醫務衛生署年報 Medical and Health Department Annual Report 1953-1954

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ANNUAL

DEPARTMENTAL

REPORTS

1953-54

ARY

LIBRARY

TITUTE

THE

DIRECTOR OF MEDICAL

AND

HEALTH SERVICES

22501293409

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

FOR THE

FINANCIAL YEAR 1953-54

SANITAR

LIBRARY

ROY,

TUTE

PRINTED AND PUBLISHED BY THE GOVERNMENT PRINTER.

HÃNG HONG.

WELLCOML INSTITUTE

Ceri

mec

Ca An

n Rup

No.

WA28

•THE

หาา

1954

CONTENTS

Paragraph Number

. . . I

12 18

20 - 26

1. GENERAL

Introduction

Personnel

г. г

Expenditure on Medical Services

Legislation

Registered Medical and Dental Practi-

tioners etc.

II. VITAL STATISTICS

Population

Births

Deaths

Infant Mortality

Maternal Mortality

Principal Causes of Death

III. PUBLIC HEALTH

Hygiene & Sanitation

Rural Health

Communicable Diseases

Port Health Administration

Social Hygiene

Maternal and Child Health School Health

....

Malaria and Mosquito Control

Tuberculosis Control

29 - 31

35 38

39 40

41 - 52

53 58

59 82

101

י.

102 116

117 124

■

125 - 129

130 174

CONTENTS-Contd.

IV. HOSPITALS

Introduction

Government Hospitals Queen Mary Hospital

Kowloon Hospital

St. John Hospital, Cheung Chau

Tsan Yuk Hospital

Eastern Maternity Hospital

Sai Ying Pun Hospital

Lai Chi Kok Hospital

г.

Paragraph Number

175

176

177 - 184

185 190

191 194

195 - 199

200 - 201

L · LI

202 - 205

206 - 210

Wanchai Social Hygiene Hospital

Mental Hospital

Stanley Prison Hospital

Lai Chi Kok Female Prison Hospital

Government Assisted Hospitals

Tung Wah Group of Hospitals

J + + L

Alice Ho Miu Ling Nethersole Hospital

Ruttonjee Sanatorium Pok Oi Hospital

г.

V. GENERAL OUT-PATIENT SERVICES

Urban Areas

New Territories

VI. AUXILIARY MEDICAL SERVICE

VII. SPECIAL SUB-DEPARTMENTS

Dental

Pharmaceutical

➖ ➖➖ ➖

Pathological including Mortuaries

211

212 - 215

216 224

225

226

227 - 230

231

232 - 233

234 - 235

236

237 250

251 - 253

■

254 - 258

259 - 265

266 271

272 - 274

CONTENTS-Contd.

VII. SPECIAL SUB-DEPARTMENTS-Contd.

Chemical Laboratory

Almoners

LLJ

Radiological

Ambulance Service

· r

Births & Deaths Registration

VIII. INTERNATIONAL ORGANIZATIONS

IX. TRAINING OF PERSONNEL

X. ACCOUNTS

T 7 -

Paragraph Number

275

281

282 287

288 - 294

295

296 297

298 - 299

300

XI. MAPS

Occupational Therapy Fund

Samaritan Fund

Nurses Rewards and Fines Fund

XII. APPENDICES 1 18

iii

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Introduction,

I. GENERAL

　　　　1. During the year under review the administrative staff of the Department were much preoccupied with planning problems and devoted much time to the planning of such major projects as a new 1200 bed hospital to be erected in Kowloon and a 500 bed mental hospital to be erected in the New Territories. Planning of other projects of lesser magnitude such as health centres for the New Territories was also undertaken and by the close of the year considerable progress had been made.

　　　　2. The only major addition to departmental buildings was the completion of a large clinical building in the Wanchai district of Victoria to house the headquarters of the Tuberculosis Service together with a large tuberculosis clinic with attendant radio- logical facilities and also the dental and physiotherapy sub- departments. The building was completed just before the end of the year and, in fact, the services it houses were put into operation from the 1st April, 1954.

3. There was no slackening in the work of the Department and, as was mentioned in the previous report, all sections continued to work under considerable pressure, Hospital admis- sions and clinic attendances again showed a general increase and accommodation in practically all cases was insufficient. Shortage of hospital beds continued to cause concern and substantial waiting lists were maintained not only for general beds but also for the specialities. In the maternity hospitals, and the maternity wards of the general hospitals, the shortage of accommodation continued to be a problem. It was only possible to retain patients in the available maternity beds for an average period of three days.

　　　　4. The major problem of tuberculosis remained and the work of the tuberculosis service continued to increase throughout the year. As is mentioned later in this report the number of

beds available in the Colony for the treatment of tuberculosis is insufficient and the tuberculosis service had to resort to out-patient treatment by means of chemotherapy on as large a scale as possible. This service did excellent work but it is felt that it is as yet merely touching the fringe of the problem.

5. No substantial improvement was effected in general environmental sanitation and it was therefore to be expected that enteric fever and the dysenteries were very prevalent. Indeed the incidence of enteric fever was higher than in any previous year and the infectious disease hospitals were barely capable of dealing with the situation. Diphtheria too, was very common in the early months of the year but although the total number of cases recorded was greater than in 1952, there was a reduction in incidence in the latter part of the year perhaps, in part, on account of the mass immunisation campaign carried out during the first quarter. Immunisation against enteric fever has also been actively pursued particularly in organized groups such as school children and employees of large firms, but the response of the general public was not nearly so good as it was for other immunisation campaigns.

6. There was no visitation of major quarantinable diseases and the Colony has remained relatively free from these for a number of years. The last outbreak of cholera occurred seven years ago and there has been no major outbreak of smallpox since 1947.

7. There was a further rise in the birth rate to 33.6 per thousand as compared with 32.0 per thousand in the previous year. The total number of births was 75,544. Deaths numbered 18,300 or 8.1 per thousand which is unusally low and is partly due to the influx of young adults since the end of the war which has given the Colony's population an abnormal age distribution.

8. The maternal mortality rate was 0.97 per thousand births as compared with 1.14 per thousand births in 1952 and 1.59 and 1.7 in 1951 and 1950 respectively. There was a further drop in the infant mortality rate from 77.1 per thousand live births in 1952 to 73.6, thus continuing the steady downward trend

from 1947 when the infant mortality rate was 102.3 per thousand live births. The low infant mortality rate for the year under review can partly be attributed to the fact that 97.5% of all births were attended either by a registered midwife or a medical practitioner.

　　　　9. The building up of an Auxiliary Medical Service to operate in emergencies continued to be a major preoccupation and a satisfactory stage of progress was achieved by the close of the year.

　　　　10. On Christmas night the Colony experienced the worst fire in its history in a squatter area. About 55,000 persons were rendered homeless. Two persons lost their lives and a considerable number received injuries which needed treatment. Government agencies and voluntary organizations provided immediate relief for the homeless and the Medical Department amongst other measures set up two temporary dispensaries to serve the fire victims. By the end of the year up to 200 cases daily were being dealt with. A temporary maternity hospital was also set up in tents and a maternal and child health centre was set up.

　　　　11. Amongst persons visiting the Colony during the year Dr. A. M. Wilson-Rae, Deputy Chief Medical Officer, Colonial Office, and Dr. Marcolino G. Candau, the Director General of the World Health Organization were of particular importance to the Medical Department.

Personnel.

12. The establishment of the Medical Department on 31st March, 1953 is shown in Appendix 1. There are in the Colony many medical men who are refugees from China but whose qualifications do not permit them to be registered under the Medical Registration Ordinance, they cannot engage in private practice but they can be employed by Government. This reserve of professionals was of great value and the Department could not have met its commitments without drawing upon it. The total number of doctors employed at the end of the year, including house officers, was 220, and of these 126 were un- registered.

13. During the year an Ophthalmic Specialist joined the Department, and 2 medical officers were transferred here from other colonies.

　　14. A large number of expatriate and locally recruited nurses left the service and the loss of the latter in particular was regarded as a most serious matter.

　　15. Of 39 nurses graduating in 1951 and 1952, 28 imme- diately resigned from the Service on completing their training. In 1953 twenty-eight graduated and eleven resigned and it is clear that unless this wastage can be prevented it is going to be very difficult to provide the leavening of trained nurses which will be esential for staffing the proposed new Kowloon Hospital or to staff other departmental institutions which have been planned. To remedy this a revision of nurses' salaries has been recommended the effect of which will be to give a substantial increase in emoluments immediately a nurse qualifies. During the year eight local nurses were promoted to the nursing sister grade and there are now in the Department eighteen local nursing sisters and six local senior nursing sisters. For some years to come, at least, any nurse who remains in the Government service will have a very reasonable prospect of early promotion to nursing sister and it is hoped that this will, in itself, counter to some extent the present wastage.

　　16. In October, a Salaries Commission was set up to review the salaries of Government servants and proposals relating to the nursing service have been submitted to the Commission providing for special salary scales for public health nurses and those engaged in the mental hospital. Should they be accepted these proposals should reduce the difficulties experienced in the past in attracting nurses from the hospital service into public health and mental nursing, both of which service need to be developed.

17. It has been difficult to recruit physiotherapists from the United Kingdom during this year, and it is possible that conditions of service in Hong Kong may not be acceptable to the Chartered Society, but this question is under consideration at present and it is hoped that a satisfactory solution will soon be found.

18.

　　　　　　　The following local staff were sent to the United Kingdom for courses of study:-

1. Dr. Ho Hung Chiu, Senior

Radiologist.

2. Dr. P. H. Teng, Senior Port

Health Officer.

3. Dr. T. M. Teoh, Medical

Officer.

Dr. Lee Kuo Tai, Assistant

Dental Surgeon.

5. Miss Alice Chun, Nursing

Sister.

Miss Phyllis Wong, Nursing

Sister.

7. Miss Agnes Leigh Siron,

Nursing Sister.

Mr. Sham Hay, Laboratory

Assistant.

Course

Diploma of Medical Roentgen

Therapy.

Diploma in Public Health.

Forensic Medicine.

Oral Surgery.

Midwifery Tutor.

Paediatric Nursing.

Associate of the Institute of

Medical Laboratory Technology.

Expenditure on Medical Services.

19. The Medical Department's estimated expenditure for the financial year ending 31st March, 1954 was $23,860,262.00, but to obtain the true figure of Government expenditure on medical services to this should be added a further $5,580,100.00, payable to voluntary organizations in the Colony which provide hospital and public health services. These include the Anti- Tuberculosis Association, the Mission to Lepers Hong Kong Auxiliary and the Tung Wah Group of Hospitals which receives the main subvention of about $4,000,000 and in its three institu- tions provides 1,219 beds. Combined expenditure on account of the Medical Department and medical subventions is approxi- mately 9% of the Colony's total budget of expenditure.

Legislation.

20. The more important legislation concerning public health enacted or projected during 1953 is as follows:-

(a) The Undesirable Medical Advertisement Ordinance,

1952.

　　21. Although enacted in January, 1953 this Ordinance did not come into operation until 1st April, 1953. Its enactment resulted in a very considerable addition to the work of the Department as a flood of dubious proposed advertisements were submitted for opinion. This continued throughout the year but there is little doubt that the enactment of this Ordinance has had a decidedly beneficial effect in reducing the number of undesirable advertisements of medicines, and remedies purport- ing to cure, cancer, tuberculosis, venereal disease and other diseases. It was departmental policy not to prosecute imme- diately but to seek the co-operation of the Medicine Dealers' Guild and the local press and this was readily given but in future, serious offenders will be prosecuted.

(b) The Medical Registration (Amendment) (No. 2)

Ordinance, 1953.

　　22. Various minor amendments of the Medical Registration Ordinance were made and one major amendment. The latter resulted from the enactment of the Medical Registration Act of 1950 in the United Kingdom providing for compulsory hospital service of medical graduates before full registration. Before the United Kingdom enactment there was complete reciprocity of medical registration between the United Kingdom and Hong Kong and, to maintain this reciprocity, it was necessary to make provisions similar to those of the United Kingdom. The amend- ing ordinance became effective on 1st July, 1953 and after this date all medical graduates of the University of Hong Kong could only have their names placed upon the medical register of the Colony after having served in hospital in a resident medical capacity for twelve months.

　　23. Before the end of the year information was received from the General Medical Council that in view of this legislation, Hong Kong registration would continue to be accepted in the United Kingdom,

24. In view of the number of recent amendments to this ordinance and the fact that further amendments appeared

　　necessary it was decided to revise the whole Ordinance and the first draft of the new Ordinance had been prepared and was under consideration by Government and the Medical Board at the close of the year under review.

25. In order to regulate the import and use within the Colony of radio-active substances and radiating apparatus, legislation based upon a recently enacted New Zealand Ordinance is under consideration. This legislation is needed to give power of control over the considerable numbers of untrained or partly trained persons who are operating X-ray diagnostic equipment and, therapeutic equipment, and to check the importation of radio-active substances.

(d) Quarantine and Prevention of Diseases Ordinance.

26. The need to amend Part 2 of this Ordinance to meet the provisions of the International Sanitary Convention and the desirability of other changes affecting the public health and sanitation of the Colony in general led to a decision to re-enact this Ordinance as a whole and the first draft of a new Ordinance has been prepared and is at present under consideration.

Registered Medical and Dental Practitioners, etc.

　　　　27. Medical and dental practitioners together with phar- macists, nurses and midwives are required by Ordinance to be registered before practising their professions in the Colony. The Director of Medical and Health Services is the ex-officio chairman of the Boards constituted under the respective Ordinances.

　　　　28. The numbers of persons registered under these Ordin- ances are as follows:-

Registered Medical Practitioners Registered Dentists

Registered Pharmacists

Registered Nurses (female)

Registered Nurses (male)

Registered Midwives

433

331

752

783

The figures exclude persons in Government service who are listed

in Appendix 1.

II. VITAL STATISTICS

(N.B. All statistics in this report are in respect

Population.

of the calendar year 1953).

29. The estimated population of the Colony in June, 1953 was 2,250,000 but this figure is only an approximation for there has not been a population census since 1931 and there have been great fluctuations since then due to the war and political changes in China.

30. More than 90% of the population is Chinese, and most of those are Cantonese, although there are large numbers of persons from Shanghai and North China. The European and American element is about 14,500, and there are smaller groups of Indians and other Asian nationals.

31. It is estimated that approximately one million persons live on Hong Kong Island about the same number in Kowloon and the remainder in the New Territories.

Births.

32. The number of births registered during the year was 75,544 as compared with 71,976 in the previous year. In view of the uncertainty of the population figures calculated birth rates can only be estimates of very doubtful accuracy. Never- theless, on the figures available the birth rate for 1953 was 33.6 per thousand, a slight increase in the rate of 32 per thousand calculated for 1952. Of the total births registered, 73,637, or 97.5,% were attended by a midwife or doctor. Details of attended births are shown in Appendix 2.

Deaths.

33. There was a drop in the number of deaths registered, from 19,459 during 1952, to 18,300 and a corresponding reduc- tion in the death rate from 8.6 per thousand to 8.1 per thousand.

Infant Mortality.

　　　34. Deaths of infants under one year of age numbered 5,560. This was slightly higher than in the previous year but in view of the greater number of births registered during the year there was a further drop in the infant mortality rate to 73.6 per thousand live births as compared with 77.1 per thousand live births in the previous year. In 1952 deaths of infants under one year constituted 28.5% of the total deaths whereas in 1953 they constituted 30.4% of total deaths.

　　　35. The following Table gives infant and neo-natal deaths and the neo-natal death rate per thousand live births for the year 1952 and 1953:-

TABLE 1

Neo-natal Mortality Rate

Age Period

0-1 day

1-7 days

1-4 weeks

4 weeks-3 months

3-6 months.......

6-9 months..

1952

1953

282

278

735

++TIT

795

873

875

1,001

1,115

ITIIT-IT

874

823

935

879

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

-----

846

795

9-12 moutha

Total under 1 year...

Infant Mortality rate...

5,546

5,560

77.1

73.6

No. of deaths under 4 week.

1,890

1,948

Neo-natal Mortality rate

26.3

25.0

Maternal Mortality.

36. For the first time the Colony's recorded maternal mortality rate was less than 1 per thousand live and still births. The actual rate was 0.97 which represents a drop of 0.17 from the previous year.

37. In the following Table are set forth live and still births, maternal deaths and maternal mortality rates per thousand live and still births during the years 1951, 1952 and 1953.

TABLE 2

Total

Pregnancy and Child bearing

Abortion

Maternal Mortality Rate

Year

Live Still

Live and

Births Births!

Still Births

Rate No. of

per Deathal 1,000

Birtba

Rate No. of

per Deaths 1,000

Rate

No. of

per

Deaths

1,000

Births

Birthe

1951

68,500 || 1,180 | 69,680

109 1-56

0.03

111

1.59

1952

71,976 1,157 73,133

80: 1.09

0.05

1.14

1953

75,544 1,158 76,702

0.96

0.01

0.97

38. The following Table shows deaths from toxaemias of pregnancy during the year under review and the two previous years:-

TABLE 3

Deaths from

Total Births

Death rate

Year

Toxaemias of (including

Pregnancy still-births)

per thousand

1951

! 69,680

0.5

1952

73,133

0.3

1953

76,702

0.3

Principal Causes of Death.

39. The principal causes of death during the year and in the previous year are shown in the following Table:-

TABLE 4

Number of Deaths

Causes of death

1952

1953

Malignant neoplasms...

807

952

Gastro-enteritis aud colitis

2,940

2,649

Pneumonia (all forms)

Premature births.

Tuberculosis of respiratory system

---------

Tuberculosis (other forms)

4,249

3,696

906

876

2,461

1,974

1,112

965

40. Further statistics relating to infectious diseases are set out in Appendices 3 and 4.

III. PUBLIC HEALTH

Hygiene and Sanitation.

41. The conditions of overcrowding in the Colony are well-known and have been referred to frequently in the past. The insanitary environmental circumstances resulting from overcrowding and the unhygienic conditions existing in the squatter areas continued to present public health staff with problems which were almost insoluble. This state of affairs was reflected in the pattern of disease incidence and, as stated elsewhere in this report, it is not surprising that enteric fever and the dysenteries were very common. The sanitary inspectors in the Urban areas, under the direction of the Urban Council, tackled these problems with vigour and achieved as much as was humanly possible. Much attention was paid to the supervision of the manufacture, preparation and sale of food, not only in established premises but in the many illicit restaurants and food shops operating in the squatter areas.

42. Refuse and night soil removal services in the urban areas operated satisfactorily.

43. In the New Territories, there was less overcrowding than in the city, but sanitary services were not entirely satis- factory, particularly in the towns which in recent years, have outgrown the sanitary services originally provided for them. Mechanization of the sanitary services in the New Territories is long overdue.

Housing.

44. Living accommodation in the Colony continued to be scarce and much of the accommodation available is unsatisfactory and unhygienic. During the year there was much new building but much of it was of expensive housing which did not meet the pressing needs of persons in the lower income groups. Nevertheless some progress was made by the Hong Kong Housing Society which erected a number of flats to accommodate families with low incomes and steady progress was made in the resettlement of squatters.

Squatters.

45. As was mentioned in the last annual report unauthorized occupants of vacant Crown and privately owned land are to be found almost everywhere in the Colony, living in the most insanitary conditions and constituting one of the Colony's greatest public health and administrative problems. These squatters were resettled slowly but steadily throughout the year and this work, in the early months of 1954, was speeded up by the disastrous fire in a major squatter area on Christmas night.

46. The squatter population is estimated to be 350,000 and up to the end of 1953 the total number of these moved to approved resettlement areas was approximately 45,000.

47. The Colony is experiencing an enconomic recession and fewer persons are now being able to buy outright the permanent resettlement houses described in the last report, or even acquire

　them by hire purchase and when an area has been cleared of squatters many take to sleeping in the streets or on stairways and roof-tops and live in most insanitary conditions. Resettle- ment areas close to the built-up areas of the city were fully occupied and one large area on the mainland, which was avail- able for resettlement and capable of accommodating more than 100,000 persons, proved unattractive to potential settlers on account of its distance from the city and places of employment, Efforts were made to establish factories in this area in order to provide local employment for the settlers but little progress was achieved.

　　　48. One of the greatest dangers in the squatter areas is fire. The buildings are mere shacks constructed of wood, canvas and even oiled paper and they are placed so close together that an outbreak of fire is very liable to devastate a considerable area. During the year six fires occurred in squatter areas, all but one of them were small but nevertheless caused much distress and suffering. On Christmas night the most disastrous fire in the history of the Colony devastated a large squatter area in Kowloon. Four villages were completely destroyed and some 55,000 persons were rendered homeless. Terrible though this event was, the area was among the most insanitary in the Colony and its cleansing and removal by fire can only lead to improved sanitary conditions.

　　　49. While steps were taken immediately to distribute free food and clothing and provide medical attention, measures were at the same time adopted to prevent the re-erection of huts in the devastated area. Government announced its intention to re-enter the land, to clear it and level it. This work was started immediately with the erection of lines of two storied cement- block houses. The homeless are being allocated these at a nominal monthly rental as they become ready for occupation. In this way it is hoped to provide safe housing of a minimum standard for some 35,000 to 40,000 persons. Those who cannot be accommodated in this area will be provided with similar facilities elsewhere in resettlement areas.

50. Of the 55,000 persons rendered homeless by this disas- trous fire some 20,000 settled down on the pavements under the verandahs of nearby shops and erected temporary shelters of paper, canvas, and any other materials they could obtain. This created a very serious public health problem which was energetically tackled by the Urban Services Department, which provided for these people temporary ablution and sanitary services and, in addition, successfully carried the seriously increased burden of maintaining a measure of cleanliness in the streets affected. People living in the streets are being given priority in rehousing and up to the end of the year under review 9,438 persons had been cleared from the streets and rehoused in the new lines erected on the scene of the fire.

Water Supplies.

51. The amount of water supplied to the urban area was still quite inadequate, and as in previous years only an inter- rupted supply was available. Considerable anxiety was felt in the early part of the year because the rainfall was below normal and the reservoirs were slow to fill, for a serious water shortage would be a serious matter indeed now that the alternative supplies are no longer available. Fortunately adequate rains eventually filled the reservoirs and a normal water supply was available throughout the remainder of the year.

52. Construction work on the new Tai Lam Chung Reservoir in the New Territories continued but the work will not be completed for several years and until then the city will not have an adequate water supply.

Rural Health

53. The population of the New Territories is, in genera), so dispersed as to make the provision of health services difficult. Nevertheless there are 2 townships having populations of nearly 50,000 and, with the increasing growth of industry in recent years, substantial urban development has taken place. The total area of the New Territories including numerous islands, is 355 square miles and to provide health and curative services

to the population the Medical Officer of Health has a staff of 5 medical officers, a senior health inspector, 5 health inspectors, 8 nurses, 8 midwives, 2 dressers, a beach overseer and 4 clerical assistants. In addition he has available 86 scavenging coolies who work in the townships.

　　　　54. The medical staff is mainly concerned with curing illness and has little time to devote to preventive medicine. Nevertheless vigorous immunization campaigns against diph- theria, typhoid and smallpox were carried out during the year.

　　　　55. At the 9 dispensaries in the New Territories there is provision for the in-patient care of maternity cases and during the year a definite advance was made with the assistance of staff paying periodic visits from the urban areas in providing, from these centres, ante-natal and post-natal services. In addition social hygiene, dental and ophthalmic services were provided on a limited scale with the help of visiting staff from the urban area.

56. During the year works affecting public health were carried out in various towns and villages. These included a new drainage system in one of the larger towns, public latrines in several villages and a new market on one of the islands. In addition the first two slaughter houses in the New Territories were privately erected.

57. At the close of the year under review a new health centre, in the industrial township of Tsun Wan, was nearing completion. This is the first health centre to be erected in the New Territories and it is hoped that it will serve as a pattern for other similar institutions which it is planned to provide in the New Territories in the future. This health centre will provide not only general out-patient services but also facilities for the in-patient care of maternity cases and other personal health services.

58. Conservancy and refuse removal services in the New Territories leave much to be desired, but plans for improving them are under consideration.

Communicable Diseases

59. There was a decrease in the number of notifications of communicable diseases to 17,319 as compared with 19,938 in the previous year. The decrease was largely due to the smaller number of cases of tuberculosis notified but there were also fewer recorded cases of pertussis, malaria and measles. There were, however, nearly twice as many notifications of intestinal diseases, mainly bacillary dysentery as in the previous year.

60. There was a substantial reduction in the number of deaths attributed to notifiable diseases, there being 3,348 in 1953 as compared with 4,060 in 1952. Of these deaths 2,939 (87.8%) were due to tuberculosis.

　61. More detailed comment on some of the important notifiable diseases is made below.

Enteric fever.

62. As already mentioned, the increase in this infection caused grave concern and the seriousness of the position can be seen from the figures below:

Year

1946

1947

1948

1949

---

1950

1951

1952

1953

-----------ut

Cases

Deaths

Case fatality rate

221

115

52%

246

24.8%

311

22.2%

408

21.8%

907

160

17.6%

1.024

134

13.1%

1,230

158

12.8%

1,434

128

8.9%

63. These figures leave little doubt that unless a radical change is effected in the circumstances at present prevailing in the Colony a further increase in incidence may be expected next year which may well necessitate special steps being taken, in the middle of the year when the peak incidence may be expected, to provide special hospital accommodation for these cases.

　　　　64. Public health staff concentrated on the supervision of food handling but the magnitude of this problem was such as to make it clear that it was necessary to resort to protective inoculation on a large scale. Special attention was paid to employees in restaurants and other establishments concerned with the handling of food. In addition, a mass inoculation campaign among school children was carried out by the School Health Service as there was clear evidence that the infection was occurring with greater frequency in the younger population age groups. Public response was not so good as it had been to other inoculation campaigns, possibly because two injections were necessary to give protection, and also, perhaps, because of the severe reaction liable to be experienced. Nevertheless, by the end of the year 91,346 persons had received protective inoculation.

65. All notified cases were treated in hospital, and chloramphenicol was the therapeutic agent generally used, with satisfactory results. The fatality rate, fell as can be seen in the figures above, and this can be attributed in part to earlier diagnosis and improved methods of treatment.

Dysenteries.

　　　　66. The number of cases of bacillary dysentery notified was practically double that of the previous year, the figure being 662 as compared with 336 in 1952. There was an increase, too, in the number of notified cases of amoebic dysentery, there being 285 notifications as compared with 201 in the previous twelve months.

Diphtheria.

67. This infection which has been increasing noticeably since 1949 continued to increase during 1953. The two infec- tious disease hospitals were under severe strain again at the season of peak incidence early in 1953 since all cases were hospitalized once the diagnosis had been established. The total number of cases notified was 1,116 and there were 133 deaths, giving a fatality rate of 11.91%. Cases and deaths in the previous year numbered 987 and 157.

68. Unfortunately too many cases still come under medical care only when the disease has gone so far that tracheotomy is necessary. Nevertheless the falling fatality rate is encouraging evidence that the value of medical services is appreciated.

69. In the first quarter of 1953 after intensive propaganda a vigorous immunization campaign was launched. The response was remarkably good, in fact so good as to embarrass the supply organization. At one stage supplies of toxoid ran out and had to be replenished by air lift from the United States of America, and the United Kingdom. The greater part of the toxoid for this campaign was supplied by the United Nations International Children's Emergency Fund. Children in the age range 6 months -10 years were offered protection. During the year 195,797 received the first injection of toxoid and the total number fully immunized was 154,377,

70. As the period of greatest incidence of this infection is during the colder months of the year, namely December, January and February, the immunization campaign was again intensified in the first quarter of 1954. During this period 82,146 first immunization doses were given and 30,159 second doses. The occurrence of cases in the first quarter of 1954 was very much less than in the corresponding quarter in 1953, there being 341 cases notified as compared with 507. This would suggest that the intensive immunization campaigns carried out in the first quarter of 1953 and the first quarter of 1954 were successful and it may well be that during 1954 incidence of this disease will fall.

Cerebro-spinal Meningitis.

71. This infection, so liable to become epidemic in conditions of overcrowding, showed only endemic incidence. Preventive measures cannot claim credit for this and there is the ever present possibility of the cases reaching epidemic proportions, particularly in the cold weather. In present circumstances there is no practicable way of countering this threat.

　　　　72. There were 12 cases and 5 deaths, exactly the same figures as in 1952.

Measles.

　　　　73. There was no major epidemic outbreak of this infection but the incidence was fairly high and, among the infectious diseases, it was a not unimportant cause of mortality. 661 cases were notified and 50 deaths were attributed measles, giving a case fatality rate of 7.6% as compared with 11.4% in the previous year. The majority of notified cases were treated in hospital. No specific preventive measures were taken against this infection.

Poliomyelitis.

74. The number of notifications of this infection during 1953 was 22 and there were 3 deaths as compared with 19 cases and 4 deaths in 1952. Of these, 17 were Chinese and 5 non- Chinese and they appeared to be unconnected.

　　　　75. During the first quarter of 1954 there was a sharp increase in incidence and 18 cases occurred with 3 deaths. Chinese cases numbered 4 and there were 14 non-Chinese. The majority of the latter were persons who had come to the Colony within the previous 12 months or so and, with few exceptions, were either children or young adults.

Rabies.

　　　　　76. Two human cases were recorded and on three occasions the infection was diagnosed in animals. This incidence is con- sidered not unsatisfactory, but stringent measures against the importation of dogs from the mainland and restrictions on the movement of dogs within the Colony were maintained. The arrangements for the protective inoculation of persons possibly exposed to the infection were modified as a result of the occur- rence cases of neuroparalysis following on anti-rabic treatment. This treatment is now given only when it is considered that the risk of infection is great.

Malaria.

　77. Notifications showed a decrease of 230 from 1,010 in 1952 to 780 in 1953. The number of deaths attributed to malaria was 46, the same as in the previous year. Approxi- mately 30% of the total cases were reported as being recur- rences of the infection.

Leprosy.

　78. The leprosarium on the island of Hay Ling Chau functioned very satisfactorily throughout the year and steady progress was made with the development of accommodation and of the island's resources. A very fine medical treatment centre was completed and formally opened towards the end of the period under review.

　79. At the beginning of the year the population of the settlement was 300, a figure which was increased to 350 at the end of the year.

However the settlement has not as yet com- pletely answered the Colony's leprosy problem as there are still considerable numbers of infectious lepers at large in the Colony. Many of these are attending out-patient clinics which are run specially for them but there is little doubt that these persons could be dealt with more satisfactorily in the settlement, and it is planned that as accommodation on Hay Ling Chau increases infectious cases will be transferred to the Island.

　80. The settlement which is operated by the Hong Kong Auxiliary of the China Mission to Lepers is a most useful addition to the Colony's medical facilities. During the year the Mission received a subvention from Government amounting to $250,000 towards recurrent costs of the institution and, in addition, a special grant of $200,000 was made towards the capital cost of the medical centre.

Tuberculosis.

　81. During the year there were 11,900 notifications and 2,939 deaths from all forms of tuberculosis. These figures are substantially less than those of the previous year when 14,821

cases with 3,573 deaths were reported. The case fatality rate for the year was 24.7% as compared with 24.1% in 1952 and 30.2% in 1951.

82. In the following Table are set forth details of the six leading causes of death from communicable diseases:

TABLE 5

Cases

Diseases

Total

Deaths

Fatality

rate

Chinese Non-Chinese

1. Tuberenlosis

2. Enteric fever

11854

11900

2039

24.70%

1413

1434

128

8.93%

3. Diphtherio

1100

1116

133

11.92%

...

4. Meadles

5. Malaria

6. Bac. Dysentery

507

154

661

7.56%

730

780

5.90%

594

661

3.78%

Port Health Administration

　　　　83. The Senior Port Health Officer is responsible for health control in the harbour and at the airport and, to assist him, he has a staff consisting of 2 Health Officers, 5 Assistant Health Officers, 1 Senior Port Health Inspector, 2 Port Health Inspectors, 39 Public Vaccinators, and 1 Fumigator. This staff in addition, is responsible for the quarantine control measures at the land frontier with China where the Kowloon-Canton Railway crosses the international boundary. Further, an inoculation service is provided for persons requiring inter- national health travel documents and this staff also provides a general inoculation service to the population as a whole.

　　　　84. The work of this sub-department shows a general increase during the year as the number of vessels entering the port was somewhat larger than in the previous year and in consequence the numbers of passengers and crew dealt with were also greater. In addition, a substantially greater number of persons entered the Colony across its land frontier.

　85. The number of incoming vessels was 3,734 and the numbers of passengers and crew involved were 57,106 and 200,701 respectively. The corresponding figures for the previous year were 3,268 vessels, 44,710 passengers and 186,940

crew.

86. The number of persons entering the Colony by its land frontier in 1953 was 301,670 as compared with 163,695 in the previous year. Of those who entered 43,212 were vaccinated against smallpox.

　87. The inspection of unberthed deck passengers travelling as emigrants was carried out as in the past but there was a further decrease in the numbers dealt with. Emigrants during 1953 numbered 3,137 as compared with 5,276 in 1952 and 13,487 in 1951. Immigration restrictions imposed by other countries and the lessened demand for contracted labour are factors con- tributing to the decline in the emigrant traffic from Hong Kong.

　88. At Kai Tak Airport passengers and crews of incoming aircraft were, medically inspected when necessary, and a further decrease in the number of passengers arriving by air was noted. Arrivals during 1953 numbered 15,372 as com- pared with 18,992 and 32,669 in the two previous years.

　89. Epidemiological intelligence was received regularly throughout the year from the intelligence station operated by W.H.O. in Singapore. Useful though this service is it does not fully meet the Colony's needs in view of the fact that informa- tion regarding disease occurrence on the Chinese mainland is not available. This important deficiency imposes a great responsibility on the Port Health staff as disease importation from China has not been infrequent in the past and for this known source of infection to be a terra incognita renders modern port health administration difficult indeed.

　90. Port health staff during the year carried out an interesting mosquito larval survey in small craft in the waters of the Colony. Mosquito breeding was found in 2.32% of the

craft examined and the predominant species found breeding was the Aedes aegypti. This species was found breeding almost exclusively in fresh water receptacles in cargo junks employed as lighters. These junks nomally do not leave harbour limits.

91. Other species recorded were C. fatigans and Aedes albopictus which were generally found breeding in casual water and in the bilges.

92. Rapid reduction in the amount of mosquito breeding in junks was achieved by regular inspection and Gammexane spraying in bilges and casual waters and by the co-operation of junk masters in carrying out instructions given individually and also by means of a loud hailer system installed in the Port Health launches, by which advice was given in the prevention of the aedes breeding in drinking water receptacles. No mosquito breeding was found in junks during December 1953 and in the first quarter of 1954.

Social Hygiene

93. The Social Hygiene sub-department, which is concerned with the control and treatment of venereal diseases, is adminis- tered by the Senior Social Hygiene Officer who has a staff of 5 medical officers, 16 nurses, 5 dressers, a technical assistant, a dispenser, 3 auxiliary nurses, 3 clerical assistants and 4 social hygiene visitors.

　　　94. No additional full time clinics were opened during the year and the service continued to operate in the 5 centres, 2 in Kowloon and 3 on Hong Kong Island. The small hospital with 28 beds for female cases, situated in the Wanchai district of Victoria, continued in operation but in view of the extensive repairs to the old building which were commended in January 1954 its work was, to some extent, restricted. The only special beds available for male cases continued to be the 6 which were

allocated in Queen Mary Hospital to the Senior Hygiene Officer for acute cases. Full use was made of these beds during the

year.

95. During the year not inconsiderable advance was made in public education on venereal disease. Two films, one for male audiences and one for female audiences, were made depart- mentally for showing to selected public audiences. In addition, a technical educational film on the performance of the VDRL test was made for use in staff training. Enamelled posters setting forth the symptoms of venereal disease and the times and places at which free clinics are held have been posted in all public lavatories, and a large number of handbills and pamphlets have been distributed. Talks on venereal disease prevention have been recorded in various Chinese dialects and are replayed in waiting rooms and used in conjunction with the films. A special talk is broadcast by the loud hailer vans while touring in connexion with other campaigns. Soon after the introduction of these health education measures there was a marked increase in attendances at all clinics.

　　96. The number of new cases dealt with was 37,392 of which 14,874 were female. The figures for the previous year were 23,565 and 8,877 respectively. Total attendances at the clinics during the year were 213,091 and 741 female patients. were admitted to hospital. This latter figure constitutes a con- siderable drop from the previous year which is accounted for by the restriction of admissions necessitated by structural repairs undertaken in the hospital.

97. Contact tracing was undertaken by four Social Hygiene Visitors. Persons diagnosed to be suffering from venereal disease are requested to supply confidential information regard- ing the source of infection and the person causing the infection may then be legally forced to submit to examination. In prac- tice it has not been found necessary to employ legal sanction to enforce attendance as the majority of suspected sources have

proved co-operative and willing to accept the advice of the Social Hygiene Visitors. The number of contact notifications received was 2,816 and the Social Hygiene Visitors made a total of 2,566 visits. Of these visits 577 were made to prostitutes who had defaulted from clinic attendance. Successful return was achieved in 23.9% of cases but in 49% the persons concerned could not be located.

98. During the year the Kahn test was replaced by the VDRL test which is carried out qualitatively on all specimens received and quantitatively when necessary. This test

This test is more sensitive than the Kahn test and, in consequence, rather more false positive results are obtained. When this is suspected a check test is made using the standard Kahn procedure.

99. A free service, which is made good use of by private midwives, is the performance of blood tests on their patients during the ante-natal period. During 1953 a total of 5,225 patients were referred by midwives for testing and of these, 377 showed a positive test, namely 7.2%.

　　　100. Penicillin treatment of primary and secondary syphilis. was so successful clinically that it was in most instances impossible to persuade the patient to return for any lengthy period for post treatment observation and it was not possible to estimate the incidence of relapse. Many cases of cardio- vascular syphilis, optic atrophy and tabes dorsalis are still, unfortunately, encountered at the clinics at a stage of the disease when even penicillin can be little more than a palliative.

　　　101. An adequate cure rate for acute gonorrhea has been maintained throughout the year with one injection of procaine penicillin. In some instances there was a suspicion that peni- cillin resistent strains of gonococci were developing and in such cases cultures were made and the organism tested for sensitivity to the different anti-biotics. No cases of penicillin resistance has so far been found.

Maternal and Child Health

102. The Maternal and Child Health services are, for con- venience, considered below under two headings:-

(a) Midwifery dealing with actual deliveries, and

(b) Maternal and Child Health with the care of the pregnant and parturient women, infants and young children.

103. Both activities are directed by the Medical Officer in charge of Maternal and Child Health services who is also Supervisor of Midwives.

104. (a) Midwifery services. The Government midwifery services is provided by 26 full time district midwives and 22 trained amahs. This staff operates from 17 midwifery centres from all of which a domiciliary service is provided and 117 lying-in facilities are available. The total number of beds in these centres is 55.

105. During the year only one additional permanent centre was brought into operation. This was at Tsai Wan at the eastern end of Hong Kong Island in a resettlement area, only domicilliary work is done from this centre as there are as yet no facilities for admission of patients.

106. A further temporary centre was established in Kowloon during the last quarter of the period under review. This was occasioned by the great fire in a squatter resettlement area which occurred on Christmas night and to which reference has already been made. It was estimated that a displaced population of 55,000 persons was liable to produce an average of 3 to 4 births per day. Normally virtually all of these births would have been domiciliary cases, but in view of the large number of displaced persons who were forced to live on the pavements in makeshift shelters it was decided to set up a temporary maternity hospital to meet the situation. This was provided

Occupational Therapy.

Newly completed clinic in Wanchai

Maternal and Child Health Centre-feeding of undernourished

mothers.

Hydrotherapy tank- supplied by U.N.I.C.E.F.

Waiting room

in the new T. B. clinic.

Infant welfare work at a Health Centre.

in marquees in a camp administered by the Social Welfare Officer and with the help of his staff pregnant women were encouraged to make use of the facilities provided.

107. During the year a total of 7,037 deliveries were carried out by this service and of these deliveries 3,177 were domiciliary cases. In 1952 the corresponding figures were 6,649 and 2,987.

108. The Supervisor of Midwives was, in addition, responsible for the supervision of registered private maternity homes. The number of these homes which functioned during the year was 138, of which 54 were in Hong Kong and 84 in Kowloon and the New Territories. These homes, consisting as they do in general of convicted domestic premises, are mostly small and simple. They may have anything from 1 to 7 beds. During 1953 the total number of cases delivered in these private maternity homes numbered 24,099 compared with 22,666 in the previous year. The number of midwives registered under the Midwives Ordin- ance during 1953 was 1,011 as compared with 980 in the previous year. Of this number 443 worked in Government or other institutions. The remainder are private midwives and only 219 of them engaged in active practice.

This branch of the

109. (b) Maternal and Child Health. work is carried out by a staff consisting of the Medical Officer in charge, 5 other Medical Officers, one Supervisor and Training Officer for Health Nurses, 2 Health Visitors, 27 trainee health nurses and a midwife. In addition, the part-time services of 9 medical officers, 11 nurses/midwives and 9 district midwives, are also used for the development of this work,

110. During the year the work of this section was consider- ably developed and expanded. Two new centres were established in resettlement areas and the work was initiated in seven existing dispensaries and institutions in other districts. The 3 main centres referred to in the previous report continued to function on a full time basis.

111. In setting up these additional centres valuable assist- ance was given by the United Nations International Children's Emergency Fund by the provision of the necessary equipment. In addition the work benefitted from the provision by the World Health Organization of a medical consultant to advise the Medical Officer in charge. This consultant worked throughout the year under review and at the end of this period a public health nursing advisor arrived in the Colony to provide further assistance to the public health nursing services.

112. New attendances at ante-natal sessions numbered 5,715 and total attendances 16,077. The average attendance rate per session was approximately 20 and the average number of visits per person was just less than 3.

113. In the latter half of the period under review post-natal sessions were initiated in the 3 main centres. This activity did not make great progress but 172 first visits and 53 re-visits were recorded.

114. Total attendances at child health centres numbered 189,554. In the main centres the average attendance rate per session was 112 and at the subsidiary centres 61. This work continues to be limited only by the staff and premises available, in fact, even now attendances are in excess of personnel and, in general, overcrowding occurs in the premises available.

115. During the year the health nurses paid 19,743 home visits and much useful work was accomplished. Health education continued to be a major preoccupation of Maternal and Child Health staff and this work was pursued vigorously in all centres in which talks and demonstrations were given, discussions encouraged and films and film strips exhibited.

strips exhibited. Secondary school girls received systematic instruction in mother craft at the main Maternal and Child Health centres.

116. Details of attendances at the various centres are set forth in Appendix 5.

School Health

　　　117. The School Health Service is available to students in Government and Government Subsidized schools who make an annual payment of $5, and those in Private and Grant-in-Aid schools making an annual payment of $15. In addition teachers from Subsidized and Private and Grant-in-Aid schools who make an annual payment of $15 are able to enjoy the benefits of the scheme, namely free medical attention. Treachers in Government schools in any case are provided with free medical attention by virtue of their conditions of service.

118. The number of participants in the School Health Service showed an increase during the period under review and reached the figure of 46,051. As the total school population is approximately 200,000 the proportion in the School Health Service amounts to little more than one-fifth, but with the present staff and premises it is not possible to treat a larger number. Participants in the scheme are medically inspected on entry to school and thereafter at the age of 5, 7, 10, 12, 15 and 18. To deal with defects found on these routine inspections 3 special school clinics were operated. These clinics, in addition, provided general and special out-patients services free to parti- cipating children and school teachers. Full clinical services are provided, including dental, eye, ear, nose and throat treatment, to the extent of available resources. Children requiring treat- ment not available at these special clinics are referred to other Government institutions. Cases requiring treatment in hospital are admitted to the Government hospitals and only a nominal maintenance fee is charged. An additional benefit which is available is the provision, when necessary, of free spectacles.

119. The number of medical inspections carried out during the year was 56,982, of which 20,369 were new entrants and the remainder re-inspections. Of all those examined approxi- mately 28% were found to be free from defects, 52% were noted for observation or re-inspection and the remaining 30% were referred for treatment. The most common defect observed was, once again, dental caries and the majority of the other cases requiring attention were minor disorders. The nutritional state of the children was little different from previous years. Approxi-

mately 16% of new entrants were classified as "slightly below normal" and "poor" and, at the periodical re-examinations, the percentage so classified was 17.23% as compared with 21.61% in the previous year.

120. The total number of attendances at the school clinics was 81,598, of which 55,187 were new cases. Attendances at the dental clinics numbered 32,356, and, of these, 17,539 were new cases. During the period under review there was a re- organization of the ophthalmic service provided within the framework of the School Health Service, in view of the appoint- ment of an Ophthalmic Specialist to the Medical Department. The school medical officers who formerly conducted the school eye clinics were transferred to the Ophthalmic Specialist as part of a general ophthalmic service. Nevertheless, children in the School Health Service found to be suffering from eye defects were referred to the Ophthalmic Service which conducts clinics for this purpose. The total number of attendances of children at these clinics numbered 8,451 of which 4,442 were new cases. Of the new cases 2,580 were referred for errors of refraction. The number of spectacles manufactured in the optical workshop and supplied to the children during the year was 2,686.

121. An important function of the School Health Service was the provision of prophylactic vaccinations. Children who were tuberculin tested numbered 39,978 and 9,965 were given BCG vaccination. In addition vaccination against smallpox, cholera, diphtheria and enteric fever was carried out systema- tically.

122. The four main infectious diseases recorded among school children were chickenpox, diphtheria, measles and enteric fever. With these diseases the numbers of cases recorded during 1953 reached new high levels, in all instances the increase being substantial. This was particularly 30 with regard to enteric fever, of which infection 282 cases were recorded as compared with 166 in the previous year.

123. The two Health Inspectors attached to the School Health Service carried out routine inspections of school premises in the urban areas as frequently as possible. During the year

a total of 2,292 visits were made. In the New Territories school premises were inspected by the Medical Officer of Health and his staff.

　　　124. The staff specifically available for the work of the School Health Service consisted of the Medical Officer in charge, 11 doctors, 1 nursing sister, 11 nurses, 2 health inspectors and 9 clerks. In addition there are 2 doctors, 2 nurses and 3 ophthalmic technicians for the ophthalmological work and 5 dentists with 5 women dental assistants for the dentistry.

Malaria and Mosquito Control

125. The number of cases of malaria reported during 1953 was 780 as compared with 1,010 in the previous year. Not all these cases were diagnosed as a result of the finding of the specific parasite in the blood, and, in fact 46 cases were diagnosed on clinical grounds. In 1953, as in 1952, the number of deaths attributed to malaria was 46. The most frequently recorded type of malaria was benign tertian, which accounted for 57% of the cases diagnosed following blood examination. However, subtertian infection occurred also in substantial frequency being recorded in 42% of cases. Only 6 quartan infections were recorded during the year.

126. It is difficult to assess accurately the incidence of the infection in the Colony as it is impossible to obtain exact information with regard to very many of the cases that are reported but, nevertheless, the incidence generally throughout the Colony is not high when account is taken of a population of some 24 million which is theoretically at risk. In the New Territories where, generally speaking, control measures to protect the civil population are not undertaken, it appears that the indigenous population has a relatively high degree of immunity to the local strains of parasites. Observations during the past 2 years have shown spleen and blood parasites rates of under 5%, although a recent spleen survey of 500 children between the ages of 3 and 5 years, conducted in the islands and other outlying parts of the New Territories, give an overall rate of 10%.

127. The basis of anti-malaria work in Hong Kong is by larval control throughout the urban area, the main vectors being A. minimus and A. jeyporiensis. This work continued steadily, water miscible Gammexane being used with good results, but residual spraying of DDT as a supplementary anti- adult measure was carried out in villages on the perimeter of the area in which larval control was alone undertaken. This spraying was carried out at intervals of 3 months. However, observations made in the New Territories on the control of A. minimus, A. jeyporiensis, A. hyrcanus and A. maculatus by residual spraying have not shown good results, perhaps, because of the type of construction of the village huts, which consist of local bricks containing a large amount of laterite, the surface being rendered with earth. On such a surface the insecticide is very rapidly absorbed. There are also indications that the mosquitoes in question do not rest long enough indoors for the insecticides to be effective. Be that as it may, it was observed that after spraying, morning catches of mosquitoes had returned to the pre-spraying level after only 7 days.

128. In addition to the control measures exercised within the urban districts, similar measures were instituted in a limited area in the New Territories in the vicinity of the construction work which has commenced on the new dam at Tai Lam Chung. The average monthly labour population engaged on this project throughout the year was 600 and no cases of malaria were recorded. This is of interest in view of the fact that exactly 20 years ago when the Shing Mun Dam was being constructed in exactly similar circumstances in the New Territories there was an average monthly population of 595 and the total number of malaria cases treated in 1933 at the dam camp was 1,096.

129. The Malaria Bureau, under the direction of the Malariologist, is responsible for anti-malaria measures through- out the Colony. The staff available to the Malariologist were 11 Malaria Inspectors and some 230 daily paid overseers and labourers. In addition the Bureau, at the request of the World Health Organization, conducted a series of experiments to deter-

mine the resistance, if any, of the local species of body lice to DDT, Gammexane and the Pyrenthrins. Some 1,000 lice were tested against standard concentrations of these substances, and no appreciable resistance to them was observed.

Tuberculosis Control

130. It has been stated that tuberculosis constitutes the Colony's major public health problem. Notified cases during 1953 numbered 11,900 and the 2,939 deaths from this cause constituted 16% of all deaths. Tuberculin testing with a view to instituting a mass BCG campaign revealed that nearly 95% of the population above the age of 14 years had already incurred some infection as evidenced by positive tests. In the face of prevailing social and economic conditions with increasing unemployment and a definite trade recession one cannot hope that a great and rapid improvement in the situation with regard to an infection which flourishes in such circumstances. Never- theless, it is interesting to note that during 1953 there was a substantial decline in the number of cases notified. The table below, which sets forth the death rate from tuberculosis per hundred thousand of the population and the percentage of deaths from tuberculosis in relation to deaths from all other causes for the past 6 years, shows a steady rise in both figures until the year 1951 and a continuing fall since then. The meaning of this is not fully understood but it cannot be due to environ- mental factors as these appear to have remained unchanged throughout the whole period.

TABLE 6

Year

!% of death

from tuberculosis

D/R per 100,000

1948

14.6

108.9

1949

16.0

140.6

1950

17.7

144.0

1951

20.0

208.0

1952

18.4

158.8

гот гит гит - - г

1953

16.0

130.6

-- гг- г г. |

131. The age distribution of deaths from tuberculosis remained substantially unchanged. Respiratory tuberculosis accounted for 67.1% of deaths from all forms of tuberculosis. At all ages deaths among males are more numerous than females and a higher death rate is noted in the 45-49 age group.

132. As in previous years the greatest number of notifica- tions of respiratory tuberculosis were in respect of the age range 20 - 40 and male cases out numbered female cases. In adolescents and children the difference between male and female is not so apparent. There was a marked increase in the noti- fications received from the non-Government institutions and private practitioners, whereas notifications from Government institutions, apart from the two chest clinics, showed a marked and surprising decrease. The source of notifications is shown below and a comparison is made with the previous year.

Government Chest Clinics

Hong Kong

Kowloon

Government Institutions

Non-Government Institutions

Private Practitioners

Total

1954

1952

3.185

3,948

3,710

3,534

1,762

6.141

2,137

301

1,106

894

11,900

14,821

133. Details of notifications and deaths from tuberculosis are set forth in Appendices 6, 7, and 8.

Out-patient Facilities.

134. There are 2 Government tuberculosis clinics, one in Kowloon and the other in Hong Kong. Under the direction of the Tuberculosis Specialist, 4 medical officers work in each of these clinics, but part of their time is devoted to conducting tuberculosis clinic sessions at 3 centres in the New Territories and 2 rural townships on Hong Kong Island. These sessions are held once per week. In addition a medical officer of the Tuberculosis Service pays a weekly visit to the Colony's main prison at Stanley to direct the treatment of pulmonary tuber- culosis among the inmates.

135. The total attendances at the two main clinics were increased by nearly 50% as compared with the previous year. This increase has resulted from a substantial expansion of out- patient treatment. Details of attendances are as follows:

First visits

Return visits

Total visits

1953

1952

30,988

28,284

IPITI

120,620

73,706

151,608

101,990

136. The origin of new patients was as follows:

1953

1952

Voluntary

24,436

22,751

Contacts

H+H-

921

1,143

Referred by--

Private Practitioners

982

591

Hospitals

1,249

1,524

Government Employees-

Routine Voluntary Survey

645

742

JIL

1,245

129

Surveys (Non-Government)

1,182

1,078

Private School Teachers

282

271

Total:

30,988

28,284

137. The condition of new patients on first attendance was found to be as follows:

1953

1952

(1) Examination incomplete:

(a) Attended but did not complete

examination

3,325

2,269

(6) Examination or diagnosis

incomplete as at 31st December

3,268

1,412

2) Examined and found to be non-

tubercular

14,847

14,999

(3) Examined and found to be

suffering from tuberculosis:

(a) Active

(b) Quiescent

Total:

4.898

5.793

3,147

2,613

1,503

1.198

30,988

28,284

138. The details above show that there was a marked increase in the number of patients who failed to complete examination and this is in part accounted for, without doubt, by the fact that X-ray facilities were not available in the Hong Kong clinic and patients had, perforce, to be referred to the Queen Mary Hospital, 5 miles distant, for this examination. This difficulty has now been overcome with the transfer of the tuberculosis clinic to the new building which was completed at the end of the period under review.

Out-patient Treatment.

139. During the year there was a very substantial increase in the amount of out-patient work undertaken and by the end of the year the capacity of the clinics was taxed virtually to the limit. The following are details of out-patient investigations and treatment carried out in the clinics as compared with the previous year.

Blood Sedimentation Rate

1953

1962

38,018

34,241

Artificial Pneumothorax-

Initial

Refills

Completed treatment

3,016

1,307

Abandoned (unsatisfactory)

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

Artificial Pneumoperitoneum-

Initial

Refills

ד ז...

Completed treatment

-------

7,285

2,765

HALIE

105

Abandoned (unsatisfactory)

Pleural Aspirations

140. Although out-patient treatment of tuberculosis with specific drugs is considered to be an unsatisfactory alternative to hospital treatment the Tuberculosis Service having an inade- quate number of hospital beds at its disposal had perforce to

　　accept this alternative and, in doing so, pressed such treatment to the limit of its resources. Nevertheless only cases in which it was considered that the disease was largely reversible were selected for this treatment, it being the intention to deal with the irreversible component later by short term admission to hospital. Also efforts were made to avoid the occurrence of drug resistent strains of the tubercle bacillus by careful selection of the cases and limited dosage of the particular drug. Observ- ing these criteria results of treatment were good.

Radiological Examinations.

141. All X-ray work throughout the Department is under the control of the Senior Radiologist, but it is intended that in due course when all medical staff in the tuberculosis clinics are competent to interpret their own X-ray films this work, as far as it concerns tuberculosis patients, will become the responsibility of the Tuberculosis Service with the Senior Radiologist con- tinuing to be available in consultation.

　　　142. New patients were examined on 35 millimetre film in the first instance and, later, on large plates, either film or paper. Towards the end of the year the use of 4" by 5" films was commenced with a view to eliminating the necessity for the larger films. Details of the X-ray work carried out are as follows:

Hong Kong Clinic-

35 m.m.

Large film or paper

Kowloon Clinic-

F.LLI ILLI JJLIJ

1953

1952

48,822

31,854

23,133

18,856

35 m.m.

16,866

15,111

Large film or paper

18,978

15,437

107,799

81,258

Bacteriological Examinations.

143. Details of bacteriological investigations carried out by the Pathological Institute on behalf of the Tuberculosis Service. are as follows:

Material examined

Sputum

Gastric Contents.

Pleural Fruid

LILIJ

Kabo Test

------

Positive

Negative

Total

4,271

11,630

15,901

149

162

Hospital Treatment.

144. The number of hospital beds available in the Colony for the treatment of tuberculosis is completely inadequate. In Government hospitals just over 300 beds are available. In the Ruttonjee Sanatorium 230 beds. An additional 259 tuberculosis beds are available in the Tong Wah Group of Hospitals which are used mostly for advanced cases. In view of this it is necessary to make the best possible use of each available bed. Admissions for investigations of lung conditions or for treat- ment of proved pulmonary tuberculosis are made through the Almoner's Section of the tuberculosis clinics, with the exception of priority cases which, in the case of Government hospitals, is made up of Government employees and their dependants and, in the case of the Ruttonjee Sanatorium, of nominees of subscribers to the Anti-Tuberculosis Association. Long term admissions. are strictly confined to patients in whom there is good hope of complete ultimate recovery. By these means the period of hospitalization is kept to the minimum and the bed turnover is as high as possible.

145. Details of admissions to Government hospitals are as

follows:

General Public

Government Servants

Government Servants dependants Re-admissions

Total:

זוויזווזווזווזויווי

224

179

508

Ruttonjee Sanatorium.

　　　　146. This institution, the accommodation of which was expanded during the year to 230 beds, is owned and operated by the Hong Kong Anti-Tuberculosis Association. This Assocía- tion is financed from voluntary sources but during the year under review it received, in addition, a subvention from Govern- ment amounting to $350,000.

147. The policy of the Association is only to admit to its Sanatorium cases of pulmonary tuberculosis and those admitted are, in general, selected from the waiting list maintained by the Government Tuberculosis Service. However, priority of ad- mission is given to patients nominated by the principal sub- scribers to the Association. After admission the Association is responsible for all treatment and after-care of these patients, except that the Almoner's Section of the Government Tuber- culosis Service undertakes social work in connexion with these cases and, where appropriate, provides financial assistance.

Government Hospitals.

148. It has not so far been possible for Government to establish its own hospital devoted solely to the treatment of tuberculosis, but in 3 hospitals beds are specifically allocated for this purpose. The details of these beds are as follows:

Queen Mary Hospital:

(Special class and general ward accommodation

for surgical and investigation cases)

Lai Chi Kok Hospital (including 10 cots) St. John Hospital, Cheung Chau

(Minimal and convalescent cases only)

Total:

208

312

　149. The fact that the tuberculosis beds are dispersed in three institutions adds to the administrative and other difficulties of the Tuberculosis Service which would, no doubt, achieve more were all the beds concentrated in a special tuberculosis hospital. That there is a great need for such a hospital, con- structed and staffed on the cheapest lines, is undoubted, but financial considerations and the Department's commitments in other directions make it unlikely that such a hospital will be available for some years to come. In present circumstances not only is administration and supervision of available beds made difficult for the Tuberculosis Service but it is also not possible to organize a proper sanatorium regime and institute an adequate system of occupational therapy.

　150. Despite these difficulties the results of treatment are reasonably satisfactory and the readmission rate was just over 10%. The total number of patients admitted during the year was greater than in any previous years on account of the careful policy adopted with regard to the selection of cases.

　151. Details of admissions and results of treatment are as follows:

1953

1952

Remaining in hospital at last day of

previous year

309

285

Admissions

508

478

Re-admitted after temporary transfer...

Discharge:

(a) Completed treatment-

(i) No abnormality detected

(ii) Improved

424

350

(iii) Unchanged

(iv) Worse

(5) Against medical advice

(e) Died

(d) Transferred

Remaining at last day of the year

306

309

152. The number of deaths recorded above is very low indeed and this of course results from the policy of admitting only cases in which prognosis is good. This policy is relaxed, to some extent, in the case of Government officers and their dependants, school teachers etc. The majority of the deaths recorded occurred among dependants of Government officers.

153. The following is a summary of treatment given in hospitals:--

A. P. T.-

Initial Refills

Pneumolysis

-- J

Abandoned

A. P. P.-

Initial

Refills

Phrenic operations

Bronchoscopy

Thoracoplasty

1959

1952

159

195

2,265

1,889

148

158

3.273

2,753

140

207

Other chest operation

154. As was the case in the previous year A.P.T. is still considered by the medical staff to be the treatment of choice in a large number of cases and, in general, more appropriate than A.P.P.

155. The response of the patients to treatment has been gratifying. It has, in general, been almost immediate, no doubt on account of the high resistance of the local population to the infection. In many cases the type of the disease is such that permanent lung collapse is indicated and in such cases thoraco- plasty is the treatment generally adopted. Results from this have been good and no death had resulted from operation. Physiotherapy is instituted very soon after operation and results have been functionally and aesthetically satisfactory. Thera- peutically also results have been good and failure to render the sputum free from tubercle bacilli have been exceptional.

Patients readily accept operative treatment but, unfortunately, facilities for this work are so limited that there is constantly a long list of patients awaiting this form of treatment.

Social Work.

　156. The Tuberculosis Almoner with her 4 assistants is responsible for all social work in connexion with the Tuber- culosis Service. The task facing this staff is indeed formidable for the social problems of Hong Kong's population in general are greatly accentuated in the sufferers of tuberculosis. There is in the Colony no general scheme of unemployment relief or sickness benefit and it is the Almoner's task to fill this gap as best she can. To some extent she does so by providing tem- porary financial relief in appropriate cases and for this purpose she has, at her disposal, some $100,000. However, this sum is not entirely available for this purpose and other calls upon it are for such items as the purchase of milk powder for patients undergoing out-patient treatment, payment of hawkers' licence fees, repatriation of patients, etc. This money is wisely disposed of and meets a very real need.

157. Allowances are generally only available to early cases undergoing treatment in hospital who had been obliged to give up work. The scale of weekly allowances is as follows:-

First Dependant

Second

Third

$15

г.

$12

$ 9

$ 5

Each subsequent dependant

In addition to the foregoing allowances are also given to assist with rent, school fees, etc., and the maximum amount paid is not permitted to exceed 75% of the worker's wage.

158. The Almoners attempt to ensure the regular attendance of cases for out-patient treatment. They are also responsible for the distribution of milk powder to patients and the main- tenance of hospital waiting lists.

　　　　159. The work of the Almoners' Section is summarized below:

1953

1952

Number of patients interviewed Admission to hospital arranged

12,805

12,116

790

773

Blood donors arranged

Transfers between hospitals

271

Home visits

611

606

Number of families on financial

assistance

130

101

Average weekly grant

$21.70

$23.02

Milk powder distributed (one pound

per head per week)

28,776 lbs.

14,940 lbs.

Hawkers Licences obtained

Patients (or relations) placed in

employment

Tuberculosis Visitors.

　　　　160. Tuberculosis Visitors who work under the direction of the Almoners have not had formal health visitor training but they have had special training within the Department to fit them for their duties in the Tuberculosis Service. There are 23 of these visitors and their main functions are to report on home conditions, arrange for the examination of contacts and to educate the patient and his family in simple methods of preventing the spread of the infection within the home and elsewhere. They are, in fact, the Almoners' field staff and they perform a most useful function.

161. The work carried out by these visitors is summarized as follows:

1953

1952

Total number of first visits made Total number of revisits

-----

17,598

10,083

4,570

3.315

Addresses not found

отг

1,786

1,401

Contact examinations arranged

28,327

11,980

Contact examinations completed

11,524

9.036

Number of patients known to have

(*) Died

1,436

1.114

(b) Returned to village

384

280

Contact Examination.

　162. The examination of contacts is carried out in such a fashion as to occasion the least inconvenience to the individual and the minimum of work for the clinical staff. Contacts are arbitrarily divided into two groups. Those under 8 years of age are tuberculin tested and the positive reactors are then X-rayed. Those above 8 years of age are X-rayed forthwith without having first to attend the clinic.

163. The results of contact examination are shown below:

Under 8 years of age:

Tuberculin tests-

{

Negative Positive

Active tuberculosis..

Inactive

1953

1952

1,747

1,526

2,131

1,404

152

200

397

320

1,546

820

3.89%

6.82%

Clinical findings of contacts

showing positive Mantoux

Suspicious

Free of

Percentage of contacts found to have active

tuberculosis

Over 8 years of age;

Active tuberculosis ..

324

275

Results of clinical

Inactive

164

examination following

X-ray

Suspicious

516

452

Free of

6,642

5,260

tuberculosis

4.23%

4.47%

11,524

9,081

Percentage of contacts found to have active

Grand total of contacts examined

B.C.G. Inoculations.

164. B.C.G. vaccination, which was commenced in April 1952 as an organized campaign with technical and material assistance from the United Nations International Children's Emergency Fund and the World Health Organization, continued as a routine activity throughout the year. Mass inoculation of the general population was not attempted in view of experience in the early stages of the campaign when the results of the tuberculin tests

　　showed that nearly 95% of the city's population of 15 years and over were tuberculin positive and it was considered not worth- while to launch a mass campaign merely to discover and protect 5% of the population. It was felt that the advantage which would accrue would be too small to justify the expense and effort involved. In consequence attention has been concentrated on the population below the age of 15 and this population was divided, for administrative purposes, into 3 groups, namely, school children, pre-school children and the new born.

165. A vaccination team was integrated into the School Health Service and vaccination was offered to all school children on a voluntary basis. Schools were visited systematically and by the middle of the year the school population as a whole had been dealt with. Thereafter arrangements were made for continuing visits to schools to test and vaccinate all new entrants. During the year a total of 719 schools were visited and the work carried out was as follows:

Tuberculin Test

Completed Test

Vaccinated

Starting Test

Positive

Negative

39.978

27,418

10,137

9,965

166. Greater difficulties were experienced in dealing with pre-school children. Those attending Infant Welfare Centres presented no difficulty but they constituted only a small pro- portion of the pre-school children in the city. In consequence arrangements were made for systematic domiliciary visits to be made. This was done in conjunction with the house cleansing squad operated by the Urban Services Department and, by the end of the year, the whole of Hong Kong Island, including Stanley, Aberdeen and other outlying districts had been dealt with. The result achieved from this effort was disappointing but nevertheless it is intended to continue these domiliciary visits in Kowloon.

The New Born.

167. Vaccination of the new born in hospitals and the larger maternity centres was carried out throughout the year, but the numbers dealt with in this way constituted a small proportion of total births in the Colony. In fact, during the year the number of new born dealt with in these institutions was merely 4,883 out of a total of 75,544 births throughout the Colony. As has been stated earlier the majority of births occur under the supervision of midwives either in private maternity homes or in the patient's home and the administrative problems of providing B.C.G. vaccination to this age group still remains unsolved. It is not considered desirable that the midwives should carry out intradermal vaccination and it would, in any case, be an immense task not only to train midwives to do so but to ensure that the technique was carried out adequately and with fresh vaccine. Thus investigations were carried out of alternative methods of vaccination, for example, by multi-puncture, in an endeavour to develop a satisfactory yet simple technique which could easily be adopted by the midwives. Various methods were

tested but by all of them a high conversion rate was associated with a high complication rate in the form of regional adenitis. This work suggests that in the new born efficient vaccination is frequently associated with adenitis and that this should be regarded as part of the "primary complex" and not unnecessarily as a true complication. A proportion of these cases do form caseous axillary abscesses but it was found that these could be quickly controlled by the timely use of isonicotinic acid hydrazide.

　168. The sum total of all B.C.G. vaccinations carried out during the year is summarized below, the figures for the previous year being shown for comparison.

חד

Period Covered

Starting

test

Completed test Positive Negative

Vac- cinated

Percent-

age vaccinated!

Newborns Total vaccinated vaccinated

April to

Dec. 1952 206,828

Jan. to

Dec. 1953

92,510

138.490 38,238 38,173

50.193

21.6

27,229 27,024 34.9

3,120

41,293

4,883

31,907

X-ray Surveys.

169. Surveys by mass miniature radiography are carried out to the limit of available facilities. All Government em- ployees are annually surveyed and free surveys are carried out of the employees of private firms and institutions which are prepared to guarantee that any of their staff found to be suffer- ing from the infection will be granted reasonable leave on pay to enable treatment to be carried out. In addition all prisoners. admitted to the Colony's main prison at Stanley are radio- graphically examined.

170. The annual survey of Government employees was commenced in 1948 but was not fully carried out until 1949. Since the initiation of these surveys there has been a steady fall in the number of active cases of tuberculosis found each year and a substantial increase in the percentage of early minimal cases among those brought to light. This has been reflected in the steady fall in the number of persons it has been found necessary to invalid from the Government service on account of tuberculosis.

171. During the year 24,915 Government employees were examined radiographically and the percentage found with active tuberculosis was 0.722%. The corresponding figures for the previous year were 19,611 and 0.984%. Below is set forth an analysis showing percentages of cases of tuberculosis found in major Government Departments (employing 500 or inore persons) during the past three years.

Department

1949/50 1951/5% 1952/58

Stores

2.38

1.36

1.69

Public Works

2.2

1.11

0.80

General Post Office

1.74

1.11

1.20

Medical

1.4

0.9

0.76

ITUTIIT |

Urban Services

0.9

0.78

0.56

Railway

0.7

1.83

0.89

Police

0.66

0.56

0.52

Education

0.18

1.32

0.36

Agriculture, Fisheries &

Forestry

2.003

0.63

* Marine

0.90

0.92

• Not included in 1949/50 6gures.

172. These figures indicate that, despite the not inconsider- able cost of the procedure, the annual radiographic survey pays material dividends in reduced commitments for sickness.

173. With regard to private firms, approximately 30 made use of the facilities offered. The number of employees in each firm varied from 6 to 1,400 and below are set forth the details of employees examined.

Total number X-rayed

Total number examined at the clinics

Number failed to attend when called

7,771

- - - - -

1,182

137

1.76%

Number suffering from active pulmonary tuberculosis Percentage of those examined found to have active.

tuberculosis

174. The number of inmates of Stanley Prison who were X-rayed during the year was 8,574 and it was found necessary for 229 of this number to be isolated in a special section of the prison for further investigation. The total number of prisoners admitted to the tuberculosis ward in the prison hospital was 58.

IV. HOSPITALS

Introduction

175. There are in the Colony 26 general and special hospitals, excluding 3 hospitals maintained by the Military and Naval Authorities for their own personnel, providing a total of 4,508 beds. These institutions vary in size from 12 beds to 587 beds. Government owns and operates 11 of them and provides sub- stantial financial assistance to 6 others operated by voluntary organizations. The remaining 9 hospitals are entirely in- dependent and receive no financial assistance from Government. The number of beds available in the Government hospitals is 1,855, in the Government-aided hospitals 1,663 and in the private hospitals 990. Details of the category of beds available in these

　　hospitals and of in-patients treated during the year are shown in Appendices 9 and 10. Details of in-patients in Government and Government assisted hospitals during the year are shown in Appendix 11 classified according to the International Standard Classification (Intermediate List of 150 causes).

Government Hospitals

　　　　176. Government maintains 2 general hospitals equiped to deal with acute cases and emergencies and, in addition, 2 materity hospitals, 2 infectious disease hospitals, a venereal disease hospital for women, a mental hospital and 2 prison hospitals. Brief reference to each of these hospitals is made

below.

Queen Mary Hospital.

　　　　177. This is the Colony's largest and most important medical centre. It is situated at the western end of Hong Kong Island, some 33 miles from the centre of Victoria in semi-rural sur- roundings. The fine 7-storied hospital building was completed in 1938 and it accommodates 587 beds. It is the teaching hospital for the Medical Faculty of the University of Hong Kong and it houses Government's main nurses training school. The radiodiagnostic and therapeutic department is the main centre in the Colony for this work and is well equipped with modern devices including a Telecurie Therapy Apparatus (Cobalt bomb).

178. There is a medical staff of 40, and, in addition, there are 25 house officers. Excluding the house officers, only just over 50% of the medical staff are Government officers, the re- mainder being provided by the Medical Faculty of the University.

　　　　179. Although this institution is the most important of its kind in the Colony there are important deficiencies in its facilities not least important of which is in the operating theatre suites. Today the vast majority of cases treated are suffering from acute conditions and the operating theatre facilities are under greater pressure than was perhaps visualized when the hospital was

planned. This pressure is so great as to make it clear that available facilities are less than adequate and it will be necessary, in due course, for additional operating theatres to be provided.

180. In other ways, too, accommodation is inadequate and, steps have already been taken to meet this difficulty in two respects. A new wing has been planned and will be constructed during the next financial year in which will be accommodated a casualty department, more adequate than the present one, and, in addition, more satisfactory accommodation will be provided for the house officers. The addition of this wing will lead to greater efficiency and to the lessening of the pressure on existing accommodation in the main building.

181. As it had become necessary to increase the output of the nurses training school as a first step in the planning of the new hospital in Kowloon to which reference has already been made, it was necessary to provide additional accommodation for nursing staff. Thus, towards the end of the period under review work was commenced on the erection of a new multi-storied building which will provide accommodation for 45 nursing sisters. When this is completed space will be freed in the existing Nurses' Home which will permit of a larger intake of trainee nurses and also of the establishment of a more adequate preliminary nurses training school,

182. Towards the end of the previous year a new building was completed at the hospital to accommodate the Blood Bank and a Central Supply Service. Throughout the year under review the Blood Bank functioned most satisfactorily and the bringing into operation of the Central Supply Service in May 1953 has proved a great boom and increased the efficiency of the hospital to a not inconsiderable extent.

was,

183. As has already been stated the institution generally speaking, a hospital for acute cases and throughout the year there was no lessening of the pressure on its beds, in fact, there was a further increase in the number of in-patients treated, an increase which was greater than could be accounted

　　for by the increase by 7 of the beds available. However, although the bed turnover was as rapid as one could expect there was, particularly on the surgical side, a lengthy waiting list for admission.

　　　　184. General out-patient treatment is not provided at the hospital and there is no out-patient department on the pre- mises. Out-patients are normally referred to the hospital, mainly from Sai Ying Pun Out-patient Department, but also from other dispensaries and clinics on the Island.

Kowloon Hospital.

　　　　185. This pavilion type hospital with 233 beds is situated on a fine open site in the centre of the Kowloon Peninsula. The inadequacy of the number of beds available will be obvious when it is mentioned that the population which it serves is considerably more than one million. As in the previous year there was again constant overcrowding and long waiting lists for admission.

　　　　186. The medical staff was 20 and, in addition, there were 11 house officers. A nurses training school was also maintained at this hospital.

　　　　187. There was no perceptible slackening of the work in the hospital although there was a slight decline in the numbers, not only of in-patients, but also of out-patients dealt with. In- patients numbered 8,104 as compared with the previous year's figure of 8,505. The average length of stay in hospital per case was approximately 10 days.

　　　　188. Total out-patient attendances were 606,192 as compared with 640,701 in 1952. This decrease was, to a large extent, accounted for by the use, for half of the year, of a penicillin preparation which enabled a single daily injection to be administered instead of the former twice daily injections.

　　　　189. The out-patient department continued to be conducted daily in two shifts extending from 9 a.m. to midnight. Never- theless overcrowding was as great as ever, long queues were in- variable and often medical officers had to work two to a consult- ing room.

190. There were no additions to hospital buildings and the only major alteration and improvement was effected by the enclosure of a large verandah at the end of one of the wards to provide a lecture room for the nurses training school. This room was well equipped and it considerably added to training facilities.

St. John Hospital, Cheung Chau.

191. This hospital is owned by the St. John Ambulance Association, but is at present administered and operated by Government under a 5 year agreement, which terminates at the nd of 1954. It is one of two hospitals in the New Territories, and is situated on the Island of Cheung Chau, an important fishing centre which lies to the west of Hong Kong Island and on the southern side of Lantao Island. Of its 102 beds, 42 are allocated for the treatment of minimal or convalescent tuber- culosis cases.

192. Until June 1953 only one medical officer was stationed at Cheung Chau and, as he was called upon to pay visits to centres in neighbouring islands, there were occasions when no doctor was, in fact, available at the hospital. This unsatis- factory state of affairs was rectified in June 1953 by the posting of an additional medical officer to the hospital. This has enabled the work in the outlying centres to be improved and extended, yet permitting the full time availability of a medical officer in the hospital itself.

193. During 1953 there was a small decrease in admissions, the number being 1,589 as compared with 1,683 in the previous year. However, there was a substantial increase in out-patient attendances, new cases rising from 16,830 in 1952 to 22,299 in 1953.

194. An important addition to the work of the hospital was the initiation of eye clinics by the Government Ophthalmologist. It had been intended to hold such clinics once each month but the response of the people was so prompt and attendances so great that since October 1953 clinics have been held once a fortnight.

Tsan Yuk Hospital.

　　　　195. This institution with only 85 beds is the largest maternity hospital in the Colony. It is accommodated in an old outmoded building situated in a highly congested area of the western district of Victoria. Although the institution is administered by the Medical Department and the Medical Superintendent, nurses and midwives are Government officers, responsibility for the clinical work in the institution lies with the Professor of Obstetrics and Gynaecology of the University and his staff.

196. The hospital is the main centre at which training of midwives is undertaken and it is the only centre in the Colony at which medical students are taught obstetrics. All these students, in small groups at a time, receive resident training in the hospital for a month as part of the University curriculum. Inspite of the unsatisfactory building a great deal of work of a high order was accomplished and busy though the hospital was in previous years there was a still further small increase in the work carried out. The total number of admissions was 7,221 and there were 6,817 deliveries. The corresponding figures in the previous year were 7,216 admissions and 6,737 deliveries. The average length of stay in hospital was 3-4 days, a situation, which had to be accepted, inspite of its dis- advantages because of the enormous demand for hospital beds. In the case of normal deliveries many patients were returned to their homes as early as the first or second day after delivery to free beds for others in need.

need. Such patients at home were supervised during the puerperium by visiting midwives. This arrangement, the best which could be adopted in the circum- stances, is an unsatisfactory one and not merely from the point of view of the patients. Early discharge from hospital does not permit of the proper training of medical students or midwives in the supervision of the puerperal period and it is thus not easy to train these personnel as satisfactorily as is necessary.

197. In spite of adverse circumstances results achieved were very satisfactory and a high standard of care was maintained. Maternal deaths during the year numbered 4, giving a maternal mortality rate of 0.58 per thousand and there were no cases of

serious infection. It is of interest that 97.5% of the patients admitted to the hospital during 1953 were "booked cases", Whilst this does not mean that all these cases had received adequate ante-natal care before admission it may be said that the majority had had sufficient ante-natal supervision to exercise a favourable influence on their subsequent confinement. The number of cases of pregnancy toxaemia encountered was 306, an incidence of 4.5%. Included in this number were 15 cases of eclampsia, one of which ended fatally, giving an incidence of one case of eclampsia to every 454 deliveries.

　198. The still birth rate was 1.39% and the neo-natal death rate was 1.05% constituting a combined infant wastage of 2.44%. Approximately 2/3 of this mortality was due to prematurity.

　199. In view of the unsatisfactory surroundings in which such good work is being done it is gratifying that construction work on the new Tsan Yuk Maternity Hospital of 200 beds which will replace the present institution has commenced on a site close by. The new hospital will be a seven-storied building and it will provide vast improvement on present maternity facilities in Victoria. It is anticipated that the building will be completed in the beginning of 1955,

Eastern Maternity Hospital.

　200. This institution provides accommodation for 24 maternity beds in an old and, in many respects, building situated in the eastern district of the city of Victoria. Nevertheless, good work is carried out and the results obtained were good.

　201. There was a small decrease in the number of cases admitted during the year, there being 2,455 admissions with 2,383 deliveries as compared with 2,706 admissions and 2,626 deliveries in 1952. There were no maternal deaths. The number of still births was 12 and there were 7 neo-natal deaths, giving a still-birth rate of 5 per thousand and a neo-natal death rate of 3 per thousand.

Sai Ying Pun Hospital.

202. This is the infectious disease hospital for Hong Kong Island and it has a nominal bed strength of 88. It has been very frequently necessary to exceed this number by providing tem- porary beds at periods of peak incidence of the more common infectious diseases. The hospital building is very old and outmoded and, although extensive repairs and redecoration were carried out, it remains an unsatisfactory infectious disease hospital. It will be necessary one day to replace it with a modern institution, which will more adequately meet the needs of the Island population.

203. The total number of patients admitted was 1,561 and the 3 main causes of admission were diphtheria, typhoid and bacillary dysentery. Diphtheria accounted for 435 admissions and 38 deaths. Cases are still too frequently admitted in a moribund condition when there is little that treatment can do.

204. At the period of maximum incidence of typhoid fever, which occurs in the warm weather about the middle of the year, and during the year under review reached a higher peak than ever before, a serious strain was thrown on the hospital's resources. The number of cases admitted was 224 as compared with 173 in the previous year. There were only 9 deaths in hospital from this infection and the low mortality rate is accounted for by the administration of chloramphenicol and, in delirious toxic cases, A.C.T.H.

205. Bacillary dysentery cases numbered 120 and there were 3 deaths. In this condition, too, chloramphenicol proved its worth and is considered to be the best drug, particularly for severely dehydrated children.

Lai Chi Kok Hospital.

　　　　206. This institution with 490 beds is the second largest hospital in the Colony. It is situated on the northern outskirts of Kowloon and serves the Mainland as an infectious disease hospital. However, only part of it is used for this purpose and

208 of its beds are devoted to the care of tuberculosis cases. Further, 180 beds constitute a relief hospital for convalescent cases from Queen Mary Hospital and Kowloon Hospital.

207. Because of the pressure on the acute beds in the general hospitals, it was found necessary during the year to improve and augment the staff of the hospital as cases requiring con- siderable care and treatment had to be transferred to the relief beds. The medical staff consists of 3 medical officers and 4 house officers and visits are paid to the hospital by various specialists from other institutions.

208. To the infectious section with 102 beds, a total of 1,484 cases were admitted. This was an increase of 176 on the previous year. Again, the two most important causes of admission were typhoid fever and diphtheria, of which there were, respectively, 518 and 417 cases. There were 115 measles admissions and tuberculous meningitis accounted for 48 cases. Like its counterpart on the Island this section of the hospital was under serious pressure in the middle of the year on account of the typhoid epidemic and a stage was reached when no further typhoid cases could be admitted and arrangements had to be made for surplus cases to be accepted by the Kwong Wah Hospital,

209. The total of cases treated in the tuberculosis section was 652, of which 442 were new cases. Full use was made of the beds available and all admissions were arranged through the Tuberculosis Service on the criteria to which reference has been made earlier in this report.

210. The relief hospital section of the institution admitted 3,957 cases during the year and the majority of these were orthopaedic.

Wanchai Social Hygiene Hospital.

211. This hospital, which provides accommodation for 20 beds and 8 cots, is situated in a congested area of Victoria in an old and unsuitable building and its function is to provide for the treatment of venereal disease in women.

As well as

in-patient treeatment an out-patient clinic is operated. There was a reduction in the number of admissions to 741 as compared with 1,106 in 1952. This reduction was accounted for by the extensive work of reconstruction and redecoration which was carried out during the year. This work will enable the hospital to continue in use for a few years but the time is not far distant when it will be essential either to rebuild on the present site or provide better alternative accommodation elsewhere,

Mental Hospital.

212. This institution situated on Hong Kong Island in outmoded buildings has accommodation which is totally insuffi- cient to meet the Colony's needs with its present population. For several years overcrowding in this institution has been a very serious problem and during the year under review the situation deteriorated. The hospital should accommodate 140 patients but, in fact, at the end of the year there were 309 and the problems which faced the staff were very grave indeed.

213. Overcrowding in the Mental Hospital is yet another of the undesirable results of the Colony's great population increase in recent years and the restriction on movements between the Colony and the Chinese Mainland. In the past many persons with mental illness were taken by their relatives to their villages in China and, in addition, an arrangement was in force whereby citizens of China so afflicted were transferred to the Mental Hospital in Canton. All this is changed and mental illness occurring within the Colony has to be dealt with from the Colony's own resources.

214. During the year there were 599 first admissions and 226 readmissions. The number of persons discharged from hospital with symptoms fully remitted was 478 and a further 179 were discharged much improved. In spite of the environ- mental conditions confronting the staff useful work was done and all the usual physical methods of treatment were made use of including electronarcosis. Because of the difficulties of supervising chronic excited patients in conditions of serious overcrowding electro convulsive therapy, and to a lesser extent,

- leucotomy were more frequently used. Also, despite the inade- quate accommodation, much occupational therapy was carried out, the main activities being rattan work and tailoring, but selected patients were employed in laundering, knitting, wood cutting, gardening and weaving. As extensive recreational activities as possible were provided and cinema shows were given throughout the year by the United States Information Service.

　215. The staff of the Mental Hospital derived some encouragement from the fact that some progress was made during the year towards the realization of plans for a new mental hospital, and the Public Works Department's staff are now working on the drawings. A suitable site has been obtained in the New Territories some 20 miles from the city. It is planned that the new hospital will provide accommodation for 500 patients and there is every prospect that at least part of this accommodation will be available in the coming financial year when it will be possible to transfer a substantial number of chronic cases from the present Mental Hospital, giving immediate relief to the present overcrowding.

Stanley Prison Hospital.

　216. This hospital with 3 wards of 16 beds and 6 isolation cells is situated within the precincts of the Colony's main prison. During the year extensive repairs and redecorations were carried out and substantial improvements were achieved in the sanitary facilities and in the lighting of the hospital.

　217. The staff consisted of the Medical Officer-in-Charge who has to assist him a hospital supervisor, an assistant hospital supervisor and 10 hospital warders. During the year these latter were provided with short courses of training in general and surgical nursing by the Medical Department. Though the programme of training was of an elementary kind it has led to a higher standard of care in the hospital.

　218. The daily average population of the prison was 2,692 and during the year 7,396 persons, all of whom were examined by the medical officer, were admitted to the prison.

219. There was a considerable reduction in the number of prisoners admitted to the hospital from 874 in 1952 to 617 in 1953. These admissions were classified as follows:

General cases Infectious cases

Tuberculosis cases

Mental cases

453

During the year 15 deaths occurred in the hospital and 2 other prisoners died in Queen Mary Hospital where they had been transferred for treatment.

　　　220. The total number of prisoners reporting sick was very much less than in the previous year, the number during 1953 being 35,266 as compared with 54,001 during 1952. This improvement may, perhaps, in part, be accounted for by improved living conditions in the prison. Improved diet scales were introduced in September 1952, and the inmates are now enjoying additional privileges and improved facilities for enter- tainment and relaxation,

　　　221. Tuberculosis continued to present a problem and the average daily number of tuberculosis cases in the prison during the year was 90. Since March 1953, the Medical Department's Mobile Mass Miniature X-ray Unit has visited the prison at short intervals to X-ray all new prisoners and, as already mentioned, a Medical Officer of the Tuberculosis Service pays weekly visits to the prison to supervise treatment.

　　　222. During the year 8,574 mass miniature and 667 large films were taken. As a result of these 229 new cases of pulmonary tuberculosis were diagnosed and segregated.

223. Venereal diseases continued to be common and the total of new cases dealt with was 3,757. Weekly clinics were conducted at the prison by a Medical Officer of the Social Hygiene Service.

　　　224. Dental treatment continued to be provided by a Government Dental Surgeon regularly visiting the prison twice per month. A total of 623 cases were dealt with by him.

Lai Chi Kok Female Prison Hospital.

225. This small hospital of 12 beds is situated within the precincts of the Colony's female prison. It consists of one large ward and a combined surgical dressing-room and office. Medical supervision is exercised by the Medical Superintendent of the Lai Chi Kok Hospital, who visits the prison daily. Total admissions numbered 72, of which 9 were maternity cases.

Government Assisted Hospitals

226. These number 6 and they are operated by charitable institutions. Three are the responsibility of the Tung Wah Board of Directors, and one each of the London Missionary Society and the Hong Kong Anti-Tuberculosis Association and the Board of Directors of the Pok Oi Hospital.

Tung Wah Group of Hospitals.

227. The Tung Wah Board of Directors, whose charitable activities are not restricted to medical matters, are responsible for the running of three hospitals, two on Hong Kong Island, namely, the Tung Wah Hospital and the Tung Wah Eastern Hospital, and one in Kowloon, the Kwong Wah Hospital. The first named with 495 beds is the largest, while the Kwong Wah Hospital has 404 beds and the Tung Wah Eastern Hospital 320. The administration of these hospitals is vested in the Tung Wah Hospital Medical Committee which consists of the three prin- cipal Directors of the Board, the Medical Superintendents of the three hospitals and two advisors. The Director of Medical and Health Services is the Chairman. The object of these institu- tions is to provide for the sick poor, and treatment is free, but there are, in each hospital, a small number of private beds for which charges are levied.

228. Although the bed strength of these institutions is as stated above, there are always considerably more persons being treated than these figures indicate, in fact as many as 200 more. In certain sections of the hospitals, particularly those devoted to tuberculosis cases and cases of chronic illness, there is extreme overcrowding.

229. Each of these hospitals has a nurses training school which is recognized by the Colony's Nursing Board. The medium of instruction is Chinese,

230. Standards of equipping and staffing in these institutions are not as high as in the Government Hospitals but, nevertheless, fine work is carried out and the value of the hospitals to the community is very great indeed. During the year, the total number of in-patients treated in the three hospitals was 47,589 as compared with 43,782 in the previous year. Total out- patient attendances numbered 271,064, as compared with 218,509 in 1952.

Alice Ho Miu Ling Nethersole Hospital.

　　　　231. This hospital is owned and operated by the London Missionary Society but receives financial assistance from Government. For the financial year 1953/54 the Government subvention amounted to $611,700. The hospital has accom- modation for 178 general in-patients and for maternity cases. During the year under review, the hospital was busier than ever before. Admissions numbered 5,135 as compared with 5,306 in the previous year. In the maternity section there were 1,506 births and maternal deaths numbered 6. Out-patients treated numbered 52,435 as compared with 45,924 in 1952. Resident medical staff numbered 8. The hospital is a recognized school for the training of nurses and it is also recognized as an approved institution for the purpose of providing posts for house officers under the provisions of the Medical Register (Amendment) (No. 3) Ordinance which follow those of the Medical Act 1951 of the United Kingdom,

Ruttonjee Sanatorium.

232. This institution is owned and operated by the Hong Kong Anti-Tuberculosis Association, but the day-to-day manage- ment is vested in a Sanatorium Management Board of which the Director of Medical and Health Services is a member. The number of beds available was 230 and these were reserved for the pulmonary form of the disease. Priority of admission is

given to the employees of the principal subscribers to the Asso- ciation but, as has been stated earlier in this report, all cases are admitted through the Government Tuberculosis Clinics.

233. The number of admissions during the year was 279 as compared with 352 in 1952. There is also an out-patient department which is attended by patients after discharge from hospital for follow-up treatment and the total number of attendances here was 6,451.

Pok Oi Hospital.

234. This small institution, providing accommodation for 36 patients, is situated at Un Long in the New Territories and, outside the urban areas, is the only hospital supported by volun- tary effort. The hospital is administered by a Board of Directors who, in March 1953, were incorporated by Ordinance. The institution, which has a history of some 30 years, is sup- ported by the voluntary efforts of the residents in surrounding districts. Substantial renovation was effected in the post-war period and the building now provides reasonable accommodation.

235. During the year under review, for the first time, the institution was in receipt of a subvention. Government seconds to the hospital 2 medical officers and the subvention is to meet their salaries.

V. GENERAL OUT-PATIENT SERVICES

236. General out-patient services during the year under review continued as in the previous year, but 2 additional centres were opened, both in Kowloon, to meet the needs of police personnel in the area and also the staff of the Kowloon-Canton Railway. Total attendances at the dispensaries showed a further increase and all institutions were, uncomfortably over- crowded. At all centres providing out-patient treatment patients are charged $1 per visit but, when necessary, even this charge was waived when it was considered to be beyond the means of the patients. Details of the attendances at the various institutions are shown in Appendices 12 to 15 inclusive. General comments on these institutions follow.

URBAN AREAS.

Sai Ying Pun Out-Patient Department.

237. This was the out-patient department of the old Government Civil Hospital which with the completion of the Queen Mary Hospital in 1938, became the Sai Ying Pun In- fectious Disease Hospital. It is situated close to this hospital in the western district of Victoria, but it serves, as the out- patient department of Queen Mary Hospital which is some miles away. Although the accommodation available is in- sufficient for the work demanded of it the institution is the largest on the Island providing out-patient services. It operates throughout the day and, in addition, clinic sessions are held in the evenings going on until midnight. It is here that medical undergraduates of the University obtain their out-patient training. The limited accommodation and the overcrowding, which was continuous, make this institution an unsatisfactory one as a teaching centre and it is also unsatis- factory from the point of view of patients and staff. attendances during the year showed a decline of 247,930 as compared with 262,198 in 1952, but this led to no amelioration of the unsatisfactory working conditions. The total Govern- ment medical staff working in the out-patient department was 10, their duties being spread over the working period from 9 a.m. until midnight.

Total

　　　238. New and more adequate premises for this work are an urgent necessity but the area in which the present institution is sited is so congested that no alternative building site is available which would permit of new premises being built without interrupting, for a substantial period, the services provided now. This problem is under active consideration. When the new Tsan Yuk Maternity Hospital is completed and the patients are moved from the present Tsan Yuk Hospital it may be possible to use the latter premises, unsatisfactory though they may be, to accommodate temporarily the services now provided at Sai Ying Pun, until such time as it is possible to erect a new building in this area.

Violet Peel Polyclinic.

239. This institution provides general out-patient services in the Wanchai district, a densely populated area in the eastern part of Victoria. Here, as at Sai Ying Pun, services are available not only during the day but also at evening clinics which are operated from 6 p.m. until midnight. Four doctors are available at the day sessions and 2 doctors for the evening sessions. Specialists officers from the Queen Mary Hospital held special sessions at the clinic.

　240. Here again the accommodation is totally inadequate to meet the pressure placed upon it. Attendances have shown a progressive increase during recent years and now equal the attendances at the Sai Ying Pun Out-patient department. During the year total attendances numbered 240,862 as compared with 235,740 in the previous year. These large numbers have created serious administrative problems, which can only be partially solved because they arise mainly from the inadequate space available. Material relief can, in fact, only be expected from the provision of additional clinic accommodation in the area.

Kowloon Hospital Out-patient Department.

　241. This is the largest and busiest outpatients clinic on the Mainland. Statistical information concerning its activities is contained in paragraph 190.

Public Dispensaries.

　242. These number 5 on Hong Kong Island and 5 in Kowloon and, with one exception, the premises are old and outmoded and are endeavouring to deal with numbers far beyond their capacity.

243. A domiciliary midwifery service is provided from 6 of these dispensaries attached to which are midwives,

　244. During the year under review total attendances again. showed an increase there being 466,659 as compared with

414,084 in the previous year. Of the total attendances 300,097 were new cases. Details of attendances are shown in Appendix 14.

Government Families' Clinic.

　　　　245. Until June, 1953 this clinic, for the benefit of Government employees and their dependants, was conducted in the General Post Office Building in Victoria. However, in that month it was moved to new and very satisfactory premises incorporated in the new Central Government Office Building, the first section of which was completed this year. The clinic operates only in the mornings and is conducted by the Families' Visiting Medical Officer. There was an increase in the number of attendances which may be partly due to the new location of the clinic. Total attendances numbered 8,869 as compared with 7,904 in the previous year.

Police Medical Post, Hong Kong.

　　　　246. This clinic is situated in the Central Police Station Building, Victoria, and is intended to serve members of the Police Department and their dependants, Attendances num- bered 24,500 and during the year it was found necessary to make the medical officer in attendance full time rather than part time as he had been in the past.

Police Medical Post, Kowloon.

247. This clinic was opened in March, 1953 and is accommodated in a large new block of Police quarters in Kowloon. A full time medical officer is available and total attendances were 18,318. By the end of the year the daily average number of attendances had risen to 110.

Medical Post, Victoria Remand Prison.

　　　　248. This clinic meets the needs of prisoners on remand before they are transferred to the Colony's prisons. Until October, 1953 it was under the care of the medical officer who was in charge of the Police Medical Post, Hong Kong but the

volume of work had increased to such an extent that from that date a full time officer was appointed. The total number of attendances at the clinic was 17,900 as compared with 12,834 in 1952.

Marine Department Clinic.

249. This clinic is accommodated in the Marine Department Building in part of premises occupied by the Port Health staff. It is conducted by members of that staff and is solely for the convenience of the Marine Department. Attendances numbered 1,165.

Kowloon-Canton Railway Clinic.

250. A new clinic to meet the needs of Railway staff was established in the Kowloon Terminus Station in December, 1953. It was opened for 2 afternoons each week, the medical officer and a part of the staff from the Hunghom Public Dis- pensary carrying out the work. Up to the end of 1953 the clinic had been in operation for only 3 weeks and attendances numbered 96.

New Terriorities.

251. Including the out-patient department of St. John Hospital, Cheung Chau, to which reference has been made earlier in this report, there are eleven establishments in the New Territories providing out-patient treatment facilities. Excluding Cheung Chau, three of these have resident doctors and there are facilities for the treatment of general in-patients and maternity cases as well. At the remaining dispensaries there is a small number of maternity beds under the charge of resident midwives.

252. In addition, from the two main centres at Tai Po and Un Long, two mobile dispensaries provide services in the rural areas on the eastern and western parts of the Mainland respectively. Medical services to the Islands are, in general, limited in scope and are provided by infrequent visits of medical staff. However, with the posting of the second doctor to the

St. John Hospital, Cheung Chau, more extensive and regular weekly visits were paid by medical officers to the island of Ping Chau and to villages on Lamma, Ma Wan and southern Lantao, other islands in the vicinity.

　　　253. The dispensaries in the New Territories are in fact embryonic health centres as not only are curative services. provided but, in many cases, infant welfare and ante-natal sessions are conducted and special clinics, namely, ophthalmic, tuberculosis and dental, are held by visiting staff from the city.

VI. AUXILIARY MEDICAL SERVICE

254. The Auxiliary Medical Service was established in 1950 by regulations under the Essential Services Corps Ordinance. It is a unit within the Essential Services Corps and its unit controller is the Director of Medical and Health Services. The purpose of the Service is to supplement in times of emergency the facilities of the Medical Department.

　　　255. In the case of a major emergency it is considered that the Colony's medical resources in hospitals and personnel will be insufficient to deal with the number of casualties expected and so the organization of the Auxiliary Medical Service has the following objectives:-

(a) To provide a large body of trained men to be responsible for casualty collection, first aid and ambulance services.

(b) To expand hospital facilities by the provision of additional beds in existing hospitals and by the establishment of new hospitals to be brought into use if required.

(c) To train recruits to supplement existing full time staff in manning existing and emergency hospitals. (d) To procure and store the equipment necessary for

attaining the foregoing objectives.

256. Substantial progress towards these objectives was made during the year and the Service has now a strength of about 4,000. The full staff training programme has not yet been completed but training continued steadily and by the end of the year more than 3,300 individual courses had been completed.

257. Good progress was made in the building up of the first aid and casualty collection organizations. The greater part of the active strength of the St. John Ambulance Brigade is en- rolled in this section of the Service. They constitute an already trained nucleus, but the numbers are not sufficient to man these services fully and a large number of men not in the St. John Organization were continuously under training. Field training exercises were carried out continuously, providing valuable practical experience to all ranks.

258. Training of auxiliary dressers for the expanded hos- pital scheme continued. These men received a series of training courses in actual ward work in Government hospitals and those with special aptitude are selected for advance training to qualify them as operating theatre dressers. During each month about 60 men completed the basic course and half of these proceeded to the more advanced training.

VII. SPECIAL SUB-DEPARTMENTS

Dental

259. This sub-department is under the charge of the Senior Dental Surgeon who is also the dental specialist of the Medical Department. The staff which is available to him consists of 2 dental surgeons, 9 assistant dental surgeons, 12 woman dental assistants, 2 dental technicians and 2 dental inspectors. The work of the sub-department may be considered under two heads, namely, the General Dental Service and the School Denta! Service.

260. The General Dental Service provides treatment for Government servants, pensioners and their families, in-patients of all Government hospitals and for prisoners. Emergency dental treatment, including oral surgery, is also available for members of the general public who are unable to pay the fees of private dental practitioners.

261. Throughout the year 2 main dental clinics were operated, one in Hong Kong at Sai Ying Pun Hospital and the other on the Mainland at Kowloon Hospital, but in August 1953 an additional clinic was opened in Kowloon at the Li Kee Memorial Dispensary, Kowloon City. About 80% of the time devoted by dental staff to the General Dental Service was given to the emergency and routine dental treatment of Government servants, pensioners and their families. Waiting lists of patients requiring treatment were maintained throughout the year, at the end of which the list consisted of 506 names with dates going back as far as November 1952. In the circum- stances it was not possible to expand dental treatment facilities to the general public, although, in addition to the regular bi-weekly sessions for the general public held at the 2 main clinics, sessions were held fortnightly in 3 centres in the New Territories.

262. The Dental Section of the School Health Service continued to operate as in the past. Only emergency dental treatment, mainly extractions, was available for pupils attend- ing Government and Subsidized schools. Although some con- servative treatment was carried out at one of the school dental clinics on the Island where a full time dental surgeon was continuously employed, owing to lack of staff no routine examinations were carried out by dental surgeons in Govern- ment and Subsidized schools. Pupils found by the School Medical Officers to be suffering from obvious dental caries were referred to the school dental clinics for treatment. Attendances of such referred patients totalled 14,530 as compared with 8,362 in the previous year. The numbers of permanent and deciduous teeth extracted were 1,474 and 10,976 respectively. On the other hand 1,572 permanent and 550 deciduous teeth were filled.

　263. Pupils and teachers in private schools, who participate in the School Health Service, were dentally examined every six months, dental operations were performed and a large number of conservative treatments were carried out. The state of children's teeth in 1953 was found as in previous years to be bad. Of 22,191 children examined, 15,076 were found to require treatment, ¿e. 67.9%. No fewer than 1,112 permanent teeth and 10,745 deciduous teeth were extracted,-regrettably high totals. The numbers of deciduous and permanent teeth which were filled were 788 and 3,431 respectively. The proportion of extractions to fillings remains high in spite of a policy directed to conservative treatment whenever this was possible.

　264. The 2 Dental Inspectors already mentioned were engaged, on duties connected with the supervision of dental practice in the Colony. Their duties included the inspection of premises of registered dentists, many of whom do not possess orthodox dental qualifications, and, in addition, they investigated and reported instances of illegal practice of dentistry. As a result of their activities in this regard 8 persons not registered as dentists in the Colony were convicted of illegally engaging in practice.

　265. A summary of the dental work undertaken by Govern- ment staff during 1953 is shown in Appendix 16.

Pharmaceutical

　266. This sub-department is under the charge of the Chief Pharmacist who has, at his disposal, a staff consisting of 4 pharmacists, and 46 dispensers of whom 11 are probationers at various stages of their training. This staff is disposed of in the Central Medical Store and in the pharmacies in various departmental institutions. A wide range of activities is covered from the issue of drugs and instruments to hospitals, clinics and public dispensaries, to the manufacture of pharmaceuticals, inspection of licensed premises and the custody and disposal of confiscated narcotics. During the year medical supplies were

issued to 191 institutions, an increase of over 50 on the figure for 1952. This figure included the issue of purely "first aid" items to other Government departments.

　　　　267. At the Central Medical Store on Hong Kong Island considerable quantities of pharmaceuticals were manufactured as is indicated below, where a comparison is made with similar work carried out in the previous year.

Bulk injection fluids, litres

Injections, various in 20 ml, containers Bulk ointments, lbs

IL-J

Bulk mixtures, concentrated, lbs Tablets

1952

1953

30,192

43,395

JLI

28,539

37,611

6,443

6,424

304,195

519,380

nil

505,060

268. Manufacturing work was greatly facilitated towards the end of the year by the installation in the Central Medical Store of a new and very large gas-operated autoclave in replace- ment of 3 old "field service models" which had given excellent service for nearly 9 years, but which were beginning to cause trouble.

269. An important duty of the Chief Pharmacist and his staff is the supervision of wholesale and retail dealers of pharma- ceuticals and the issuing of licences thereto. The numbers of licences issued during the year as compared with the previous year are shown below together with the number of premises registered and visited.

Wholesale Dealers Licences

Listed Sellers Licences (Retailers)

1952 1953

465

475

222

229

- atı

204

207

157

895 1078

Licences issued to Authorized Premises

(Pharmacies)

Antibiotics Permits

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

Restricted Antibiotics Permits

Premises inspected

270. As a result of the inspectorial activities of the Depart- ment's staff legal proceedings were instituted in 11 instances for offences against the Pharmacy and Poisons and Penicillin Ordinances.

　271. Seizures of contraband narcotic drugs by Police and Revenue Officers during the year numbered 4,364. There were no particularly large seizures of good quality raw opium and the majority were small amounts of opium prepared for smoking and small parcels of heroin. Of the raw opium seized a small quantity was retained by the Department for the preparation of Tincture of Opium, the remainder was held for disposal through the offices of the Crown Agents for Oversea Govern- ments and Administrations. Other items were disposed of by dumping at sea.

Pathological (including Mortuaries)

　　272. The Pathological Institute in Victoria and a sub- sidiary institute in the Kowloon Hospital constitute this sub-department, which is also responsible for a small clinical laboratory in the Queen Mary Hospital and two public mor- tuaries in Victoria and Kowloon. The Government Pathologist is in charge and he is assisted by 3 pathologists. Other staff consists of the Chief Laboratory Technician, 2 laboratory technicians and 20 laboratory assistants together with menial staff. In past years and until recently the laboratory staff was insufficient and the laboratory constituted a definite bottle-neck in the Department's work. During the year under review the situation was substantially improved by the addition of 8 pro- bationer laboratory assistants and, in due course, when these men have been trained the laboratory service should be very much more satisfactory.

　273. The total number of specimens examined during 1953 was 239,943 which represents a considerable increase over the corresponding figure of 214,026 in the previous year. The examinations undertaken by the sub-department during the year are summarized in Appendix 17 and a summary of the work carried out in the public mortuaries is set forth in Appendix 18. An important event in the year's working was the adoption of the V.D.R.L. flocculation slide test for syphilis as the routine serological examination by the end of the year. The Kahn test was only employed as a check on doubtful findings.

　　　274. As in the past preparation of vaccine lymph and other vaccines accounted for a substantial proportion of the work of the Institute. The volume of this work also showed an increase in the year under review and the Table below indicates what was accomplished.

TABLE 7

Vaccinc prepared

Vaccine

issued

Anti-smallpox vaccine

24,970 ml.

26,855 ml.

Anti-cholera

176,400

189,890

Anti-typhoid-paratyphoid vaccine (Adult) ...

Anti-plague vaccine

412,880

(Children)

204,850 29,320

148,740

3,500

rabic

(2%)

65,450

340

39,000

וי

(4%)

43,400

31,000

■

rinderpest vaccine

54,500

Diluted tuberculin

Grand Total

---

-------

38,500

1,050,270

532,325

Chemical Laboratory

　　　275. The Chemical Laboratory is the responsibility of the Government Chemist who has a staff of qualified chemists and 3 laboratory assistants together with menial staff. It under- takes analytical and consulting chemical work for all Govern- ment departments and in addition carries out work for the Services, public bodies and the commercial community.

　　　276. The Laboratory is well equipped and supplied and an improvement in its equipment was effected during the year by the installation of a small air-conditioning and dehumidifying plant with a view to preserving the valuable optical and electrical equipment from deterioration during the hot weather. However, accommodation in the laboratory is restricted and adequate space is not available for the proper storage of Police exhibits and hazardous chemicals.

　277. A total of nearly 25,000 examinations were carried out, which greatly exceeds that of any previous year, and the increase was accounted for mainly by the increase in biochemical work resulting from an increased programme in the social hygiene clínics and to the greater number of seizures of narcotics, principally opium and heroin, by the Police. Commercial work showed a slight decline but the volume of this work is scarcely less than that of the prosperous postwar years. Specimens numbered 1,747 and consisted of some 140 different commodities, of which the more important were drugs, foods and chemicals.

　278. Public health work included an investigation of the flourine content of tea and of the water from a number of village wells and a number of water specimens from the harbour were examined for sewage contamination.

　279. Chemico-legal examinations included 262 poisoning cases, mostly suicide or attempted suicide. They included a fatal case of poisoning by the morphine substitute "amidone", and 4 cases of severe poisoning of Dock workers by cargoes of the dyestuff-intermediate paranitraniline, which is not usually regarded as a specially dangerous substance.

　280. Assistance was also given by the laboratory to the Fisheries Research Unit of the University in an investigation of the water in fish breeding ponds in the New Territories.

　281. In the Table below the work carried out in the year under review is briefly summarized:-

TABLE 8

1952

1953

Public Health

9,256

12,282

Chemico-Legal

815

800

Commercial

1,839

1,747

Revenue Control, Narcotics, Strategic

Materials

6,657

9,828

Miscellaneous Government Work

284

250

Total

18,851

24,907

Almoners

282. The Almoner sub-department had an establishment consisting of the Principal Almoner, 6 Almoners and 14 Assistant Almoners, but this full complement of workers was not available during the whole of the year. In the latter part of the year the establishment consisted of the Principal Almoner, Almoners (including one who had just returned from a full course of training in the Institute of Almoners, London) and 13 Assistant Almoners. The work of these officers had in the past been seriously hampered by inadequate accommodation but there was an improvement during the year at the Queen Mary Hospital and the Kowloon Hospital. The working con- ditions in some of the other institutions leaves much to be desired.

　　　283. There was some development in the almoners' work at the Mental Hospital during the latter part of the year and the development of the ophthalmic service brought new duties. A full time almoner is really required for this work.

284. During the year certain of the more senior members of the staff, through the co-operation of the Social Welfare Officer, paid refresher visits to the Moral Welfare, Probation, Youth Work and Relief Sections of the Social Welfare Depart- ment. Students of the Social Science Department of the University spent several weeks with the almoners in hospitals and clinics as part of the practical work of their course.

285. Suitable nourishment, home care and employment are perhaps the most essential needs for recovery and rehabilitation but are hard to obtain in Hong Kong. The problems facing the almonering staff are considerable, but they have cause to be grateful to the statutory and voluntary organizations as well as to many individuals for the help they have had in meeting the particular needs of patients. The co-operation of such organizations in the placing of children during the illness of the mother is of the greatest value.

286. A considerable amount of the almoners' time is devoted in attempts to make arrangements for the return to China. of persons domiciled there. In the circumstances of today this is a difficult task indeed.

287. A Samaritan Fund which is maintained by voluntary donations is dispersed by the almoners and during the year this source provided $3,743, which was mainly used to enable patients to attend hospital for treatment and to help establish those discharged from hospital. These sums are in addition to the $100,000 dispersed by the tuberculosis almoner to which reference has already been made in this report.

Radiological

288. This sub-department is under the charge of the Senior Radiologist who had throughout the year a staff of one radio- logist, 7 Medical and Assistant Medical Officers performing radio- logical duties, 1 Superintendent Radiographer, 10 radiographers and 17 radiographic assistants. In addition, the physiotherapy staff, consisting of 10 physiotherapists and assistant physio- therapists and one occupational therapist, was the administra- tive responsibility of the Senior Radiologist.

289. A further increase in the work of this sub-department was evident during the year and it suffered seriously from the general overcorwding which was a problem in so many other sections of the Medical Department. The work of this sub- department falls into the following sections:

290. Radio-Diagnostic-The work of the diagnostic section again increased substantially. A total of 195,673 investigations were carried out as compared with 141,694 in the previous year. By far the greater part of this increase was accounted for by the increased activity of the mass miniature X-ray survey conducted by the Mobile Unit, but all other centres and investigations showed a general increase as well. Certain new diagnostic

equipment was installed during the year but there is still equip- ment in use which should be replaced and arrangements have been made for this to be effected during the forthcoming financial

year.

291. Radio-Therapeutic-The work of this section was con- siderably hampered by the breakdown of the only deep X-ray therapy machine available to the Department which was out of action for almost half the year. The total number of deep X-ray and superficial therapy treatments given was 138.

292. In June 1953 a 24.9 Curie Radio-Cobalt Telecurie Unit was brought into operation in the Queen Mary Hospital, an event which created considerable interest in overseas territories and led to a number of inquiries from neighbouring countries. This useful piece of apparatus was used particularly for the treatment of naso-pharyngeal carcinoma which occur in relatively high percentage among the peoples of South China. The number of persons treated during the year was 31.

293. Physiotherapeutic-The volume of work carried out by this section also showed an increase, 56,764 treatments provided as compared with 47,176 in the previous year. Again, this section was to a great extent hampered by the inadequacy of the accommodation available in the Queen Mary Hospital. but at the end of the period under review preparations were being made for the transfer of the section to the very adequate accommodation provided in the new clinic to which reference has already been made.

　　　294. Occupational Therapy-During the period under review for the first time the Department had available to it a qualified occupational therapist and a satisfactory start was made with this work in which a number of voluntary workers participated in the Queen Mary Hospital, Lai Chi Kok Hospital and the Mental Hospital. Again, limitations of space seriously hamper- ed this work, but its scope will be greatly widened by the space provided in the new clinic building.

Ambulance Service

295. This service was, until 1st July, 1953, the responsibility of the Medical Department but from that date the Chief Officer of the Fire Brigade took over administration of the service and the Medical Department's vehicles and personnel were transfer- red to him. This change not only led to more economical opera- tion of the Government ambulances but led to a more efficient service being provided.

Births and Deaths Registration

296. The Births and Deaths Registration Ordinance provides machinery for the registration of these events. The Director of Medical and Health Services is the Regisrtar of Births and Deaths. The General Registry Office is situated in the centre of Victoria and there are a number of branch registries throughout the Colony.

297. There was again an increase in the work of this sub- department and during the period under review the number of birth certificates issued was 78,406 as compared with 69,883 in 1952.

VIII

INTERNATIONAL ORGANIZATIONS

298. The World Health Organization and the United Nations International Children's Emergency Fund again provided the Medical Department with some very useful and welcome assistance. Not only were a number of valuable fellowships provided to enable local personnel to obtain advanced training in overseas countries, but substantial material assistance was given by the provision of toxoid for the anti-diphtheria cam- paign and B.C.G. vaccine for the anti-tuberculosis campaign. Further a substantial amount of equipment was received from U.N.I.C.E.F. not only to equip the increased number of Maternal and Child Health Centres which were provided during the year. and to which reference has been made in a previous paragraph, but also large quantities of milk powder and diet supplements were also provided. Certain hospital equipment was also added to the Department's resources.

299. A Maternal and Child Health project which provided for certain international personnel to work in the Colony for a period of 2 years did not, unfortunately, come into full operation during the period under review as only one member of the inter- national team was available during that period. This resulted from difficulties which were experienced by the World Health Organization in recruiting the necessary personnel but as the period under review was drawing to a close it appeared that these difficulties were being overcome and that these personnel would be arriving in the Colony at an early date.

IX. TRAINING OF PERSONNEL

　　　　300. In addition to the overseas training referred to in para- graph 18 the following Table gives details of personnel trained within the Department during the year under review,

TABLE 9

Appoint-

Strength

Resignation at

Paised

meat

31,3.54

Probationer Assistant

Physiotherapist

Probationer Radiographic

Assistant

...

Probationer Dispenser

JIIILID

Probationer Laboratory Assistant

Probationer Assistant Almoner

Probationer Nurse Probationer Dresser Pupil Midwife....

----

126

ཌ ཌ རྞཧྨ ཧྨཨྠ

K. C. YEO,

Director of Medical and Health Services.

OCCUPATIONAL THERAPY FUND

Statement of Receipts and Payments for the year ending 31st March, 1554,

RECEIPTS

Description

Amount

PAYMENTS

Description

Amount

Ç.

To Balance brought forward

To Sale of Rattan ware

To Supply of rattan baskets to Stores Department

3,036.95 | By Tailoring Workmanship.

8,399.97

By Monthly honoraria to voluntary workers...

6,400.00

360.00

By Purchase of Materials

374.05

306.50

By Hire of Pool transport and travelling expenses

1,394.20

By Crown Agent Account for Occupa- tional Therapy Equipment

815.16

By Balance earried forward

11,743.42

2.400.01

11.743.42

The above account has been examined in accordance with the Conditions set out in the Schedule to the Resolution approving the Establishment of the Occupational Therapy Fund. I have obtained all the information and ex- planations that I have required, and I certify, as a result of this audit, that in my opinion the Account is correct.

Sgd. P. H. JENNINGS Director of Audit.

Certified correct.

Sgd. F. J. ANSLOW

p. Director of Medical & Health Services.

Sgd. B. L. BICKFORD

Secretary, Occupational Therapy Committee.

8th July, 1954.

SAMARITAN

FUND

Statement of Receipts and Payments for the year ending 31st March, 1954.

RECEIPTS

Description

To Balance brought forward

To Donations...

To W. & O. Pensions (Mrs. Li Sbuk Hing widow of late Mr. Chan Nai Too. now an inmate in mental Hospital)...

To Salary and Gratuity (Mr. Wong Kai, driver of P.V.D. now an inmate in Mental Hospital)

Amount

PAYMENTS

Description

4,286.87

6,611.12

By Providing maintenance and capital grants, clothing, food, travelling expenses and etc.. to patients

By Balance carried forward

....

176.17

1,163.34

Amount

4,193.80

8,043.90

The above account has been examined in accordance with the Conditions set out in the Schedule to the Resolution approving the Establishment of the Samaritan Fund. I have obtained all the information and explanations that I have required, and I certify, as a result of this audit, that in my opinion the account is correct.

8th July, 1954,

Sgd. P. H. JENNINGS Director of Audit.

12,237.70

Certified correct.

Sgd. F. J. ANSLOW

p. Director of Medical & Health Services.

Sgd. M. BENHAM

12,237.70

Principal Almoner Medical Department.

NURSES REWARDS AND FINES FUND

Statement of Receipts and Payments for the year ending 31st March, 1954,

RECEIPTS

PAYMENTS

Description

To Balance brought forward

To Forfeiture of deposits from Misses B. Penn, R. Chan, P. Tan, M. Boey, J. Lam, J. Mui (Yee Jong) and N. Yeung Wai Kun

Amount

Description

543.82

By Expenditure ail

1.400.00

By Balance carried forward

Amount

1,943.82

The above account has been examined in accordance with the Conditions set out in the Schedule to the Resolution approving the Establishment of the Nurses Rewards and Fines Fund. I have obtained all the information and explanations that I have required, and I certify, as a result of this audit, that in my opinion the account is correct.

Sgd. P. H. JENNINGS

1.943.82

Certified correct.

Sgd. F. J. ASNSLOW

p. Director of Medical & Health Services.

Sgd. M. L. EVERETT

1,934.82

Principal Matron, Medical Department.

Bih July, 1954.

Director of Audit.

NEW TERRITORIES MEDICAL FACILITIES

COLONY OF HONG MEDICAL FACILITIES

CHINESE

TER

ORY

MAR 1953

D***

ខ

CASTLE

PEAK

HOSP.

UN LONG DISPENSARY

TDISPENSART

LOR MA CHAU

SHA TAU KÒN DISPENSA

TA KU LING

SHEUNG

SHUT

CISPENSARY

FAN LINK

TALPO DISPENSARY

NEW TERRITORIES

SILVER MINE BAY, OISPENSARY

TALO DISPENSARY

LANTAO

SHATIN,

SAI

DISPENI

MATERNITY HOVĚ

THAY LING CHÂU PLEPER SETTLEMENT

KONG

[Zee Separate Map :)

HERING CHỊU

JOHN HOSPITAL

HONG KONG ISLAND MEDICAL FACILITIES

ESLANO MEDICAL FACILITIES

LING TUỆT SIN INFANTS HOSPITAL

TSAN YÜK HOSPITAL

MENTAL HOSPITAL

TAI WO HOSPITAL

SAI YING PUN HOSPITAL & OUT-PATIENT DEPT

HONG LONG

TUNG WAH HOSPITAL

NETHERSOLE HOSPITAL

PORT HEALTH INOCULATION CENTRE

CENTRAL PUBLIC DISPENSARY

POLICE MEDICAL POST

ון

HK FAMILIES CLINIC

STATUE SOUARE INOCULATION CENTRE

HK.CENTRAL HOSPITAL

MILITARY HOSPITAL

ST FRANCIS HOSPITAL

VIOLET PEEL POLYCLINIC

EASTERN DISPENSARY & MATERNITY HOSPITAL

AUTTONJEE SANATORIUM

MATILDA HOSPITAL

WANCHAT S H HOSPITAL

국

QUEEN MARY HOSPITAL

HARCOURT HEALTH CENTRE

ABERDEEN PUBLIC DISPENSARY

ST PAUL'S HOSPITAL

SHAURIWAN PUBLIC OISPENSARY

ST JOHN AVBULANCE BRIGADE CENTRE

STANLEY DISPENSARY & MATERNITY HOME

TUNG TAM EASTERN HOTEL

STANLEY PRISON HOSPITAL

H.K SANATORIUM & HOSPITAL

25 NAVAL HOSPITAL

NORTH POINT MATERNAL & CHILD HEALTH CENTRE CHAT VAN MATERNAL & CHILD HEALTH CENTRI

KOWLOON PENINSULA MEDICAL FACILITIES

LAI CHI KOK HOSPITAL

FEMALE PRISON HOSPITAL

PRECIOUS BLOOD HOSPITAL

SHAM SHUI PO PUBLIC DISPENSARY

MONGKOK CLINIC

MILITARY HOSPITAL

LI KEE MEMORIAL DISPENSARY

ST. TERESA'S HOSPITAL

KOWLOON HOSPITAL & OUT PATIENT DEPARTMENT

KOWLOON CHEST

CLINIC

KWONG WAH HOSPITAL

YAUMAT! PUBLIC DISPENSARY

HUNG HOM PUBLIC DISPENSARY TSIM SHA TSUI HEALTH CENTRE

ASHLEY ROAD SOCIAL HYGIENE CLINIC

KOWLOON POLICE MEDICAL POST

KOWLOON-CANTON RAILWAY STAFF CLINIC NGAU TAU KOK MATERNAL & CHILD HEALTH

CENTRE

14.

mung Ho

KOWLOON BAY

CA 5040 201

APPENDIX 1-18

THE ANNUAL REPORT 1953-54

MEDICAL DEPARTMENT

Ꮀ

BLENE ZNIA BA

ᎺᎵ

Tiiwi

. I

APPENDIX I

Establishment of the Medical Department as at 31.3.54

but

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

---

L-1

Senior Specialist (Medical)

Senior Specialist (Malariologist)

Government Pathologist

Surgical Specialist

Senior Radiologist

Tuberculosis Specialist

Senior Port Health Officer

Senior Dental Surgeon

Senior Social Hygiene Officer

Ophthalmic Specialist

Psychiatric Specialist

TIL

---

TII

г..

---

...

г..

---

т г.

---

- 17

---

TII

- LI

...

---

Gynaecological and Obstetrical Specialist

---

...

IIL

יי

---

209

---

-IL

Medical Officers, Assistant Medical Officers, Women Medical Officers,

Assistant Women Medical Officers and House Officers Dental Surgeon and Assistant Dental Surgeons

ILI

JL.

Pathologists

LII

---

IIL

Radiologist

Government Chemist

тго

Chemist and Assistant Chemists

Principal Matron

Nursing Staff

Principal Almoner

Almoners

ז..

Executive Officers

Clerical Staff

---

•

...

rit

...

זוי

Chief Pharmacist, Pharmacists, Dispensers and Dispensary

Supervisors

TII

H+

---

г.1

---

г..

668

133

ILI

TIL

IIL

ח..

...

---

-t

---

Superintendent Radiographer, Radiographers, and Radiographic

Assistants

- J-

---

Physiotherapists and Assistant Physiotherapists

---

Chief Laboratory Technician, Laboratory Technician, and

Laboratory Assistants

Chief Hospital Secretary and Hospital Secretaries Health and Malaria Inspectors Occupational Therapist

ILI

LJ J

JLI

- L

Dietitian

---

Public Vaccinators

---

...

Other Staff

...

TOTAL:

47 1,845

3,160

APPENDIX 2

Births attended by a doctor or a midwife-1953

1946

1947

1948

1949

1950

1951

1952

1953

Kowloon Hospital...

Queen Mary Hospital

Tano Yuk Hospital

Busters Maternity Hospital

Lai Chi Kak Female Prin

Hospital

117

398

719

979

1,261

1,189

2,645

3,826

4,458

1,164 1,287 4,223 5,012

1,580

1,910 1,998

1,951

1,576

2,175 2,545

2,371

5,781 6,740

6,787

868 1,633

1,831

1,783 1,995

2,254

2,650

2,378

St. John Hospital

Private Hospitals

Government Dispensaries

T 379

360

294

4,058

9,066

12,161

15,387

16,333

20,002

21,163

24,741

(attended by Midwives).. Private Maternity Homes...

640 1,260 9,586. 13,150

1,582 2,013 14,324 | 18,730

2,633

21,226

3,544 3,662 22,338 | 22,666

3,860

24,099

Total Birthe delivered in boo.

pitals and maternity homes. 18,893 30.594

36,264 44,587

50,355

58.390 61,790

66.492

Domiciliary cases delivered

by Midwives

5,698

9,237 10,120 8,991

9,125 9,054 7,701

7,145

Total Number of Birth.

attended

-----------

24,521

39,831 46,384 53,578

59,480 | 67,444 49,49] 73,637

Amoebiasis

Diseasen

ILLIII-J. LI......

Cerebro-Spinal Meningitis

Chickenpox

Cholera

Diphtheria

Dysentery (Bacillary and Clinical)

Enteric Fever

Malaria

Moncler

Plague....

Poliomyeliti.

Puerperal Faver Babice Human Aabies - Animal Relapsing Fever Scarlet Fever Small-pox..... Tuberculosis

Typhus Fever

Whooping Cough

Yellow Fever

APPENDIX 3

Notifiable Diseases

Notifications and Deaths-1952/53

Total No. of Notifications

Total No. of Deaths at all uger

1952

1953

1952

1953

201

285

176

298

IJJL-

987

1,116

157

193

336

6-62

1,230

1,434

158

128

1,010

780

674

661

14.821

452

11,900

131

3,573

2,939

APPENDIX 4

Age Group and Sex Distribution of Notifiable Diseases 1953

Under | year!

Lyr. to 3 yrs.

4 yrı. to 9 yı..

ym. to 14

уг

Over 14 you.

Total

M. F. Tota

M. F. Total

F. ! Total

Totul

F. Total

M. 1 F.

Total

Amoebiasis.

128

2081

176 109

245

Cerebro-spinal Menigitis.

Chickenpox

291 La 47

113

59.

106

167, 131

298

Diphtheria

241 16

195

147

342

273 233

506

31 391

108

158

513 543

1,116

Dysentery (Bucillary and Clinicel.)..

24! 20-

120 | 203 | 223

#7:

190

102

292

388

274

662

Kateric Fever

Human Rabies

Mularis

Measles

----

Poliomyelitis, Acute.....

Puerperal Fever

161

122

283

$8 179

585

355

940:

858 $76

1,434

等

59 1

35 12

47 412 183

5951 533 247

780

41 43

172

¦ 125 297

102

143

245

343

318

661

Scarlet Fever

Tuberculosis

Typhus Fever (Serub)...

Whooping Cough

}

129 115

244

706

586 | 1,392

$10

446

11 20

956

54 55

1096,617 2,582

9,299) 8,016) 3,884 | 1,1900

231

274 232

510 1,347 1,075 2,422 | 1,272 | 1,115, 2,387

241 216 457

| 8,016 3,527 11.543 11.154 6,265 17,319

Nil return for Smallpox, Cholera, Plague, Epidemic typhus, Yellow fever and Relapsing lever,

APPENDIX 5.

Attendances, etc., at Ante-natal Clinics during 1953.

Without Defect

Some Abouruality

Total Attendancer

% of

Centres

Defect

New

Rev. Total

New

Rev.

Total

New

Rev. Total

Harcourt....

450

Western

254

| 1,902 2,156

1,598 2,048

120

Kowloon

530

3,267 | 3,805

288

127

500

1,675

2,175

5.84

170

374

1,952

2,326

7.31

152

232

618

3,419

4.037

5.74

TOTAL...... 1,242

6,767 8,009

250

279

529 1,492 7,046

8,538

6.19

Attendances etc., at Post-untal Clinice during 1953,

Without Defect

Some Abnormality

Total Attendancer

Centres

% of Defect

New

Rev. Total

New

Rev. Total

New

Rev. Total

Harcourt............................

Western

114

117

----------

Kowloon..

ERA

43.33

136

16.18

18.64

TOTAL.....

130

179

172

225

20.44

Infant Health Clinics.

Without Defect

Same Abnormality

Total Attendance.

% of Defect

Centres

New Rev. Total New

Rev. Total New

Rev.

Total

Skambuipo

Kowloon City.. North Point Yaumuti... Hung Hom..

Tai Pe...

307-

0-1 y.

Harcourt..

Western

Kowloon

Aberdeen

Shaukiwan Stanley ...

2,910, 34,079| 34,989 935 3,011 33,201 36,212 3,389: 35,548 38,937 326 1,806 2,132 1,208 7.945" 9.153-

159. 1,534 1,693 27 119: 234 1,10 2,044

760) 1,095) 3,245 818 1,684 2,502 3,829) 687 1,723 2,410 4,076 165 2021 361 581 1,305

32,539 34,885 37,271; 1,971

36,0841 10.32) 2.31|| 3.03 38,714) 21.36 4.83.

6.46

41,347) 36.85| 4.62; 5.82

10.19:

8.37

8.65

7.43

5.621

5.97

146

1,653.

14.51! 7.20

7.94

1470

239

1,957

20.02) 7.51 10.64

3,092,

3.479

157

179

409%

3,249:

3.659

BL-

187

266

192

266.

936

1,202

978

5.351 4.83; 4.89 4.80: 2.60: 3.30 2.91 4.29 3.99

1941

1,003;

1.197!

210

1.075

7.61 6.69

6.84

187

1,074)

216

956

3,172

13.42| 7.21

8.36

Un Loog

257

697

9543

308

1.05

14.55 6.19

9.22

San Hui...

150

5941

40.

161

473

Shatin

154

487:

6451

634 6.83 6.13

6.30

39 167

$17

664 5.381 5.80! 5.72

Chaiwan

449

2,786

3,237

100 469 2.868

Ngau Tau Kok

104

1571

3,337 4.26' 2.79

166] 3.631

3.00

6.33

5.42

TOTAL... 13,419 124,548 137,967 2,265 5,619 7,884 15,684 130,167|| 145,851| 14.44|

7,884|15,684|

4.31

5.40

Centres

APPENDIX 5.

Infant Health Clinics,-Conid,

Without Defert

Some Abrorninlily

Total Attendances

%% of Defect

New

Rev. Total

New

Rev. Total New

Rev.

Total New

Rev. Total

1-2 yr.

Harcourl Western

Kowlooo...

JILLI

143

7,284

7,447

143

10,272 10,415

103

12,584

12.687.

Aberdeen

917.

937i

Shaukiwan

3,635)

3,929

Stanley

979)

-----

987|

Shemehuipo

1.023

1.0231

Kowloon City....

852!

898!

North Point

21,

73:

ايو

Youmati

45'

174

219

Hung Hom

414!

474

Tai Po..

451

446.

Un Long

265.

296

ăn Hai

167,

200

ནཱཧུཀཏྠཱཝཾ ས ཝཙམྨཾཨེ

263- 200 178-

7,549.

580: 645 208.

10,852

13.

319

332

116:

12,903

73 181

27:

990

1911 104

4,016

1,034

7.727, 8.43 11,060; 31.25- 13,019) 11.20

1,017 25.93, 4,120 9.62 1,043, 11.II;

3.51 3.62

5.34* 5.43 2.47. 2.55 7.37. 7.87

4.51 4.64

5.32.

5.34

14!

1,036)

1,039 66.66

1.34' 1.53

15.

867

915 4.16

1.73.

1.85

74.

1.40;

1.05

178

231 15.00'

2.25

5.15

421

487. 9.09

1.66

2.66

481'

528

25.53

6.33

7.95

261

269

322 41.50

1.45:

8.07

183-

227) 4.54; 8.74

7.92

Shatia

316

341

10.

17.

3261

3981 9.721

3.06.

4.27

Chaiwan kaset

1,285

1,383,

1,3091

1,419; 10.91|

1.83

2.54

Ngau Tau Kok

23|

561 4.34

3.03

3.57

TOTAL...

997. 40.922 41,919

185 1,599 1.784 1,182 42,521 43,703 15.65)

3.76!

4.06

Totali

Harcourt.............

Western

Kowloon

3 073- 3,154 3,492

Aberdeen

ILIJLI

Shaukiwan

Stanley

Shamshuip

346 1.302 11,780, 167 2,513 235 2,832.

39.363 42,436 43,473

46,627 48,132 $1,624 2,723 3,069 13,082

Kowloon City.

433

3,944

350 1,025 1,375|| 3,423|| 883 2,264 3,147 4,037) 700; 2,043) 2,742 | 4,192)

44 238 282 107: 665. 2,680

28 174 3,067! 94. 161 4,377

40,388,

43,811 10.93 2.54

3.14

45,737

49,774 21.87

4.95

6.32

50.174

$54,366, 16.69|

4.06

5.04

390 1,409 202 195 255 329

2,961

3,351 11.26

8.04

8.42

12,445

13,854

7.59)

5.34

5.57

2,687.

2,882

14.36

6.48

1.01

2,993

3,322 28.57.

$.37:

7.67

172

196

457

4,116,

4,573

5.25

4.17!

4.28

North Point

102

260

362

1061

266

Yaumati.

372,

3.80 2.30 2.70

311

1,110

1,42]| 16

46.

62.

3271

1,156

Hung Hom

1,483

4.89. 3.97

4.18

254

1,417 1,671

101

276

Tai P..

1,496

1.772

7.97:

5.28

5.60

222

1,338 1,560

140

263 1,437

Un Los

1,700 15.58|

6.88

8.33

288

962

1,250;

123

361

1,012,

San Fed.

1,373 20.22) 4.94

8.95

19:

611

B03/

205!

656

Statio

861 6.343

6.85.

6.60

223

803 1,026!

16!

56! 239

843

Chaiwan

547'

4,073

4,620

1,062, 6.69 4,74:

5.38

32: 104 136

579

4,177.

Ngau Tau Kok

4,756

5.53

2.491

2.86

136

211

11:

78.

144

223

3.84

5.55'

4.95

TOTAL... 14,416

145,470° 179,886) 2,450. 7,218) 9,668| 16,866) 172,688| 189,554 14.52,

7,216

4.18 5.10

APPENDIX 6

Tuberculosis (all forms), 1953

Notifications and Deaths.

Year

Estimated population

Notifications Deaths

D/N Ratio

Rates per 100,000

esting ted population

1920

648.150

2.082

321.2

1921

625.116

1,891

303.1

1922

638.300

1923

667,900

1924

695,500

1925

725,100

1926

710,100

1927

710,300

1928

766,700

1929

802,900

1930

838,800

1931

840,473

1932

900,812

1933

922,643

1934

944,492

1935

966,341

NOT

NOTIFIABLE

2,096

328.3

2,108

315.6

2,358

339.0

2.291

315.9

1,912

269.2

2,123

286.7

2,537

330.9

2,158

268.7

1,994

237.7

1,983

235.9

2,042

226.6

2.225

241.2

2.179

230.7

2,237

231.5

1936

988,190

2.416

244.5

1937

1,281,982

4.028

314.2

1938

1,478,619

4,920

332.7

1939

1,750,256

7,591

4,443

I to 1.7

253.8

1940

1945

1946

1,600,000

2.801

1,752

1 to 1.6

109.5

1917

1,750,000

4.855

1,861

1 to 2.6

106.3

1918

1,800,000

6,279

1.961

I to 3.2

108.9

1919

1,857,000

7,510

2,611

1 to 2.8

140.6

1950

2,265,000

9.067

3,263

1 to 2.8

144.0

1951

2,013,000

13,886

4,190

1 to 3.3

208.0

1952

2,250,000

14,821

3,573

1 to 4.1

158.8

1953

2,250,000

11,900

2,939

1 to 4.01

130.6

APPENDIX 7

Deaths from Tuberculosis of Respiratory System

by Age and Sex 1951 to 1953

1953

1 9 5 2

195

Age Group

Malc Female Ferona Malc Female

Репоня

Male

Female Persons

Under 1..

113

110

105

A N = 3

111

104

14.....

15 19.

20 24..

145

139

70.

209

2529..

111

E39

207

209

107

316

30-34

103

156

176

255

236

123

359

39..

143

196

194

279

252

124

376

44.

146

208

217

291 |

201

288

45 49

150

195

160

229

172

219

50 5.

147

193

141

184 !

147.

219

SS 59.

131

135 100

143

64..

108

117

125

69.

74.

14:

יזי

26:

79.

-1

80 H

85 & over

Lnknown

11 IT

| 1

Total:

1,252

722

1,974 1,582

879

2,461 |1,899 1.107

3,006

Age Group

APPENDIX 8

Notifications of Respiratory Tuberculosis by

Age and Sex for the years 1951 to 1953

19 5 3

1 9 5 2

Male

Ferale Persons

Male

Female

Perenne

Male

1 9 5 1

Female

Periana

Under 1........

9.4

184

178

1...

127

214

169

168

337

163

132

295

163

114

277

205

148

353

177 182

359

144

137

201

215

176

391

189 168

357

106

195

184

160

344

177

143

320

9...

268

227

495

417

289

706

435

303

738

170

101

188

19.

240

123

363

410:

237

647! 349

206

$55

24.

987: 317

1,304 1,330

421

1,754 1,089

406

1,495

25 29

---

1,016 359 1,375

1,488

506

1,994 1,279 401

1.760

30 34.

3539.

1,099 420

1,519 1,334

537

1,871 1,216

543

1,759

984 368

1,352 1,117

464 ¦

1,581

985 453

1,438

▬▬

40 44.

769 324

1,093

892

367

1,259

732

409

1.141

550

180

730 565

249

814

479

235

714

54.

435

190

625

409

168

577

361 239

600

55. - 59..

201

145

346

173

14+

317

205

110

353

FLL

64.

123

217

121

103

224

111

113

221

69...

111

102

70 71.

LL.

- 79.

80 84....

―

85 & over

Unknown

----➖ ➖ ➖ ➖➖

Total:

7.431 3,379 10,810 9,332 4,390 13,722 8,268 -4,439

12.707

APPENDIX 9

Available Hospital Beds-1953,

No. and Category of Beds

Name and Location of Hospital

Re-

Gen- Obstet

Obstet Tuber-Infect- eral rics caloris ious

marke

Mentali

Queen Mary Hospital,

Pokfulam Road. Hong Kong

Kowloon Hospital,

Argyle Street. Kowloon........

Mental Hospital.

High Street, Sai Ying Pun

Hong Kong

Sai Ying Pun Hospital,

Queen's Road West,

Sai Ying Pun, Hong Kong

Tsan Yuk Maternity Hospital,

Western St., Sai Ying Pun, Hong Kong

Lai Chi Kok Hospital,

Lai Chi Kok, Kowloon

Eastern Maternity Hospital,

Stone Nullab Lane, Wanchai, Hong Kong

Wanchai Female V.D. Hospital,

Wanchai Toad, Wanchai, Hong Kong

St. John Hospital,

Cheung Chau Island

Prison Hospital, Stanley

(Male)

Prison Hospital,

Lai Chi Kok (Female)

487

183

180

-----

85 !

208

102

140

TOTAL

941

204

332 237 141

APPENDIX

In-patients admitted into Government and Government Assisted Hospitals 1953.

including cases remaining in hospital from the previous year.

NAME

General Infectious

Beds

Tuber-

culosis

Maternity Mental

Total

casca

cases

Queen Mary Hospital Kowloon Hospital...

Sai Ying Pun Hospital

Tean Yuk Hospital

LIL

587

8,010

130

606

2,277

10,925

233

5,445

108

121

2,585

8.270

416

1,203

1,669

7,326

Mental Hospital.

140

1,085

Stanley Prison Hospital

464

656

Eastern Maternity Hospital.

2,586

2.586

Wanchai Social Hygiene Hospital

LIL

757

Lai Chi Kok Hospital

יווי

490

2,178

1.436

810

4,424

St. John Hospital.............

102

1,14]

137

337

1,645

Lai Chi Kok Female Prison Hospital

Total Government Hospitals

New Territories Dispensaries

Tung Wah Group Hospitals

Alice Ho Miu Ling Nethersole Hospital Ruttonjee Sanatorium Pok Of Hospital

ILL - - - - |

LJILI

1,855

18.463

3.003

1,809

234

15,020

3,327

1,120

39,415

3,561

---

1,219

22.250

273

3,667

21,399

178

3,541

140

1,557

47,589

5,310

230

437

1,102

631

437

1.733

Grand Total..

3,574

45,590

3,348

6,053

41,934 · 1,120

98,045

APPENDIX 11

In-patients treated in Government and Government Assisted Hospitals 1953,

Classified according to International Standard Classification Intermediate List of 150 Causes.

Inter-

mediate

List

Number

Thetailed

List

Number.

Cause Groups

Cases

Treated 1953

Govern-

Deaths 1953

H Deaths 1953

Govern-

! ment

ment

Govern-

ment

Assisted

Hospitals

Hospitals Hospitals |Hospitals

Govern.

Assisted

Whole Colony

Male Female

Sex Un-

known

Total

A 2

010

001-008 Tuberculosis of respiratory system Tuberculosis of meninges and

1,307

3,217

38 1,337 1,252

722

1,974

| central nervous system

144

765

490 346

317

66.3

A 3

011

Tuberculosis of intestines, peri-

toneum and mesenteric glands...

012013

Tuberculosis of bones and joints...

218

100

014-019

Tuberculosis, all other forms

129

118

020

Congenital syphilis.

021

Early Syphilis.

118

تات |

024

Tabes dorsalis.

A 9

025

General paralysis of insane

A 10

022, 023

All other syphilis

176

མཎྜལ།བས

106

218

026 - 029

A 11

030 035

Gonococcal infections...

262

A 12

040

Typhoid fever.

823

320

126

A 13

041-042 Paratyphoid fever and other

Salmonella infections.

1-11 11

A 14

043

Cholera...

JILLJLII

A 15

044

Brucellosis (undulant fever)

! | ¦

A 16 (a)

045

Bacillary dysentery

321

(b)

046

Amoebiasia

151

(e) 047, 048 Other unspecified forms of

A 17

050

dysentery Scarlet fever

]

Carried forward.

3,864

4,722

240

1,959 1,907 1,278

| 3,185

APPENDIX 11-Continued

Inter-

mediate

List

Number

Cases

Treated 1953

Deaths 1953

Detailed

List

Cause Groups

Govero-

Number

Thent

Hospitals

Govern-

ment

Assisted

Hospitals

Govern

Govero-

ment

Whole Colony

Hospitals

ment

Assisted

· Hospitals

Male Female

Sox Va.

known

Total

Brought forward.

3,864 4,722

240

1,959 1,907 1,278

3,185

A 18

051

Streptococcal sore throat

г.

A 19

052

Erysipelas

A 20

053

Septicaemia and pyaemia.

A 21

055

Diphtheria

1,007

113

133

A 22

056

Whooping Cough

A 23

057

Meningococcal infections

A 24

058

Plague

יי

A 25

060

Leprosy

A 26

061

Tetanus

100

A 27

062

Anthrax

A 28

080

Acute poliomyelitis

A 29

082

Acute infectious encephalitis

A 30

081, 083

Late effects of acute poliomyelitis

and acute infectious encephalitis

A 31

084

Smallpox

A 32

085

Measles.....

244

A 33

091

Yellow fever

+++

A 34

092

Infectious hepatitis

A 35

094

Rabica

A 36 (0),

100

Louse borne epidemic typhu

+++

الرحام

101

(c)

104

(d)

105

(s)

102, 103

106 - 108

A 37 (0)

110

Flea-borne epidemic typhus

(murine)

Tick-borne epidemic typhus.... Mite-borne typhus

Other and unspecified typhus

¡Vivax malaria (benign tertian Carried forward.......

5,411 4,888

456

1,9782,075

1,978 2,075 1,397

3.472

100

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

Govern-

*****

APPENDIX 11-Continued

Cases

Treated 1953

- -

| Govern-

Govern-

meat

Deaths 1953

Govern-

Whole Colony

ment

Assisted

Hospitals

Hospitala

Hospitals

Assisted

Hospitals

Male Female

Saz Un-

known

Total

Brought forward.

5,411

4,888

456

1,978 2,075 1,397

3,472

A 37 (b)

111

Malariae malaria (quartan)

(d) 115

Falciparum malaria (Malignant

tertian).

164

Blackwater fever

(e) 113, 114

Other and unspecified forms of

116, 117

i malaria......

267

A 38 (0); 123.0

Schistosomiasis vesical (5. haema-

tobium)

(b)!

123.1

Schistosomiasis intestinal (S.

Mansoni)

fe)

123.2

Schistosomiasis pulmonary

(S.

Japonicum)

LLLLLL

€

123.3

Other and unspecified schis-

tosomiasis

A 39

125

Hydatid disease

| |

A 40 (a).

127

Onchocerciasia.

(b)

127

Loiasis

127

Filariasis (bancrofti)

127

Other filariasis

A 41

129

Ankylostomiasis

A 42 (0);

126

Tapeworm (infestation) and other

cestode infestations

(b)

130.0

Ascariasis

133

(d) 124, 128

A 43 (a);

130.1, 130.2

037

Guinea Worm (dracunculosis)

Other diseases due to helminths..

Lymphogranuloma venereum

Carried forward.

5,618

5,606

461

1,995 2,110 |1,408 1

3,518

101

102

Inter-

mediate

List

Number

Detailed

APPENDIX 11-Continued

Cages

Treated 1953

List

Number

Cause Groups

Govern-

meot

ment

Deaths 1953

Govern-

ment

Deaths 1953

Hospitals

Assisted

Hospitals

Govern-

ment

A waisted

Hospitals

Whole Colony

Male

Female

Sex Un! Total

known i

5,618 5,606 46]

1,995 2,110 1,408

3,518

]

A 43 (b)

038

(c); 039

(d)! 049

(e) 071

(S)

072

Brought forward....

Granuloma inguinale, venereal

Other and unspecified venereal

diseases

Food poisoning infection and

intoxication

ו--וי

Relapsing fever

Leptospirosis içterohaemorrhagicu

(Weil's disease)

(g) 073

(h) 087

(1) 090

Yaws

Chickenpox

121

г.

Tengue...

(J) 095

Trachoma

(k)

096.7

Sandfly fever

(t)! 120

Leishmaniasis

(m),

121 (a)

Trypanosomiasis gambiensis...

(b)

Trypanosomniasis rhodesienзів

DILI

(c)

Other and unspecified

trypanosomiasie

(x) 131

Dermatophytosis

(v). 135

Scabies

(p) 036,054,095,All other diseases classified as

063,064,070.; infective and parasitic

074,086,088.

089,093,

096.1, 096.6.|

096.8,096.9,

122,132-134,

136-138

ויז

¦ ¦

Fπ

་

Carried forward.....

... 5,842 | 5

5,640

469 1,996 |2,115

1,413

3,528

Inter-

moediate

List

Number

Detailed

APPENDIX 11-Continued

Cases

Treated 1953

Deaths 1953│

Deaths 1953

List

Number

Cause Groups

Govern-

ment

Govero-

Govern

MeAt Assisted ment Hospitals Hospitals Hospitale

ocat

Assisted

Hospitale

Whole Colony

Male Female

Sex Uni

knowb

Total

Brought forward.

5,042

5,640

469

1,996 2,115 1,413

3,528

A 44

- 140 148

Malignant neoplasm of buccal cavity and pharynx

JUL-

104

140

105

167

A 45

150

Malignant neoplasm of oesophagus

A 46

151

Malignant neoplasms of stomach

174

121

A 47

152,153

Malignant neoplasm of intestine,

except rectum

A 48

154

A 49

A 50

161

Malignant neoplasm of rectuni Malignant neoplasm of larynx 162,163 Malignant neoplasm of trachea,

and of bronchus and lung not specified as secondary

A 51

A 52

170

171

Malignant neoplasm of breast Malignant neoplasm of cervix

וי.

---

129

婴儿

A 53

172 174

uteria

Malignant neoplasm of other and unspecified parts of uterus

179

155

105

A 54

177

Malignant neoplasm of prostate

ស

A 55

A 56

190 191

Malignant neoplasm of skin.....

196, 197

Malignant neoplasm of bone and connective tissue

A 57

155 160

164, 165,

Malignant neoplasm of all other and unspecified sites

223

205

195

278

זויז---

175, 176,

178 - 181,

192 - 195

A 58

198 - 199

204

Leukaemia and aleukaemia

5.0

Carried forward.

6,737

6,759

654

T-IT

2,407 2,623 | 1,889

4,512

103

Inter-

mediate

List

Number

Detailed

APPENDIX 11-Continued

Cases

Treated 1953

Deaths 19$3

Death 1953

List

Number

Cause Groups

Govern-

otot

meat

Govern-

ment

Gove

Whole Colony

Hospital

Assisted

Hospitals

ment

Assisted

Hospitals

Male Female

Sex Un-

knowa

Total

Brought forward..

6,737

6,759

654

2,407 2,623 | 1,889

4,512

A 59

200 - 203

205

Lymphosarcoms and other

neoplasms of lymphatic and

haematopoietic system

A 60

210 - 239

Benign neoplasms and neoplasms

of unspecified nature.

651 !

233

A 61

250, 251

Nontoxic goiter

++++

A 62

252

A 63

260

Tyrotoxicosis with or without goiter Diabetes mellitus

168

66 ]

A 64 (a,

280

Beriberi

130

(b)

281

Pellagra

282

Scurvy

(d)

283 286

Other deficiency states

259

༅། །

A 65 (a)|

290

Pernicious and other hyperchromic

----

(b)}

291

Iron deficiency anaemias (hypochromic)

292, 293 Other specified and unspecified

207

A 66 (a)

241

Asthma

296

32: 28

(b)

240

242 - 245

253, 254

All other allergic disorders, endocrine, metabolic and blood diseases.

290

7 10!

270 - 277

287 - 289

294. 299 |

104

Carried forcard.....

8,221

8,064 699 2,574 2,790 2,007

4,797

APPENDIX 11-Continued

Inter-

mediate

List

Number

Detailed

Cases

Treated 1953

Deaths 1953

List

Number

Cause Groups

Govern-

Govern.

ment

Govern- Govern-

Dacat

Deaths 1953

Whole Colony

10100

Hospitala

Assisted ment Assisted Hospitals Hospitals Hospitals

Male Female

Total

known

Brought forward.

8,221

8,064

699

2,574 | 2,790 | 2,007

4,797

A 67

A 68

300 309 Paychoses.

748

15*

310-324 Psychoneuroses and disorders of

326

personality

241

A 69

325

Mental deficiency

ILI ILL

A 70

330 334

Vascular lesions affecting central

nervous system

202

397

122

269

329 234

563

A 71

340

A 72

345

Nonmeningococcal meningitis Multiple sclerosis

A 73

353

Epilepsy

A 74

370 - 379

Inflammatory diseases of eye

37.

A 75

385

Cataract

..гги г - г.

124

A 76

A 77 (0)|

387

Glaucoma.

390

Otitis externo

(b)

(c)

391 - 393

394

¡Otitis media and mas toiditis

到

A 78 (a)

380 384

386, 388

389

Other inflammatory diseases of car All other disease and Conditions

of eye

Carried forward..

9,756 8,046

860

2,854 13,142 2,264

5,406

105

* Among these,

1 died of Al-Tuberculosis of respiratory system. 1 died of AS-Tuberculosis, all other forms.

2 died of A64(a)-Beriberi.

1 died of A80-Chronic rheumatic heart disease.

1 died of A81-Arteriosclerotit and egenerative heart diseases.

1 died of A90-Bronchopneumonia.

2 died of A91--Primary atypical, other and unspecified potumonia.

6 died of AN143-Head injury (excluding fracture.)

† 1 died of AE148-Suicide and self-inflicted injury.

Inter-

mediate

List

Detailed

APPENDIX 11-Continued

Cases

Treated 1953

-TI

Deaths 1953

Number

List

Number

Cause Groups

Covero-

rcat

Hospitale

: Govern-

ment

Assisted

Hospitula

Govern-

Govern.

ment

Hospitals

meat

Assisted

Hospitals

Deaths 1953

Whole Colony

Male

Female

Sex Un-

known

Total

Brought forward..

All other diseases of the nervous system and sense organs

9,756 8,846

860

2,854 3,1422,264

5,406

114

103

(b)

341 344

350 - 352

354-357!

360 - 369

395 - 398

A 79

400 - 402

Rheumatic fever

A 80

410-416

Chronic rheumatic heart disease...

215

489

A 81

420 - 422

Arteriosclerotic and egenerative

A 82

430 434

A 83

A 84

heart disease

440 - 443 Hypertension with heart diseases.. 444 447 Hypertension without mention

$32

Other diseases of heart.....

131

319

115

103

12 285

}

184

153

168

321

136

252

198

450

of heart

A 85

450-456

Diseases of arteries

148 88

112

A 86

460 - 468

Other diseases of circulatory

system

226

333

A 87

470-475

Acute upper respiratory infections|

457

298

A 88

480 - 483

Influenza

316

A 89

490

Lobor Pneumonia

938

158

177

104

281

A 90

491

Bronchopneumonia.

307

3,849

110

1,617 |1,637 | 1,717

3,354

A 91

492, 493

Primary atypical, other and

unspecified pneumonia

454

A 92

500

Acute bronchitis.

194

191

A 93

501, 502

A 94

510

Bronchitis, chronic and unqualified) Hypertrophy of tonsils and

428

LÀ ÁN -

132

adenoide

тиг - т г .

+ LL

314

A 95

518, 521 Empyema and abscess of lung

Carried forward..

12,313

17,416

1,101

5,108 | 5,775 | 4,769

10,544

106

197

107

later-

mediate

List

APPENDIX 11-Continued

Casca

Treated 1953

Deaths 1953

Deathe 1953

Detailed

List

Cause Groups

Govern-

ment

Govern-

Number

Assisted

ment

Hospitals

Hospitals Hospitals

Govern-

ment

Assisted

Hospitals

Whole Colony

Male Female

Sex Un-

known

Total

Brought forward

12,313

17,416

1,101

5,108 5,775 4,769

A 96

519

Pleurisy

144

10,544

117

A 97 (0)

523

Pneumoconiosis

(6)

511-517

All other respiratory diseases

293

121

107

520 - 522

524 - 527

A 98 (*)

530

Dental Caries

(b)

531 - 535

All other diseases of teeth and

supporting structures.

113

A 99

540

Ulcer of Stomach

292

466

A 100

541

Ulcer of duodenum

331

A 101

543

Gastritis and duodenitis

366

A 102

550. 553

Appendicitis

758

479

|ཡ།ཨེ

111

A 103

560, 561, Intestinal obstruction and hernia.

526

212

570

A 104 (a)

571.0

¡Gastro-enteritis and colitis,

between 4 weeks and 2 years.

469

990

1,225

9871,153

2,140

rb}

571.1

Gastro-enteritis and colitis, ages

2 years and over

231

2,419

439

272 202

474

- -

572

Chronic enteritis and ulcerative

colitia

-------++-PH

149

A 105

A 106

A 107

501

Cirrhosis of liver

121

352

584 - 585

Cholelithiasis and cholecystitis.

185

125

ឥដ្ឋ។

123

158

536 - 539

Other diseases of digestive system

650

800

64 102

144

542, 544

545

573 - 580

582. 583

586, 587

Carried forward.

ILII■

16,412 24,103

1.326

7,053 7,535 6,388

13,923

Inter-

mediate

Detailed

APPENDIX 11-Continued

Cases

Treated 1953

Deaths 1953

List

Number

List

Cause Groups

Number 1

Govern-

mcat

Coverde

ment

Assisted

| Govern-

Govern-

ment

Hospitals

Hospitala

Hospitali

ment

Assisted

Hospitals

Deaths 1953

Whole Colony

Male Female

Sex Up-

kaowo

Total

Brought forward.

16,412

24,103

1,326

7,053

7,535

6,388

A 108

A 109

590

Acute nephritis

102

13,923

591-594 Chronic, other and unspecified

nephritis

150

697

182

170

161

331

A 110

600

Infections of kidney

A 111

602, 604

Calculi of urinary system.

155

A 112

A 113

610

Hyperplasia of prostate

620, 621

Diseases of breast

LIJII----

| |

A 114

320

(a)

613

Hydrocele

634

605, 609

Disorders of menstruation

All other diseases of the genito-urinary system

וח--ז.

103

| !

TIT

1,150

997

108

611, 612

614-617

622 - 633

635 - 637 İ

A 115

640 641, Sepsis of pregnancy, child-birth

681, 682,

and the puerperium

------

684

A 116

642, 652 Toxaemias of pregnancy and the

685, 686

puerperium

441

121

A 117

643, 644

Haemorrhage of pregnancy and

670 - 672

childbirth

PJELLJ

274

221

A 118

650

Abortion without mention of

sepsis or toxaemia

410

786

A 119

651

Abortion with sepsis

Carried forward..

++++

19,305

27,280 1,370

7,299 7,748 6,646

14,394

Jater-

mediate

List

Number

Detailed

APPENDIX 11-Continued

Cases

Treated 1953

Deaths 1953

List

Number

Cause Groups

• Govern.

Govern-

meat

Hospitals

Govero-

ment

m.at

Assisted

Hospitals

Hospitala

Govern.

Foot

Assisted

Hospitals

Deaths 1953

Whole Colony

Male

Female

Sex Un-

known

Total

19,305 | 272,80

1,370

7,299 7,748 6,646

A 120(a) 645-649 Other complications of pregnancy,

2,978 1,594

14,394

Brought forward.......

673 - 680

childbirth and the puerperium

683

(b)

A 121

687 - 689

660

690 - 698

Delivery without complication. Infections of skin and

11,498 22,041

[

A 122

A 123

720-725

subcutaneous tissue Arthritis and spondylitis

726, 727 Muscular rheumatism and

406

685

та г гтг

331

rheumatism, unspecified

A 124

730

Osteomyelitis and periostitis

A 125

737

Ankylosis and acquired

745 - 749

musculoskeletal deformities

A 126(a)

715

Chronic ulcer of skin (including

tropical ulcer).

452

(b)|

700 - 714

All other diseases of skin.

202

278

[ '

| "

1 !

716

(c)

731-736

All other diseases of

738 - 744

A 127

751

A 128

754

musculoskeletal system

Spina bifida and meningocele Congenital malformations of

circulatory system

142

HILLLI

A 129

750, 752

All other congenital malformations

112

753

755 - 759

A 130

A 131

760, 761

762

Birth injuries

Postnatal asphyxia and atelectasia

Carried forward.

200

34,939

53,157

1,416

功劳

→

158

7,425 7,934 6,779

1 '14,714

109

APPENDIX 11-Continued

Inter-

mediate

List

Number

Detailed

Cases

Treated 1953

Deaths 1953

List

Number

Cause Groups

Govern

Covers

Govern-

Deaths 1953

Whole Colony

ment

thent

ment

Hospitals

ment Assisted

Hospitals

Assisted

Hospitals

Sex Un-

Male Female

Total

known

Brought forward.

34,939

53,157

1,416

7,425

7,934 6,779

1 | 14,714

A 132(a)

764

Diarrhoea of newborn

(under 4 weeks)

ILL

205

61 39

100

(b)| 765

Ophthamia neonatorum.

(e) 763,766-768 Other infections of newbord

208 i

179

205

131

336

A 133

A 134

770 Haemolytic disease of newborn 769,771,772 All other defined diseases of early;

infancy.

112

163

A 135

773 -776

Ill-defined diseases peculiar to

110

early infancy

106

657

438

452

425

877

A 136

794

Senility without mention of

Psychosis

360

139

86 132

218

A 137(a)

(b)

788.8

Pyrexia of unknown origin

144

793

Observation, without need for

further medical care

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

110

(€) 780 - 787

All other ill-defined causes of

788.1-783.7

788.9

morbidity

271

103

587

529

1,138

789 - 792

795

Total..

35,536

54,914

1,492

8,284 | 9,395 8,159

23 | 17,577

APPENDIX 13-Continued

Inter-

mediate

Detailed

Cases

Treated 1953

Deaths 1953

List

Number

List

Number

Cause Groups

Govern

Govern-

ment

mcat

Assisted

Govern.

acat

Hospitals

Govern

mcot

Assisted

Hospitals

Deaths 1953

Whole Colony

Male Female

|Sex Un-:

known.

Total

Brought forward..

35,536

54,914 1,492

8,284

9,395 8,159

23 17,577

AE 138 E810

E835 Motor Vehicle Accidents

890

AE 139

E840 - E866

E800 E802 Other transport accidents.

234

AE 140

AE 141 E900 - E904 Accidental falls

'E870 E895 Accidental poisoning

1,077

103

AE 142 E912

AE 143 E936

Accident caused by Machinery

106

Accident caused by fire and

explosion of combustible matéria)

113

15 10

111

AE 144 E917, E918 Accident caused by hot substance,

corrosive liquid, steam and

radiation

174

13.

AE 145 E919

Accident Caused by firearms ......

AE 146

E929

Accidental drowning and

submersion

AE 147

(e) E920

Foreign body entering eye and

adnexa

TT T

(b)|E923

Foreign body entering other

orifice

(c).E927

----------

Accidents caused by bites and stings of venomous animals and insects

9,640, 8,278 23 | 17,941

Carried forward....

38,364

55,023

1,651 8,285

9,640

112

APPENDIX

13-Continued

Inter

mediate

List

Number

Cases

Treated 1953

Deaths 1953

Deathe 1953

Detailed

List

Number

Cause Groups

Govern

Govern-

meat

Hospitals

mcat

Assisted

Hospitals

meat

Hospitals

Cover-

ment

Assisted

Hospitals

Whole Colony

Male Female

Sex Unel

known

Total

Brought forward...

38,364

55,023

1,651

8,285

9,640 8,278

23 | 17,941

(d)|E928

Other accidents caused by animals

E910, E911. All other accidental causes

360

20*

47. 16

E913- E915,

E921. E922.

E924-E926.

E930 - E965

AE 148 E970-E979 Suicide and self-inflicted injury AE 149 E980-E985 Homicide and injury purposely inflicted by other persons (not in war)

AE 150 E990 - E999 Injury resulting from operations

of war

GRAND TOTAL.

402

63.

167 99

266

JL+

[]

Among these, 1 died of A90--Bronchopneumonia

277

39,415 55,069 1,744 8,285 9.878 8.399

23.18.300

1 died of A91-Primary atypical, other and unspecified pasumonia

I died of A70-Vascular lesions affecting central nervous system

APPENDIX 13-Continued

Inter-

mediate

List

Number

Detailed

Cases

Treated 1953

Deaths 1953

List

Number

Cause Groups

Govern-

meat

Hospital.

Deat

Assisted

Hospitala

Govern-

ment

Hospitals

Covers

Geot

Assisted

Hospitals

Whole Colony

Male Female

190x Un

know

Total

AN 138

N800 N804 Fracture of skull

340

AN 139 N805 - N809 Fracture of spine and trunk

378

AN 140

N810 N829 Fracture of limbs

793

AN 141

N830 N839 Dislocation without fracture

139

KA=!

123

164

AN 142

N840 - N848 Sprains and strains of joints and adjacent muscle

103

AN 144

AN 143 N850-N856|Head injury (excluding fracture)... N860 - N869 Internal injury of chest, abdomen

457

and pelvis

AN 147

AN 145 N870 - N908 Laceration and open wounds AN 146 N910 - N929 Superficial injury, contusion and crushing with intact skin surface İN930-N936 Effects of foreign body entering through orifice

540

- 29

186

AN 148 N940- N949 Burns

266

AN 149 ¡N960 - N979 Effects of poisons

372

131

Las

192

AN 150

N950 - N959 All other and unspecified effects N980 - N999 of external causes

139

→

160.

247

113

TOTAL

3,879

155

252

483

240

723

114

APPENDIX 12

Out-patients-1953

Total Attendances at Government and Government Assisted Hospitals, Clinics and Dispensaries.

INSTITUTIONS

General Chil-

Dree-

Out- drea'

Acter

Post-Gynaeco-Social

sings

Natal

patiente Clicies

Natal logical | Hygiene

Bar,

Nose

Eye

Throat

Tuber

culosis

Mental

Total

Hospitals:

Queen Mary

Kowloon

5,689 11,521

3,341

311

2,473,

Tan Yuk

-----------JELLJ -

345,097

224,874;

503

16.202

251

2,911

299

10,777

191

5,577

270

24.084

606.192

10,362

24,081.

6291

35,072

St. John......

Stanley Prison

➖➖➖➖➖ ➖➖➖ ➖ ➖ ➖➖➖➖

9,581

10,898

13,575 11,977

102

111

521

35,869

38,867

54.675

Montal

L. C. K. Female Prison...

Clinics and Dispensaries

9,306

9.306

1,251

Sai Ying Pun

Violet Peel............. Harcourt T.E. Kowloon T.B.

40,949. 109,448 77,667 81.771 85,046 70,853

4,155

(4) 971

571

4.313

1,6291

(b) 8,741)

247.930

1,149 2,043)

240.862

77,665

73,943

73.943

Social Hygiene

£13,091

------

213,091

10 Public Dispensaries.

77,426

178,870 195,301|

7,174

7,190

467

154

466,659

12 New Territories Dips,

46,556

111,175

939

4,248

3,764,

646.

3.255

173.537

Families Clinic

8,869.

8.869

Police Medical Post..

2,887

8,613, 11,187

265

133

150

$61

663

24,500

Kow. Police Med. Post

1.066

4.375

10,358

139

431

85!

1,164

619

18.318

Victoria Remand Prison........

992

15,586.

3231

461!

191

347

17.900

Port Health

1,165;

1,165

K. C. R. Clinic

Health Centres :

Western

2,326

136

Kowloon

4,037

591

4.096

Alice Ho Miu Ling

- -וו-וו

Harcourt

-----------------IT-

JELEL.

I. PLEAS

Total of Government

Institutiona

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

622,922

Tung Wah Group of Hosps.

18,543

821,350, 389,173: 124.761 69.494

Nathersole Hospital. Buttonjer Sanatorium..........

3,369

-------

Pok Of Hospital

2,175

935

3,140

18.476

2,203

66,951

13,446

25,247 6,370 1,301

GRAND TOTAL.....| 644,834 1,019,834) 465,037) 644,834 1,019,834) 465,037 89,901|

(4) Patients seen in Government Eye Clinics.

(6) Patients seen in Hongkong University Eye Clinics.

1.476 17,562 221,276|

2,919

29,431 12,026 157,264 30,360

1,251 2,340,682

11,533

271.064

1,092 9,056:

52.435

6,451

6.451

2,011

52.690

4.579 29,537 221,276

59,799 12,026) 175,248

1,251 2,723,322

APPENDIX 13

Out-patients-1953

New Cases at Government and Government Assisted Hospitals, Clinics and Dispensaries.

INSTITUTIONS

inge

General Chit. Out+ dren's patients | Clinics

↓

Ante-

Post Gynaeco Social Natal Natel logical Hygiene

Eye

Ear,

Nose &

Throat

Tuber-

culosis

Mentol

Total

Hospitals:

Queen Магу

5.699

10,748

485

627

Kowloon.

Tran Yuk

345,097

192,159

109

2,907

224

1.369

288

7,252

191

2,176

4.365

8,278

295

St. Jobo...

4,594

9,516

8,645

413

Stanley Prison

3,622

29,248

1.591

L. C. K. Female Prison..

9,306,

Mental

270

18,298

$51,297

12,938

22,299

805

35,266

391

9.306

391

Violet Peel..

Families Clinic

Clinics and Dispensaries #

Sai Ying Pun

Harcourt T.B.

Kowloon T.B.

Social Hygiene

10 Public Dispensaries

12 New Territories Dispa..

LJJJJOILIJ

Police Medical Post.................. Kow. Police Med. Post Victoria Remand Prison.....

Port Health

K. C. R. Clinic

Health Centres :

Western

45,573) 58,569 50,656

4,695 76,407;

56,917

1,496

51.

1,602,

689

669

(=)

666

501

1 │

156,155

(6) 2,3-20

141,655

16,474

16,494

14,494

14.494

37,392

$7,392

гг 1

33,567' 108,666| 150,089

4,192

3,116

380

300,097

11,018, 65,426

433 1,539

542

646.

554

82,403

574!

574

1,624

6,510

7,077

225

921

416

429:

16,477

603

3,055 7,547

125

180

292

344

12,219

288!

7.567;

161|

981

8,378

JIO`LLL

885!

085

$74

117

491

Kowloon...

Harcourt

618:

654

5.00

963

Institutions

Total of Government

Tung Wah Group of Hoaps.

Alice Ho Miu_Ling

Nethergole Hospital

Po Oi Hospital..

456,379 577,689) 285,861 20,816 7.4061 55,829 31,818 12,520, 6,442 1.402 2,282, 28,481

748 7,040 39,745 15,252 5,434

682

1,092

610.

1,581|

4.865,

11,537,

32,857

1,983,

391

1,442,212

122,554

16,083

29,973

GRAND TOTAL,

463,865 668,441 319,081 36,500

2,450 13,496 39,745 26.5-89 5.434 34.840

391

1,610.822

(a) Patients seen in Government Eye Clinics.

(6) Patients seen in Hongkong University Eye Clinica.

115

APPENDIX 14

Attendances at Public Dispensaries - 1953

Out-Patients

Deliveries

Public Dispensaries

Children

Adults

Vaccina Inocula-

Total

New

Atten-

Cares

New Cases

dances

Atten- i dances

Total In-pat- Dom- ients iciliary

tions tions

Central

Eastern

20,098 33,748, 9,817 23,096 15.251 19,810 9,985 20,324

2,700 8.632

10,370

2,819

Shaukiwan

26,897

36,076 11,946 22,524

619

4,755

8,310

Aberdeen

6,884 8.580

5.143 8,538

406

2,350

7,501

Shamehuipo

51.612 101,318

5.50

14,592

Yaumati

Hung Hom

Stanley

12,922 17,026,

9,433 22,168:

294

6.606 11,290

13,713

17,238,

9,870 15.224

2,499

5,729

---

Mongkok

Li Kee Memorial...

1,490 20,589 32,245

1,863!

2,146, 5.227 262

10!

202

1,816

24.595

21,090 27,625

966' 6.582

4,887

36,365' 18,966 25.314

Total......

150,089 195,301 150,008 271,358

262 2,855|| 50,656

51,064

APPENDIX 15

Attendances at Medical Centres - New Territories - 1953

Out-patients

Deliveries

Dispensaries

New Canes

Total Attendances

In-patients

Domiciliary

Tai Po

Họ Từng Shataukok

Un Long Sun Hui

Sai Kung

Shatin

Tai (

---

Silver Mine Bay Ping Chau

Travelling (East). Travelling (West)

25.973

46.410

85-9

1.750

4,801

377

2.064

5,047

171

18,196

38.389

862

1.894

4,555

299

4,772

8.409

192

3,172

6.803

15-0

9,735

29.723

334

2.433

4,814

5-3

2,364

3.684

7,768

11.647

2.282

9,255

Total.

+++

02.403

173.537

3,297

320

116

117

APPENDIX 16

Statistical Summary of Dental Treatment carried out during 1953

A. General Dental Service.

Type of Patients

Visits Extractions

Surgical

Operations

Fillinge

& Crowns

Conserva-

tive

Prophylaxis Prostheses

Dressings

Government Ser-

vants Government Ser- vants' Families General Public

Total.

---

Numbers

rendered

Dentally Fit

7.959

3,618

6,220

3,133

13,809

15,647

2,423

629

773

377

720

2.425

498

317

151

570

27,988

22,398

218

4,884

B. School Dental Service

' ח'

1,170

1,130

574

1,294

Type of

Schools

No. of

Children

Dentally

examined

No. of

Children

found to

require treatment |

Extraction

Visita

Ferm Decid,

Other

Surgical

Opera

tions

Fillings & Growma

Conservative Dressings

Perm. Decid, Perm. Decid.

Government & Subsidi-

zed

Privule

Numbers

Prophy rendered Lazin Dentally

Fir

-------‒‒‒‒‒

14,530

1,474 | 10,976

1,572

550

$80

149

233

257

22.191

15,076

17.792

1.112

10,745

3,431

788

675 |

663

344

3,020

Total

22.191

[ 15.076

32,322

2,586 21,721

5,003

3,338

1.255

812

577

3.277

APPENDIX 17

Pathological Sub-Department Summary of Examinations carried out in 1953

NATURE OF EXAMINATION

Patho logical Hospital Institute Labora-

Queen

Kowloon Mary Patho

logical Tostitute

Total

tory

Agglutination

Salmonella group Br. melitensis.

Weil Felix reaction

Seriological reaction for syphilis

1,303

143

1,456

2.902

-ILLI

150

193

105,008

Malaria..

Filacio

Blood amerN

Kala-azar

B. anthracis

1,839

327

1,643

3,809

~----LLJI

Haematology

Hb. percentage

Total Red Cell Count

Total White Cell Count

Differential Count

Platelet Count

765

1,832

2,682

638

584

673

1,995

1.011

1,115

2,009

4,135

526

795

1,445

2,766

144

160

Reticulocyte Count

Sedimentation Rate

139

1,098

430

1,667

Congulation Time

104

133

Bleeding Time.....

28.

100

Blood Grouping

210

244

Cross Matching

Haematocrit estimation

-------➖➖➖➖➖---------

Nasal-pharyngeal swabs (C. diphtheriae)

5.431

29]

4,228

9,950

Haem. streptococci

4,271

161

2,325

6,760

Cerebrospinal fluid for pathogenic

organisms.

139

213

164

520

-----rrı

Pregnancy tests :

ƒ(Friedman)............................

Frog)

Culture

examination

Farcer

Tissue section......

Cerebro-spinal fluid for cell

count & protein..............

Faeces for pathogenic organisms

Blood clot culture (enteric organisms

only)..

Blood

LPI-----

Bone marrow

Urine

Intestinal parasites

Occult blood

M. tuberculosis

Brains for Negri bodies

Spute

Gastric lavages for M. tuberculosis

Smears for gonococcus

Smear for H. leprae

Rat spleen ametri for P. pestis

Pus & body fluid

Urine (Routine, chemical & microscopic)

Bacteriological examination of milk and foods

analysis of water

2.384

716

3,131

ווי-ו

2,759

1,153

3,365

7.277

2,658

172

1.466

3,306

219

309

275

603

-JIILLIJI-ILI

891

944

879

2,714

4.796

2,779

5.993

13,568

208 16

276

349

733

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

466

------------------T~----TT------------------------

466

8,931

2,961

14,898

26,790

658

283

343

1,284

205

121

216

7,762

8,760

16.520

133

194

411

➖➖➖➖➖LIJOJILLL-JUL-

1,710

4,987

5,128

11,825

999

-----------------............ILL

199

1,198

717

TM10‒‒TT-----T

1,100

1,817

2,053

448

2,501

Miscellaneous

LLI --

1,426

141

430

1,997

Grand Total...

158,823 19,616

61,504

239,943

118

APPENDIX 18

A Summary of the work done at the Hong Kong and

Kowloon Public Mortuaries, 1953

Total No. of Post-mortem Examinations performed during the year 3,629

No. of male bodies examined

No. of female bodies examined

Sex unknown owing to decomposition

No. of claimed bodies sent from hospital, etc.

- LII

No. of unclaimed bodies, mostly abandoned

No. of bodies cremated

--------- J

No. of Chinese bodies examined

No. of Non-Chinese bodies examined

No. of Medico-Legal Cases

2,135

1,472

891

2,738

912

3,604

...

----

480

Male

Female

Total

No. of bodies under 2 years of age

1,018

928

1,946

No. of bodies over 2 years of age

1,117

544

1,661

No. of bodies received from the following sources:

(Hong Kong)

Victoria District

Shaukiwan District

Infant Hospitals

Other Hospitals

Marine Police

Total

י.

119

423

166

168

830

(Kowloon and New Territories)

Police

Water

T. Land

Station

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

143

465

328

Yaumati

Mongkok

Shamshuipo

Kowloon

Hunghom

Tsun Wan

Castle Peak

Pingshan

}

Lok Ma Chau"

Pat Heung

Sheungshui

Takuling

Shataukok

Tai Po

Shatin

H+++

TI-

Sai Kung

Tai O

Cheung Chau

Police H.Q. (K)

Hospitals, etc.

1,495

Total

No. of rats caught and brought to mortuaries

No. of rats examined

No. of rats' spleen smears taken for examination

No. of rats infected with plague

120

2,799

251,872

16,532

Nil

ort.

FREES