the technical groups that have received training during the years:

Probationer Assistant

Physiotherapist

Probationer Radiographic

Assistant

Probationer Dispenser

Assistant

Probationer Laboratory

Probationer Assistant Almoner

Probationer Nurse

Probationer Dresser

Pupil Midwife

Table 61

Appoint- Resigna- Strength

ment

tion

at 31.3.52.

Passed

}

-------

183

Health Inspectors.

530. The Royal Sanitary Institute is represented in Hong Kong by a local Examination Board with the Director of Medical & Health Services as Chairman. Local examinations for the various certificates are set by this body, and certificates granted after approval by the Royal Sanitary Institute of England. Teaching and training is carried out by selected personnel from the Sanitary Department, Health Officers of the Medical Department, and Officers of the Public Works Department.

K. C. YEO,

Director of Medical & Health Services.

184

185

OCCUPATIONAL THERAPY FUND

Statement of Receipts and Payments for the year ending 31st March, 1951

To Donations

Receipts

Description

Amount

Payments

Description

1,007.50 By Purchasing tools, rattans and

Amount

materials

236.90

To Proceeds from sale of finished rattan-

ware

365.70 | By Payment of grant to a patient for acting as rattan instructor at $150.00

per month, six months

900.00

...

By Balance carried forward

236.30

יי+

1,373.20

Confirmed

Sd. W. R. N. ANDREWS, Appointed Auditor, 18th May, 1951

Certified correct,

Sd. K. C. YEO,

p. Director of Medical & Health Services.

186

SAMARITAN FUND

Statement of Receipts and Payments for the year ending 31st March, 1951

Receipts

Description

To Balance transferred from

Bank account to Treasury aç- count

гг.

- 1

To Donations:

Dept, of Veterans Affairs, Canada for Miss V. Buckler, patient in Mental Hospital

Command Paymaster for Mrs. B. Bacon, patient in

$623.68

Mental

Treasury

Hospital

$214.63

for Mrs. Lt

Transley, patient in Mental

Hospital

LJL

...

$270.00

Jewish Benevolent Society

Amount

Payments

Description

3,430.63

By Providing clothing, food, sweets and maintenance grants etc. to hospital patients

...

By Loan to patients

By Balance carried forward

for Mrs. M. Weinberger,

patient in Mental Hospital $270.00

Hong Kong Jockey Club Other sources

To Repayment of loan from

$2,500.00

$273.20

4,151.51

the fund

TII

490.00

8,072.14

Confirmed

Sd. W. R. N. ANDREWS,

Appointed Auditor,

18th May, 1951

Amount

$ #

1,570.65

295.00

6,206.49

Certified correct,

Sd. K. C. Y50,

p. Director of Medical &

Heatlh Services.

8,072.14

187

NURSES REWARDS AND FINES FUND

Statement of Receipts and Payments for the year ending 31st March, 1951

Receipts

Description

To Balance brought forward

To Forfeiture of deposit from Miss Lena

Bebe Cheung

ITI

...

Amount

Payments

Description

Amount

1.821.15 By Balance carried forward

2.021.15

200.00

2,021.15

Confirmed

Sd. W. R. N. ANDREWS, Appointed Auditor, 18th May, 1951

Certified correct,

Sd. K. C. YEO,

p. Director of Medical & Heatlh Services.

188

OCCUPATIONAL THERAPY FUND

Statement of Receipts and Payments for the year ending 31st March, 1952

Receipts

Description

Payments

Amount

$ f

To Balance brought forward

--1

...

236.30 By Purchasing materials

tools,

IJL

JLI

- JL

---

rattans and

4.00

To Donations

TII

r. I

...

6,200.00

To Proceeds from sale of finished rattan articles

2,770.00

By An advance to British Red Cross Society to purchase materials for open- ing Occupational Therapy class

100.00

By payment of Salary to Leung Ming for acting as rattan instructor to scheme

...

1 гг

3,000.00

By Balance carried forward

6,102.30

9,206.30

Examined.

Sd. P. H. JENNINGS, Director of Audit.

7th November, 1952.

Certified correct,

Sd. UJAGAR SINGH p. Director of Medical & Heatlh Services.

* Red Cross Society failed to produce bills for the payment of materials purchased before the end of the financial year, hence the sum of $100 was shown as an advance to them. This has been adjusted in this year's account.

189

SAMARITAN FUND

Statement of Receipts and Payments for the year ending 31st March, 1952

Receipts

Description

Amount

To Balance brought forward

...

Payments

Description

6,206.49 By Providing clothing, food, sweets and maintenance grants, etc. to hospital patients

To Donations

11,489.84

To China Motor Bus Co. Ltd. compensa- tion for patient, Yeung Kan To Repayment of Loan by the patients

By Loan to patients

3,000.00

ITI

300.00

20,996.33

By Compensation for injury to Yeung Kan from China Motor Bus Co., Ltd. By Adjustment of incorrect credit of Medical Fees to Samaritan Fund By Balance carried forward

- J-

Amount

5.338.10

475.00

3,000.00

46.50

12.136.73

20.996.33

Examined.

Sd. P. H. JENNINGS, Director of Audit. 29th November, 1952.

Certified correct,

Sd. UJAGAR SINGH p. Director of Medical & Health Services.

190

NURSES REWARDS AND FINES FUND

Statement of Receipts and Payments for the year ending 31st March, 1952

Receipts

Description

Amount

Payments

Description

Amount

---

2.021.15

By purchase prizes, certificate & tea etc. 792.75

By purchase books as prizes to dressers

200.00

nurses

TII

...

- - -

· ·r

105.33

By Balance carried forward

1,323.07

To Balance brought forward

To Forfeiture of deposit from Miss

Maria Li

TII

- - -

2,221.15

Examined.

Sd. P. H. JENNINGS, Director of Audit.

27th August, 1952.

Certified correct.

Sd. UJAGAR Singh

p. Director of Medical & Heatlh Services.

191

GULARY OF HONG KONG,

MEDICAL TAGIHITI,

* EtipƐnuary

1951.

Conti.

Peak

Sap Hul

Dispensary

NEW TERRITORIES MEDICAL FACILITIES.

TEMATIKANA.

Sheung Shul

Lak Ma Chau

Lapey

Kan tia

$ilyar Hine Bay,

Cheung Sh

fig Diapsssary Two Ling

Maternity Home

Jene

pital

BNG KONG

( See separate map

D12

192

HONG KONG 1SLANG

MEDICAL PACILITIES

31. John)

Health

"Propita 1

Inoculation Centre.

Yuk

Ital,

TAL

$1-

Hospital.

Hospit Mental

Hospital.

Ketheranla Kraplial,

Harcourt Health Centre.

• St. Paul'a Kapten).

* Kuttanjaa Samatörlum.

'* Taschal 9.X. Hoapital. p 55. Prancia

Hospital, Hompitul.

HONG

a H.T. Sama tartun 4 Reapital.

Saturn Supernary Haternity Hospital.

* Military Holpitel.

* Kaval Hapital.

o Tung Tan Katern Happ) (0.

KONG

* Matilde descital

Aberdeen

193

KOWLOON PENINSULA MEDICAL FACILITIES.

• Penale Prison Papital

* Tai Chi Kok Hospit

o Military #aplual

a St.

o Ko-logh Jupital & Out-patient Debrtment

Precious Mood

Tapitel

a Kowlgory/Tuberculosta oliuže

Sama Shul Apo Public Diapeteary

o Hongkok Clinio

o Kuong bah Hospital

How Public Dispensary

T:L. SC Tadi Health Centra

Hospital

17 2

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