醫務衛生署年報 Medical and Health Department Annual Report 1956-1957

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ANNUAL

DEPARTMENTAL

REPORTS

1956-57

THE ROYAL SOCIETY OF HEALTH

LIBRARY

19479

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

22501293285

HONG KONG

ANNUAL DEPARTMENTAL REPORT

BY THE

DIRECTOR OF MEDICAL

AND HEALTH SERVICES

FOR THE

FINANCIAL YEAR 1956-57

PRINTED AND Published by S. Young, ACTING GOVERNMENT PRINTER, AT THE GOVERNMENT PRESS.

JAVA ROAD, HONG KONG

WELLCOME NST TUTE

Coli.

Call

No.

WAZE THE

1957

CONTENTS

I. THE COLONY'S HEALTH SERVICE

Government Supervision of the Public

Health

Organization of the Department of

Medical and Health Services

Professional Registers

Expenditure

Health Legislation

II. THE HEALTH OF THE COLONY

General Comments

Environmental Factors Affecting Health. Vital Statistics and Natural Increase of

the Population

III. WORK OF THE HEALTH DIVISION

Hygiene and Sanitation

Urban Areas

Rural Areas

L -

Epidemiology

г. ·

Paragraphs

7 -

11 - 20

21 - 26

27 - 31

32 46

Vaccination and Innoculation

Campaigns

Port Health

48 - 59

Tuberculosis

60 - 73

Government Tuberculosis Service

Facilities

74 - 91

Radiological Examinations

Ambulatory Chemotherapy

Collapse Therapy Hospital Treatment

92 - 98

99 - 104

105 106

107 - 112

CONTENTS-Contd.

III. WORK OF THE HEALTH DIVISION Contd.

Ruttonjee Sanatorium

The Tuberculosis Almoner Service ..

B.C.G. Vaccination

X-ray Surveys

School Teachers

Future Outlook

Malaria

Leprosy

Paragraphs

113 114

115 - 128 129 - 139

140 148

149 - 150

151 - 152

153 - 165

166 172

Social Hygiene

Maternal and Child Health Services

School Health

Health Education

IV. THE WORK OF THE MEDICAL DIVISION

General Survey of Hospitals

Assisted Hospitals

Specialist Services

י.

Medical and Surgical Services

173 - 182

183 - 196

197 210

· ...

211 - 213

Obstetrical and Gynaecological Service.

Radiological Sub-department

Radiodiagnostic Section

Radiotherapeutic Section

Ophthalmic Service

Dental Service

The School Dental Service

Voluntary Dental Services

214 - 224

225 - 226

227

228 - 229

---

230 - 231

232 - 234

235 - 237

238 - 240

241 - 245

Government Dental Scholarships Control of Dental Practice

Out-patient Services

Pathological Service

246 247

248

249

250 - 251

252

254

255 - 258

CONTENTS-Contd.

IV. THE WORK OF THE MEDICAL DIVISION-Contd.

Public Mortuaries

Forensic Medical Service The Chemical Laboratory Special Ancillary Services

The Medico-Social Service

The Pharmaceutical Service

Physiotherapy

Occupational Therapy

Blood Banks

Stores and Equipment

Paragraphs

259

262

263 - 265

266 - 270

271

272 - 274

275 - 277

1 P

1 -

278 - 279

280 - 283

284

Auxiliary Medical Service Medical Examination Board

V. TRAINING PROGRAMME

Nursing Training

Health Visitors

Technical Training

285 - 286

LJ L

287 - 291

292 - 295

296 - 299

L J

H L

300 - 302

303 - 306

Fellowships and Scholarships

Liaison with International Organizations. U.N.I.C.E.F. Milk Feeding Schemes...

VI. BUILDING PROGRAMME

VII. PUBLICATIONS

307 - 308

309

310

313

314 315

316 317

318

VIII. ACCOUNTS

IX. MAPS

Occupational Therapy Fund

Samaritan Fund

Nurses Rewards and Fines Fund

X. APPENDICES

Statistical information in this report

refers to the calendar year 1956.

THE COLONY'S HEALTH SERVICES

Government Supervision of the Public Health.

　　RESPONSIBILITY for the administration of the services safe- guarding the public health in Hong Kong is shared mainly between the Department of Medical and Health Services, the Urban Services Department, the New Territories Administra- tion and the Labour Department, while the Education Depart- ment and Social Welfare Office also have some interest in certain aspects of health and, to some extent, both the Police and Prisons Departments, particularly in regard to drug addition. The Department of Medical and Health Services is responsible for the outlining of medical and health policies, vital statistics and morbidity returns, administering the Government hospitals, out-patient clinics, investigative laboratories (pathological and chemical), vaccine production, the control of dangerous drugs and such matters as the study and control of communicable diseases, mental diseases, maternal and child health, school hygiene and the health of school children, malaria control, measures to combat social diseases, port health control and inter- national health matters, and the education in general of the public in health practices. The Urban Services Department is concerned with public amenities, sanitation and domestic cleanliness, the safety and quality of food locally produced and imported, (in which matter the Director of Agriculture. Fisheries and Forestry is also concerned together with his Veterinary staff) its handling, preparation and sale for public consumption, disposal of the dead, pest control and environ- mental factors affecting health. The District Commissioner, New Territories, is statutorily responsible for the public health of the New Territories and is advised by officers of the Depart- ment of Medical and Health Services. During the year plans to develop rural committees in the New Territories to control certain sanitary activities amongst other functions, have been further developed and implemented in certain districts with a view to interesting the local population in administering their own affairs. The Commissioner of Labour is responsible for the health of industrial workers and hygiene of factories and

is advised by a medical officer seconded from the Department of Medical and Health Services. The Education Department is interested in school hygiene and the mental and physical health of school children, while many aspects of the work of the Social Welfare Office touch on matters of health, for example, matters concerning cases of physical handicap, calling for close coopera- tion with officers of the Department of Medical and Health Services. Responsibility is thus divided and shared but very close cooperation and exchange of information is maintained between all the Authorities involved and also with many non- Government agencies engaged in medical and health work. There are voluntary organizations working in the fields of tuber- culosis control, blindness, deafness, leprosy, refugee care, family welfare and numerous other medical activities.

Organization of the Department.

The Department of Medical and Health Services is headed by the Director of Medical and Health Services who is the chief adviser to Government on all medical and health matters. It is divided into two main Divisions, Medical and Health, both headed by an Assistant Director. Within these two main Divisions the Department is organized into various sub- departments and services on a functional basis according to the service rendered to the community. Both Divisions are served by the Nursing Service which constitutes a third major ad- ministrative division or arm of the Department. The Health Division comprises the services designed to promote health and prevent ill health while the Medical Division is responsible for the curative and investigative services and the ancillary medical services. Under the Assistant Director of Health Services come the sub-departments controlling malaria, tuberculosis and social disease, the Port Health Office, the Maternal and Child Health Service, School Health Service and the activities of the various Health Officers including the Medical Officer of Health, New Territories, the adviser to the District Commissioner; each sub- department or service being headed by a medical officer specially trained and experienced in the particular work he supervises. The Assistant Director of Health Services is also concurrently ex-officio Vice-Chairman of the Urban Council and health adviser to the Director of Urban Services, who is Chairman of the Urban Council. Under the Assistant Director of Medical

Services come the Government hospitals, clinics and laboratories, pharmacy and dispensing and such ancillary services as physio- therapy and occupational therapy, the medico-social (or al- moner) services and the Auxiliary Medical Service. He is also responsible for maintaining liaison with non-Government insti- tutions run by private or voluntary bodies, many of which are in receipt of a Government subsidy. Each Assistant Director is assisted by a Senior Medical or Senior Health Officer at Head- quarters while the two main Government General Hospitals are superintended by two other Senior Medical Officers. The Nursing Service is headed by the Principal Matron who has her office at Medical Headquarters. The major clínical services of surgery, medicine, obstetrics, and gynaecology, anaesthesia, pathology, dentistry, ophthalmic service, radiotherapy and diagnosis, tuberculosis and social diseases control are all headed by Specialists or Senior Specialists. Appendix I shows the establishment at 31st March, 1957.

Professional Registers.

3. Except where the legislation provides for exemption in certain specified instances, medical and dental practitioners, pharmacists, nurses and midwives are required by law to be registered before being entitled to practise their professions in the Colony. The number of persons so registered 31st March, 1957 was as follows:

Medical Practitioners

Dentists

ILI

Pharmacists

Nurses

Midwives

530

337

881

901

4. These figures do not include Armed Services or Govern- ment personnel, who are subject to discipline within their respective services.

　　　5. The Ordinances which require these professions to be registered empower Boards comprising professional people, under the Chairmanship of the Director of Medical and Health Services, not only to effect registrations within the bounds of the law but also to discharge disciplinary duties and punish a professional person who is deemed to have acted contrary to the interests of his or her profession. The Medical Board and the Dental Board, which follow the examples of the equivalent

bodies in the United Kingdom, have been active in this respect. The Medical Board considered a complaint of infamous conduct in a professional respect against one registered practitioner and recorded a verdict of guilty which was however upset on appeal to the Governor in Council, while the Dental Board found three dentists guilty of unprofessional conduct during the year under review. The extreme penalty for unprofessional conduct is to have the offender's name struck permanently from the register, in which case he is permanently debarred from practising his profession in the Colony. Minor offences against professional ethics are punishable by censure or temporary suspension from the register. In all cases the finding of the Board and penalty imposed is published in the Government Gazette for public information.

Expenditure.

6. The Medical Department's actual expenditure for the financial year ending 31st March, 1957, was $30,048,868.19 but to obtain a true figure of the Government's expenditure on medical services a further $7,431,262.91 should be added to this. This sum was paid to the voluntary organizations in the Colony that provide hospital and other public health services. These include the

　　　　the Anti-Tuberculosis Association ($550,000), the Mission to Lepers Hong Kong Auxiliary, ($480,000), the Tung Wah Group of Hospitals, which receive the main subvention of $6,140,669, and other smaller institutions such as the Alice Ho Miu Ling Nethersole Hospital which receives a subvention of $150,000. Combined expenditure on account of the Medical Department and medical subventions was approximately 7.98% of the Colony's total actual expenditure. This expenditure of course does not cover the whole of the Government spending on health as it does not include the very considerable budget of the Urban Services Department or that of any other Department active in health administration.

Health Legislation.

7. The following legislation administered by the Medical Department was enacted during the year 1956-57:

Ordinance:

(a) Births and Deaths Registration (Amendment) Ordin-

ance No. 9 of 1957.

Rules & Regulations:

(a) Nurses Registration (Amendment) Regulations (G.N.A.

24 of 1956).

(b) Poisons (Amendment) Regulations (G.N.A. 28 of 1956). (c) Poisons List (Amendment) Regulations (G.N.A. 29 of

1956).

(d) Dangerous Drugs (Amendment of Schedule) Order

(G.N.A. 32 of 1956).

(e) Dangerous Drugs (Amendment of Schedule) (No. 2)

Order (G.N.A. 74 of 1956).

(f) Births and Deaths Registration (Amendment of Sched-

ule) Regulations (G.N.A. 85 of 1956).

(g) Penicillin (and other Substances) (Amendment) (No. 2)

Regulations. (G.N.A. 86 of 1956).

(h) Quarantine and Prevention of Disease (Scale of Charges) (Amendment) Regulations (G.N.A. 87 of 1956).

(i) Castle Peak Hospital Declaration (G.N.A. 6 of 1957). () Births and Deaths Registration (Amendment of First

Schedule) Regulations (G.N.A. 18 of 1957).

(k) Dangerous Drugs (Amendment of Schedule) Order

(G.N.A. 19 of 1957).

(1) Nurses Registration (Amendment) Regulations (G.N.A.

20 of 1957).

　　　　　The following legislation was in process of revision during the year:

Ordinances:

(a) Medical Registration Ordinance, Cap. 161.

(b) Mental Hospitals Ordinance, Cap. 136.

II. THE HEALTH OF THE COLONY

General Comments.

　　　9. In 1956, as in the previous three years, the Colony remained completely free from any case of the six internationally quarantinable diseases, namely, cholera, plague, smallpox, epi- demic typhus, yellow fever and relapsing fever, nor were there any noteworthy outbreaks of any other notifiable communicable diseases. The incidence of notifiable diseases in general decreas- ed as did also the mortality, from 18,142 cases and 3,095 deaths

in 1955 to 16,071 cases and 2,870 deaths during 1956. The largest variations from the figures of the previous year occurred in the notification of tuberculosis, diphtheria and whooping cough, all of which dropped considerably, and in malaria which shows a marked increase. The increase in malaria, however, was due to a tightening up on notification when it came to light that many doctors working in the areas not protected against this disease had not been reporting all cases seen. The enteric diseases, while continuing to remain somewhat of a public health problem, showed no increase on the figures for 1955, when the disease began to show evidence of coming under effective control after reaching very serious proportions in previous years. The incidence of the dysenteries showed little change but deaths from bacillary dysentery dropped dramatically from 37 in 1955 to 4 in 1956, the lowest figure on record for ten years. Approxi- mately 40% of cases of this type of dysentery occurred in children under four years of age, a state of affairs probably reflecting the congestion in the homes of the people and pre- vailing water shortage, with consequent difficulty in maintaining adequate cleanliness, more than any other factor. Overcrowd- ing also affects the incidence of measles and other infections spread by sneezing, coughing and spitting but interestingly enough cerebrospinal meningitis, which is generally regarded as a disease of congestion, shows a surprisingly low incidence of 21 only. Poliomyelitis also, as notified, did not constitute any serious problem and indeed showed a decrease on previous years but investigations carried out on the blood antibodies of a sample of the population indicate that a large proportion of the local population appears to acquire a natural immunity to this disease at a very early age, which suggests that the infection is very widespread, probably in a very mild form producing only transient sore throats and fever. For the first time since the war no case of rabies either animal or human was reported. Campaigns designed to increase protection against smallpox, diphtheria and typhoid were conducted during the year and in this connexion it has been demonstrated that the loud hailer mobile van is much the most effective agent in stimulating public response. The number of births once more increased and there was no significant rise in the total number of deaths, indeed the crude death rate fell from 8.2 in 1955 to 7.9 in 1956. On the

whole it can be said that the Colony maintained a very gratify- ing state of good health during 1956 despite many factors that still continue to be adverse.

Environmental Factors Affecting Health.

10. The Summer climate is tropical and humid, which tends to facilitate the growth and spread of the causes of many diseases, and a large area of the Colony is not yet protected from malaria, although obviously very effective control is operating in the Island and in the built-up area of the Mainland. Water shortage remained a grave problem although longer hours of supply proved to be possible during more of 1956 than in the worst periods of former years. By far the most important health hazard however is the almost unbelievable congestion and overcrowding, particularly in the poorer class dwellings. Tremendous efforts have been made to cope with the squatter problem and this is gradually coming under control. During 1956 rapid strides were made in low cost housing development on a major scale but it will be long before these efforts effec- tively overtake the need and can be reflected in the health of the people. The tremendous swelling of the population in recent years has completely overtaxed all existing medical facilities and hundreds of patients have literally to be turned away from the doors of the Government outpatient clinics in the city areas daily. Industry is expanding so rapidly that it is proving difficult to control adequately all the health hazards involved with the available staff. Fortunately most of the larger manufacturing concerns and employers of labour have a real interest in the welfare and health of their workers and take steps to protect them by voluntary efforts. Unfortunately this is not always so, particularly of smaller mushroom busi- nesses, and strict observance of the regulations is not always found. Trade Unions, Kai Fong and other organizations have set up clinics and are trying to assist in alleviating distress. Though there is no true lack of food and no actual starvation nor any serious food deficiency disease there is yet much poverty and a great deal of undernourishment, a good deal of it due to ignorance of food values more than actual inability to obtain adequate food. The most alarming factor affecting health, amongst other things, during the year, though fortunately of short duration, was the October rioting. These riots, and the

counter-measures taken to suppress them, very effectively dis- rupted normal medical services not only in Kowloon, which was directly involved, but also indirectly on the island, while at the same time flooding the hospitals with casualties. Staff, immo- bilized by curfew orders, were unable to report for duty and staff on duty could not be relieved. The Military Authorities, however, came to the assistance of the civil medical services with transport and guards and placed the facilities of a military hospital at the service of civilian casualties with the result that the difficulties were rapidly overcome. The experience was not without value and lessons learnt will be applied in future. It is obvious from the almost suprisingly good state of the public health that the Colony as a whole succeeds in overcoming all these adverse factors to a very marked degree.

Vital Statistics and Natural Increase of the Population.

11. The Births and Deaths Registration Ordinance requires compulsory registration of births and deaths occurring in the Colony. The Director of Medical and Health Services, who has been the Registrar of Births and Deaths since 16th October, 1931, ceased to act as such as from 1st April, 1957, when the function of registration of births and deaths was taken over by the Registrar General. A scheme for the reorganization and decentralization of the Births and Deaths Registry was imple- mented late in 1956, and as a result, additional registries have been established in various districts throughout the Colony.

12. The number of registered births-96,746-again exceed- ed all previous records. It was 6,235 more than in 1955, which was itself a record year. Taking the estimated mid-year population of 2,440,000, the crude birth rate was 39.7 per thousand of population, which was slightly higher than the rate in 1955 of 38.7 per thousand.

13. On the other hand, the total number of deaths from all causes was only 19,295, just 215 more than in 1955, 12 more than in 1954 and 164 less than in 1952. The crude death rate was 7.9 per thousand of population, compared with 8.2 per thousand in 1955,

14. The net natural increase in the population of the colony during 1956 was thus 77,451, as against 71,341 in 1955,

15. There were 988 still births recorded, which gives a pre-natal wastage of just over 10 for every 1,000 of all births. The number of children dying in the first month of life, always the most dangerous period of a child's life, was 2,842, giving a neo-natal mortality rate of 24.2 in every thousand live births. This shows a slight increase over 1955, when the rate was 23.1 per thousand live births.

16. Deaths of infants under one year of age numbered 5,895, (30.6% of all deaths from all causes as compared with 31.5% in 1955). This gives an infant mortality rate of 60.9 per thousand, compared with 66.4 per thousand in 1955. Out of an increasing number of babies born, an increasing number is surviving. On an average almost 265 babies are born in the Colony each day (or practically one every five minutes), of which at least 249 survive their first year of life, whereas in the past it would not have been unusual for at least 100 of them to die before their twelfth month of life. This dramatic success of the Maternal and Child Health Scheme is most gratifying but it is posing fresh problems in regard to medical services, education, employment and housing.

17. The following table sets out the figures of infant and neo-natal deaths in detail:

Age Period

Table 1

1954

1955

1956

1 day

199

224

212

7 days

803

989

1,091

1--1 weeks

1,048

882

1.039

↓ weeks-3 months

1,179

1,148

961

3-6 months

1.112

1,121

944

6-9 months

991

957

904

Y 12 months

696

691

144

Total under 1 year..

6,028

6,012

5.095

Infant Mortality rule

No. of deaths under 4 weeks

Neo-natal Mortality rate

--JUL-JI.

72.4

66.4

60.9

2,050

2,095

2,342

24.6

23.1

24.2

18. There has been a further drop in the maternal mortality rate from 1.16 per thousand deliveries in 1955 to 0.90 per thousand deliveries in 1956. The following table sets out the maternal mortality figures for the years 1954-1956 in detail:

Table 2

Pregnancy and Child bearing

Abortion

Maternal Mortality Rate

Year

Live Birth

Still Birth

Total

Live and

Still Birth¦ No. of

Rate

I Etate

deaths

рег 1,000

: No. of

рет

No. of

deaths

1,000

deacha

per 1,000

births

birth

birth.

1954

83,317

1,341

84,658 102 1.20

0.04

105

1.24

1955

90,511

1,250

1956

96.746

91,761

988 97.734

104 1.13

0.03

107 1.16

86 0.88

0.02

88 0.90

19. The following Table shows deaths from toxaemias of pregnancy during the years 1954-1956: -

1954

1955.

1956..

Table 3

Year

Deaths from Toxaemias of Pregnancy

Total births (including still births)

Death rate per thousand

84,658

0.4

91,761

0.5

97,734

0.4

20. Details of the principal causes of mortality are set out in the following Table:

Table 4

Number of Deaths

Causes of Death

1954

1955

1956

Malignant neoplasms

Gastro-enteritis and colitis

Pneumonia (all forms).

Premature births

Tuberculosis of respiratory system

Tuberculosis (other forms)...

1,000

1,190

1,262

----

2,690

2,264

2,361

3,837

3,821

3,548

921

912

982

2,052

824

1,925

885

1,901

----ILLI☐

728

III. WORK OF THE HEALTH DIVISION

Hygiene and Sanitation.

Urban Areas.

21. The area Health Officers in Hong Kong and Kowloon are primarily concerned with the health aspects of environmental sanitation, the maintenance of food hygiene, particularly in licensed premises, and the investigation and control of cases of infectious disease and their contracts. A proportion of their time is also taken up with training of health staff, particularly of Health Inspectors and Health Visitors.

22. Mosquito and fly nuisances were again the subject of numerous complaints during the year. Two anti-mosquito campaigns were carried out in April and September 1956, and of over 1,200 breeding places found 50% were on domestic premises-the most common sites being uncovered roof water storage tanks. Early in the summer, special measures were required to eliminate very extensive fly breeding in semi-matured fertilizer which was being used over a large area in the Pok- fulam district. A special sanitary survey, with subsequent recommendation to improve environmental hygiene, was carried out at Hing Wah Village (Chai Wan area) Healthy Village, Kan Man Village, Kung Man Village (Mount Davis) and Ching Man Village (Sookunpoo area).

23. Regular inspections of food handling premises were made without prior warning and health talks were given on the spot stressing the need and reasons for hygienic practices in the preparation of food, personal cleanliness of employees and the sterilization of utensils. Reported food poisoning cases were fortunately few in number during the year. A sample survey of licensed food premises in the Urban areas of Hong Kong and Kowloon was undertaken by three Health Officers in December 1956. 346 separate food premises, representing one sixth of the total number, were selected at random for careful inspection and assessment with the object of ascertaining their degree of compliance with the by-laws and the licensing conditions and requirements for such premises. Results revealed that infringe- ments or non-compliance were present with regard to 11.2% of the total legal requirements which were checked; that a particu- lar group of licensed food premises associated with converted pre-war domestic residences was responsible for the majority

of the illegalities and that, although the by-laws and require- ments were found reasonable and capable of being enforced, considerably more supervision and food hygiene education was necessary to raise standards to a desirable level.

24. In the control of infectious diseases, immunization campaigns against smallpox, diphtheria and the typhoid fevers, were conducted during the months preceding the expected seasonal occurrence of each disease. Routine diagnostic throat swabbing was done for all family contacts of diphtheria cases and routine stool examination for similar contacts of all notified typhoid and dysentery cases.

25. A complete review and follow up of all known chronic carriers of typhoid and dysentery was undertaken in order to revise the current list and check on the occupations of carriers who might endanger public health.

26.

　　　In Kowloon nearly half the notified cases of typhoid fever occurred in the "undeveloped" and squatter areas where neither mains water supply nor water-borne sewage disposal was adequate.

Rural Areas.

27. Industrial and housing expansion continued at an in- creasing pace particularly in the Tsuen Wan area. Such rapid and uncoordinated development places a very considerable strain on public services.

28. In October 1956 the scavenging services throughout the New Territories were transferred from the Medical Department and became the responsibility of the District Administration. A long needed increase in the staff for these duties was made at the same time.

29. Standards of food hygiene still leave much to be desired and lack of hygienic methods of transport is partly responsible for the many unsatisfactory reports of bacteriological examina- tions. There has also been a great increase in the hawking of fresh meat and fish to supply the expanding population in the absence of official markets.

30. The expansion of clinic services has been successfully continued, particularly as regards Maternal and Child Health. The number of B.C.G. vaccinations given continues to increase steadily.

31. A feature of the year was the absence of any reported case of rabies,-animal or human. Increased anti-rabic inocula- tion of dogs and the strict measures controlling stray dogs have doubtless contributed to this record.

Epidemiology.

　　　32. Notifiable diseases reported reached a total of 16,071 during the year, representing a drop of 2,071 or 10.8% as compared with the 1955 figure of 18,142. The largest variations were decreases of 1,993 for tuberculosis from 14,148 to 12,155; 126 for diphtheria from 840 to 714; 107 for chickenpox from 880 to 273 and rises of 65 for malaria from 431 to 496 and 166 for measles from 543 to 709. Of these notifications, 12,155 or 75.6% were reported by Government institutions, 1,976 or 12.3% by the Tung Wah Group of Hospitals and the remaining 1,940 or 12.1% by other hospitals and private practitioners. The incidence rate of notifiable diseases during 1956 was 658.6 and the mortality rate 117.6 per 100,000 population. Excluding tuberculosis, the incidence and mortality rates were 160.5 and 9.9 respectively.

　　　33. During the year under review, a total of 83 reminders covering 279 cases was sent out to various hospitals and practitioners calling attention to their failure to report a notifi- able disease. Of these, 63 were sent out to private practitioners, 11 to Government institutions and 9 to the Tung Wah Group of Hospitals.

34. The number of deaths due to notifiable diseases was 225 less than that in the preceding year, i.e., 2,870 as compared with 3,095. Excluding tuberculosis, measles was responsible for the greatest number of deaths with 86, followed closely by diphtheria, 75, and enteric fever, 48.

　　　35. The table at Appendix 2 sets out in detail the returns of communicable diseases notified during the year as compared with 1955, including the mortality due to these diseases.

　　　36. The Colony was free from the 6 quarantinable diseases. One case of non-epidemic typhus, a non-quarantinable disease, was reported during the year.

　　　37. Bacillary dysentery totalled 560 notifications in 1956 as against 524 in the preceding year, showing a slight increase of

36 or 6.9%. Most of the cases were recorded between the months of May and August. The number of deaths, however, showed a very marked drop from 37 to 4 giving a case fatality rate of 0.71%, the lowest on record since 1946. The percentage of children under 5 years of age who were affected remained high although it was lower than those of the previous 3 years. 540 or 96.4% of the cases were notified by Government institu- tions, and the remaining 20 by private practitioners. 29 dysentery carriers were discovered and dealt with during the

year.

38. There were 789 reported cases of enteric fever including 40 paratyhoid cases, during the year. There was an absence of a sharp incidence peak during the summer season in spite of water restrictions and an overcrowded population. The annual total, though higher than that of the preceding year, was lower than those of the previous five years, being 789 as against 735 in 1955. 48 deaths were recorded, giving a case fatality rate of 6.08%, which, being the lowest on record, followed the continuous downward trend of case fatality rates from 50.0% in 1946 to 21.8% in 1949, 12.8% in 1952 and 7.9% in 1955. The cases were well-distributed throughout the Colony with no explosive outbreak in any particular area. 327 or 41.4% occurred on the Island, 342 or 43.3% in Kowloon, 86 or 10.9% in New Territories and the remaining 34 or 4.3% mainly among the "floating" population and persons of no fixed abode.

39. An interesting feature in the age group distributions is the change in the incidence peak since 1953 from the 20-24 to the present 5-9 group. While the number of cases in most of the age groups has shown a tendency to decline or remain at about the same level, the 5-9 group has followed a steady upward trend from 7.52% of the total in 1951 to 20.78% in 1955 and 23.83% in 1956.

40. The preventive measures taken included a mass inocula- tion campaign, the supervision of eating establishments and their employees by the health staff of Urban Services Depart- ment, hospitalization of the sick, the exclusion of known carriers from employment as food handlers, and the education of the public in such matters as personal hygiene and the sanitary disposal of excreta. The annual T.A.B. inoculation campaign was launched during the second quarter of the year,

the total number of inoculations carried out being 150,282 1st doses, 95,920 2nd doses and 137,232 booster doses.

41. 273 cases of chickenpox were reported in 1956.

184 or 67.4% of the cases were recorded in the first quarter of the year. The number of missed and hidden cases is considered high as is also the case with measles and whooping cough.

year.

42. Diphtheria infection has continued its downward trend since 1954. A total of 714 incidence returns was received during the year, as compared with 840 in the preceding year, representing a drop of 126 or 15%. The number of deaths, however, was 4 more than that of 1955, being 75, giving a case fatality rate of 10.5% as compared with 8.5% in the previous The decline in incidence of this disease in the Colony can be attributed to the annual immunization campaigns, although the response from the public this year was not as satisfactory as in previous years. The inoculation figures for the whole year were 74,082 1st doses, 58,197 2nd doses and 46,303 booster doses. It is apparent however that many very young children still escape immunization and fall victim to this disease. The routine investigation of reported cases and their contacts was carried out by the health staff. Altogether 12 carriers were discovered and dealt with in 1956.

　　　43. Measles continued to be the principal cause of infant mortality among the notifiable diseases due to respiratory complications. Cases recorded during the year numbered 709 with 86 deaths as against 543 with 88 deaths in the preceding year. More than 600 cases have been reported in the first quarter of 1957 which is the highest figure on record for the first quarter of any year since 1946.

44. Poliomyelitis occurred sporadically in various parts of the Colony, indicating a wide spread infection with a higher incidence in Kowloon and the New Territories than on the Island. Cases reported during the year numbered 31 (with 3 deaths) as against 51 (with 3 deaths) in 1955, and 49 (with 9 deaths) in 1954. The incidence returns were highest in the third quarter when 21 or 67.74% of the total were recorded. Those affected were mainly infants. There were a few European adults who had recently arrived in the Colony, but there has been an appreciable drop in incidence among Europeans since the last half year of 1954. Of the cases reported, 23 were

Chinese and 8 Europeans, the latter all being military personnel and their families, with the exception of one case in an infant, reported by the Navy.

45. Poliomyelitis has been notifiable as an infectious disease since July 1948, the first full year for statistical purposes being 1949. Only paralytic cases are usually notified and all figures given are for such cases, with the exception of 7 cases in 1954 which were non-paralytic. No virus laboratory is available nearer than Singapore, and few serological tests to confirm diagnoses have been made. Infection chiefly affects two quite

specific groups, namely,

(a) infants and young children both Chinese and Non-

Chinese; and

(b) young Non-Chinese adults, particularly those who have

recently arrived in the Colony.

The

The first group (under 5 years of age) have accounted for 54% of all cases notified from 1949 to 1956. The majority have been Chinese but it is to be noted that the ratio of Chinese to Non-Chinese in the population is approximately 100 to 1. The second group of young European adults appears to be especially at risk within the first year or so of arrival, and a large number of the cases occurring in this group have been among British servicemen and their families. Visiting United States Navy personnel have also been affected. The disease is also more fatal in this group, with a tendency to a rapidly ascending paralysis causing death within one or two days of onset. There appears to be no real sex difference in the infantile group. young adult group naturally shows more males affected since the servicemen at risk are predominantly male. As regards season of the year, cases have occurred at random throughout the whole year with the exception of 1955 when 26 cases were reported in June. There has been no apparent association between the incidence of cases and immunological procedures- particularly anti-diphtheria inoculations-though several hundred thousands of these injections have been given to children under 10 years of age since 1952. An investigation into the titre of antibodies to this disease circulated in the blood of various categories of the population is being made with the cooperation of Professor Hale of the University of Malaya, who visited the Colony to assist in planning the work.

46. Scarlet fever returns showed a considerable drop; only 14 cases were registered as compared with 45 in the preceding year. They were all under 15 years of age, 6 of them Europeans, and 8 Chinese.

Vaccination and Inoculation Campaigns.

47. The anti-smallpox campaign launched in December 1955 remained in full operation until March 9th, 1956 and was almost immediately followed by the annual anti-typhoid inoculation campaign which lasted until June. The anti-diphtheria inocula- tion programme ran for a period of 2 months from September to November and on December 10th another anti-smallpox campaign was launched, which ended on March 15th, 1957. In between these campaigns, mobile teams continued to operate in various places in the New Territories, the resettlement and squatter areas and amongst the floating population. 619 requests for prophylactic vaccination teams from various Government Departments, factories and other institutions were dealt with during the year. Two vans fitted with loud hailers, which had been donated to Government some years previously, rendered valuable services in disseminating health propaganda and were most useful in drawing crowds to the mobile stations. They also followed up the work of the mobile teams in overcrowded places especially in the resettlement and squatter areas. Figures showing numbers of prophylactic immunizations carried out during 1956 are shown in Appendix 3.

Port Health.

48. The Port Health Administration is responsible for the prevention of the importation of infectious diseases into the Colony by sea, land, and air, for the sanitary control of the port area and airport; for the carrying out of the provisions of the International Sanitary Regulations as embodied in the Quaran- tine and Prevention of Diseases Ordinance; for the compilation of epidemiological statistics and reports, and for rendering assistance in prophylactic vaccination campaigns.

49. Passengers and crews of incoming vessels were inspected at the two Quarantine Anchorages in Kowloon Bay and Stone- cutters Island respectively; arrivals by air were inspected at Kai Tak Airport, and persons entering by the land frontier were checked at Lo Wu Station Quarantine Post. In the absence of

epidemiological information from the Chinese Mainland it was considered advisable to continue to regard all Chinese ports east of Canton as being suspected areas of smallpox infection.

50. Vessels inspected at Quarantine anchorages during the year numbered 4,543, carrying 67,076 passengers and 233,378 crew as against 4,073 ships, 54,651 passengers and 225,932 crew in 1955. There was an increase in air traffic during the year but fewer passengers arrived from infected areas. A total of 23,660 passengers were inspected as against 25,118 in 1955. The routine spraying of all aircraft with insecticide before arrival was insisted upon. 666,365 persons entered the Colony by the land frontier station at Lo Wu as compared with 113,871 in 1955. Of these 596,954 were vaccinated against smallpox. 11 cases of suspected leprosy were detected and handed over to the Immigration Authorities for disposal.

51. Four launches and one fumigation barge were provided by the Marine Department for port health work. The four launches are fitted with radio telephones and carry first aid equipment. They also provide an ambulance service and were used for miscellaneous duties such as the transport of sick, medical stores, lepers and specialists to and from the outlying islands.

52. 45 ships were fumigated with sulphur dioxide and 29 with cyanide. 125 were granted deratting exemption certificates as against 134 in 1955. The fumigation staff also carried out disinsecting of vessels and fumigation of cargo in lighters.

53. In accordance with the Asiatic Emigration Ordinance, the inspection of vessels carrying over 20 unberthed passengers travelling as emigrants was carried out as usual. 62 ships carrying 10,173 emigrants were inspected during the year as against 59 ships with 6,389 emigrants in 1955.

54. Although no longer required for international voyages, Bills of Health continued to be sought by masters of vessels. 1,823 Bills of Health were issued, including 70 to H.M. Ships or United States Naval vessels, as against a total of 2,216 in 1955.

55. 3 Port Health Vaccination Centres were maintained, 2 on the Island and 1 in Kowloon, for the convenience of persons

requiring certificates for international travel. They also provid- ed free prophylactic vaccinations to members of the public.

　　56. International Sanitary Regulations require control of aedes mosquito breeding in ports and regular inspections for presence of mosquito larvae were carried out on small craft in the harbour. Mosquito breeding was negligible and no aedes aegypti larvae were found on any of the 5,722 junks inspected during the year. Aedes aegypti, although not found on shore in recent years, was the predominant species of mosquito found breeding on junks in the harbour in 1953, and since then the mosquito has been eliminated by control measures which depended largely on the cooperation of junk masters.

57. The dock area and airport are included in the rodent control scheme for the Colony and returns of rodents destroyed and spleen smears examined for P.pestis were submitted weekly to the Epidemiological Intelligence Station, Singapore.

58. A constant check was maintained on the purity of drink- ing water supplied to ships by bacteriological examination of weekly samples from water boats and dock hydrants, and immediate remedial action was taken when necessary by the Water Authority or Port Health Office. 495 samples were taken from water boats and dock hydrants and were submitted to the Pathological Institute for bacteriological examination, 31 sam- ples did not conform to the standard of purity. 61 samples of water were taken from ships on request; of these 22 were sub- standard.

59. A weekly exchange of epidemiological information was maintained with the World Health Organization Epidemiological Intelligence Station, Singapore. Hong Kong, because of its use- ful radio station, is frequently contacted by ships at sea seek- ing medical advice. During 1956, 16 ships requested "PORT HEALTH" Hong Kong for advice regarding treatment of sick persons on board and the period under treatment in each case ranged from one to seven days.

Tuberculosis.

　　60. The combined effects of a refugee problem of gigantic proportions and overcrowding probably without parallel have produced in the community a tuberculosis infection rate higher than in any other part of the world. Despite these facts there

is ground for some satisfaction with the present trend of tuber- culosis mortality. Excluding the immediate post war years when statistics could not be regarded as reliable, the mortality rate for 1956 was the lowest on record.

Table 5

Tuberculosis

Year

Estimated Population

Death-rate per 100,000

Percentage of total deaths

of tuberculosis deaths below 5 years

1948

1,800,000

108.9

14.6

1949

1,857,000

140.6

16.0

34.8

1950

...

2,265,000

144.0

17.7

38.3

1951

2,01 3,000

208.0

20.0

34.0

1952

2,250,000

158.8

18.4

34.3

1953

2,250,000

130.6

16.0

36.2

1954

2,277,000

126.3

14.9

31.2

1955

2,340,000

120.0

14.7

28.0

1956

2,440,000

107.0

13.6

25.0

61. The actual number of deaths from respiratory tuber- culosis in adults has remained substantially unchanged over the past few years showing a 3:1 male preponderance and maximum deaths in the 35-54 age groups. In children below the age of 5 years, where deaths show equal sex distribution, the actual deaths in the past 3 years were 293, 159 and 139 respectively, despite a steady increase in the number of births.

62. Deaths from Tubercular meningitis, though still account- ing for more than 20% of the total tuberculosis deaths, were lower than in any year since 1948. Deaths from forms of tuberculosis other than respiratory and meningeal are the lowest on record. Deaths from progressive primary and post- primary tuberculosis are therefore falling rapidly. It is against this type of disease that the tuberculosis control programme is specially directed and it is also in this group that modern chemotherapy is most effective.

63. As already stated Hong Kong has the unenviable distinc- tion of having the highest infection rate (76%) at the age of 8 years reported in the world, as was shown in a table recently

　published by the World Health Organization based on results of tuberculin tests. Information on the actual tuberculosis morbidity is scanty and cannot be regarded as reliable. The notifications of tuberculosis made during the year were:-

1955.

1956.

Government Chest Clinics

---JL

9,843

7,704

Other Government Institutions Non-Government Institutions including

1,43-1

1,643

Tung Wah Group of Hospitals

2,352

2,222

Private Practitioners

519

586

14,148

12,155

64. It will be seen that the fall in the notifications of tuber- culosis has been due almost entirely to a fall in the returns made from the Government Chest Clinics. This fall was produced artificially by a necessary deliberate restriction of attenders and is not compensated for by an increase in notifications from other sources. Notifications made by private practitioners remain low and do not truly reflect the degree to which private treatment of tuberculosis is carried out.

65. Of the total tuberculosis notifications 11,326 relate to disease of the lung. The peak prevalence is in the 25-29 age group with a 2: 1 male preponderance.

66. It can be said that government policy in relation to certain social welfare services is to act as far as possible. through voluntary agencies by providing funds, control being financial rather than administrative, each agency attacking the problem in hand according to its own ideas and facilities. This same policy is applied in the tuberculosis field, the govern- ment taking part directly in the control programme through the Tuberculosis Service of the Medical Department and indirectly through the voluntary agencies.

67. The Hong Kong Anti-Tuberculosis Association is the only voluntary body in the Colony which devotes its activities ex- clusively to tuberculosis, including among its activities the maintenance of 338 beds for the treatment of pulmonary tuber- culosis, and, to a lesser degree bone and joint tuberculosis, and after-care clinic for patients on discharge, a health education service in tuberculosis and a B.C.G. clinic.

　　68. Details of the activities of this body may be seen in their official report which is published annually.

　69. The Tung Wah Group of Hospitals also include in-patient and out-patient facilities for the diagnosis and treatment of tuberculosis.

　70. The Family Welfare Association provides assistance to the needy, among whom are included a number of tuberculosis sufferers. Close liaison is maintained with the Government tuberculosis almoner.

　71. Certain Government departments, principally the Social Welfare Office, participate indirectly, by providing assistance to the needy including the tuberculous. Closer liaison

　　　　　　　　　　　　　　　　　　　　　　　Closer liaison is being established between this Office and the Tuberculosis Service with the object of avoiding overlap and providing assistance where it is most needed.

72.

Private practitioners, private clinics and hospitals play a considerable part in the treatment of tuberculosis but the degree to which this is done is not known. A large new hospital of 540 beds has now been completed by the Hong Kong Anti- Tuberculosis Association. This hospital was financed by a Government grant and a long-term Government loan to operate a non-profit-making basis for the benefit of tuberculosis sufferers who can pay for treatment.

73. Control is based on treatment of known cases mainly on an ambulatory basis, examination and treatment of their close contacts, and a limited amount of Mass Miniature X-ray survey work. In addition B.C.G. vaccination of children is taken where possible, with special attention being given to new-born babies. It is not necessary at this stage to operate a case finding service nor is it considered that utilization of available beds for the isolation of a few of the infectious cases is likely to make any substantial contribution to the problem as a whole in view of the fact that 2% of the population suffer from active pulmonary tuberculosis and the population at large can be regarded as contacts.

Government Tuberculosis Service Facilities.

74. This service, which was instituted in 1947 with one clinic and limited hospital beds, was increased within one year to the present facilities, none having been added since. Expan- sion has been mainly by the increase in provision and efficiency of the out-patient service.

　　75. The staff employed full time in the service is follows:

Tuberculosis Specialist

Medical Officers {

Hospital

Clinic

Nurses

Almoners & Assistant Almoners Tuberculosis Workers

Clerks

Ancillary

וחו יזויווי

B.C.G. Clerk

}

Vaccinators

Driver

L L

Total

г. г.г.

ז.

יז.

76. This does not include X-ray staff, laboratory staff or hospital staff, all of whom provide assistance to the Tuberculosis Service but work under their respective sub-department heads.

77. The service operates as a single integrated unit under the immediate control of the Tuberculosis Specialist. The out- patient staff operate from two large full time central clinics each holding two evening sessions per week for employed persons. This staff also operates eight branch clinics, each holding one half day session per week and in addition is responsible for the diagnosis and treatment of tuberculosis sufferers in Stanley Prison as well as the supervision and treatment of 42 tuber- culosis cases in St. John Hospital, Cheung Chau. The three in-patient medical officers, who are responsible for a total of 278 beds, work under the administrative control of the Medical Superintendents of Queen Mary and Lai Chi Kok hospitals but are responsible to the Tuberculosis Specialist in regard to clinical work.

　　78. The part time services of a thoracic surgeon are available once a week in the clinic as well as in the hospitals. The Con- sulting Orthopaedic Surgeon to the Government conducts a clinic once a week for the diagnosis and treatment of orthopaedic tuberculosis.

79.

　　　　　All diagnosis and treatment in the clinics is carried out free of charge. Treatment in hospital in the general wards is normally free of charge also but occasionally a maintenance charge up to the maximum of HK$1.50 per day may be made if the financial circumstances of the patient so dictate.

　80. Because of annual increases in attendance at the clinics by 50% in each of four successive years it was decided in December, 1955, to limit voluntary attenders until additional staff and premises became available. This has necessitated turning away varying numbers of voluntary attenders practical- ly every day throughout the summer season. Despite this restriction there has been a further increase in total attendances of 20%.

81. Attendances at the branch clinics also show increases in both new patients and old patients, but efficiency was seriously affected by the absence of X-ray facilities in the latter half of the year, due to the mobile unit, which normally provides X-ray service to the outlying clinics on the mainland once per month, being out of commission.

82.

Details of attendances were as follows:

Table 6

First Visits {

Main Clinics

Branch Clinics

Revisits

{

Main Clinics Branch Clinics

LJILJ

Total attendances

1955.

1956.

37,789

32.276

2,272

2,331

40,061

34,607

...-

304.231

373,222

16,195

28,346

320,426

401,568

360,487

436,175

83.

　　　　Due to the shortage of clerical staff in the branch clinics full details of patients attending are not available, but the following table shows the classification according to origin of new patients attending the main clinics during the year,

Table 7

1955.

1958.

Voluntary attenders Contacts

------

30,293

25,118

---------

1,086

1,043

Referred cases

Private practitioners.

1,029

900

Hospitals, etc.

1,235

1,073

Government

Routine

1,519

1,473

Servants

Voluntary

Survey

1.087

1,181

Survey, non-government

Private school teachers

Evening Clinic

684

567

340

452

475

425

Total

37,789

32,276

　　84. Analysis according to the clinical findings on first attend- ance of all new patients including branch clinics is as follows:-

{

Table 8

Examination incomplete Information not complete

Patient did not attend

No evidence of tuberculosis or other disease Lung disease other than tuberculosis Pulmonary tuberculosis

Total

- JL-L

1955,

1958.

2,543

1,827

3,572

3,534

22,920

18,056

465

457

10,449

10,733

39.949

34,607

　　85. Classification of cases of pulmonary tuberculosis accord- ing to the stage and extent of disease on first attendance was as follows:

Table 9

Active disease

Minimal Moderate ( Advanced

Quiescent

Arrested

Recovered

1955.

1956.

2,021

1,898

2,018

1,837

1,857

1.966

2,989

3,434

1,125

1,241

439

357

　　　86. 41% of active cases were found to be infectious on first diagnosis.

87. It will be seen that despite the restriction of attendances the actual number of tuberculosis patients who attended the clinics was greater than in 1955 and that the fall in the number of first attendances affected only those who were free from tuberculosis. There was, however, a drop in the total number of active cases. Comparing the findings in the different clinics, Wanchai Chest Clinic, which had the biggest number of new cases, showed only 11.3% of active tuberculosis compared to 22.5% in Kowloon and 18.5% in the branch clinics. The proportion of minimal cases was greatest in Wanchai. It has been a constant finding in past years that the public on the Island attend the clinics more freely and at an earlier stage of the disease. It is also an impression that the average economic status of the Island patient is better.

88. Efforts are made by the Tuberculosis Visitors to ensure that all close contacts of known cases of tuberculosis are examined. Arrangements are usually made during the course of the visit to the home. Contacts are divided into two groups

according to age, those below the age of 8 years being examined by Mantoux Test and vaccinated with B.C.G. if negative, and X-rayed if positive. Those above this age proceed straight to X-ray, attending the Chest Clinic only if the X-ray findings are abnormal. The findings were as follows:

(a) Under 8 years of age.

ƒ Negative

Tuberculin tests {

Clinical findings

of tuberculin

tested positive

cases

Positive

1955.

1956.

1,148

866

Lot-

2,295

2,292

157

109

212

315

1,830

1,814

4.55

3.45

Active tuberculosis Inactive tuberculosis. Suspicious

Free of tuberculosis

Percentage of active tuberculosis

(b) Over 8 years of age.

Results of exam-

ination following

contact X-ray

Active tuberculosis

451

372

Inactive tuberculosis. Suspicious

228

159

452

+--------

633

Free of tuberculosis.

8,380

6,535

Percentage of contacts over 8 years with

active tuberculosis

Grand total of contacts examined

1.75

4.83

12,954

10,857

89.

　　　　The Orthopaedic Tuberculosis clinic now in its second year of operation is proving to be a most valuable adjunct to the Tuberculosis Service and a convenience to patients-many of whom suffer from both pulmonary and orthopaedic tuber- culous disease and can therefore have both conditions treated in the same premises. All cases are investigated as to their chest condition in the first instance so that by the time the patient attends the orthopaedic session he is fully documented and home visited, and the treatment for his chest condition already arranged. There is at present no provision for bone and joint X-rays on the premises and patients have to travel to Queen Mary Hospital for this purpose. Patients who require hospital treatment are admitted to either Queen Mary Hospital or Ruttonjee Sanatorium by the arrangement of the Consulting Orthopaedic Surgeon who conducts the clinic. The results of treatment so far are very encouraging. Total attendances for the year were 556.

90. A surgical chest clinic is held once per week by the thoracic surgeon, using the resources of the chest clinic, for the benefit of patients suffering from tuberculosis who appear to require surgical treatment to effect control of their pulmonary

　disease. Cases for the most part originate in the Chest Clinics. This session also affords the Thoracic Surgeon an opportunity to review cases who have previously had surgical treatment.

91. The total attendances for the year were 619.

Radiological Examinations.

92. All X-ray work is done by the respective X-ray depart- ments which are controlled by the Senior Radiological Specialist. X-ray facilities are available in the main clinics for both day and evening sessions. In the branch clinics no facilities are available on the spot but may be provided by the monthly visit of the mobile X-ray unit or by sending the patients to central X-ray departments. During the latter half of the year the

mobile unit was not available.

　　93. First examinations are normally carried out on 35 mm. film. Special examinations such as tomography and broncho- grams are available only in the two main general hospitals.

94. Details of work done during the year on behalf of the clinics are as follows:

Hong Kong,

(Including Wanchai,

Cheung Chau, Aberdeen, Stanley & Mobile Unit)

Kowloon.

Kowloon Chest Clinic

& New Territories Clinics

1955,

1956.

35 mm.

50,847

37,221

Large film or paper. 20,678

29,595

5′′ X 4′′

14,599

11,467

35 mm.

17,434

16,330

Large film or paper. 22,042

26,528

5" X 4"

9,008

8,138

95. It will be seen that the 35 mm. figures are substantially reduced as a result, mainly, of the mobile unit not being available. The use of large films and papers has increased due to increase in the number of patients dealt with and partly at the expense of 5" X 4" films which do not find universal acceptance.

96. It has not been found possible, mainly for administrative reasons, to avoid the time between X-ray and communication to patient below one week. This adds unnecessarily to the time taken to arrive at a diagnosis but this cannot, at present be avoided.

97. All laboratory work done in connexion with the Tuberculosis Service is the responsibility of the Government

Pathologist and is carried out in the Pathological Institute or one of its branches. The number of examinations is voluntarily restricted to a minimum by the clinic staff on account of staffing problems in the laboratory service. The examinations carried out on behalf of the Tuberculosis Service during the year were as follows:

Positive

Sputum { Negative

1955.

1956.

7,503

7,208

22,309

26.033

29,812

33.241

Gastric Lavage {

Positive

Negative

230

236

272

329

98. It will be seen that the total examinations have increased by 3,486 or over 11.

Ambulatory Chemotherapy.

99. Ambulatory chemotherapy was started in the chest clinics in an experimental way in 1950, has steadily increased in scope and magnitude since that time, and has now become the spearhead in the therapeutic attack on the tuberculosis. problem. The hospital beds, which at the inception of the service were the only available means of treatment, have now been relegated to a secondary but very important role in the treatment scheme, being now used for the further treatment of cases whose disease has not been controlled by ambulatory treatment, for the isolation of certain special cases, and for the investigation of cases where there is doubt in the diagnosis.

100. Treatment by ambulatory chemotherapy is now inter- nationally accepted as having a useful part to play in the treat- ment of tuberculosis, its application varying according to local circumstances. The advantages of this method in Hong Kong are as follows:

(i) the available beds are totally inadequate to deal with the tuberculosis problem using orthodox hospital treatment; (ii) many patients prefer ambulatory treatment as it enables them to retain their job and to maintain their family during treatment;

(iii) it is almost 90% as effective as hospital treatment although 10-15% of patients require subsequent admission to hospital;

(iv) using combined ambulatory and hospital treatment, nine times the number of patients can be treated at the same cost as by orthodox hospital treatment.

101. Treatment is arranged in "courses" each lasting 12 weeks and is based on accepted combinations of drugs, using streptomycin (biweekly injection) P.A.S., I.N.A.H. and various proprietary preparations.

102. To operate the scheme efficiently it is necessary to have an adequate number of hospital beds with full surgical facilities to support the ambulatory phase of treatment. As two addition- al clinics have already passed the planning stage it will be necessary to increase the beds available to support the increased volume of ambulatory work when these clinics come into operation.

103. Cases treated during the year were as follows:

Cases brought forward from 1955 Started treatment in 1956

Total

1,703

7,861

9,564

Completed treatment 1956

1,037

Failed to attend

2,022

Treatment incomplete

Admitted hospital Transfer elsewhere Known to have died

445

140

Still on treatment at 31.12.56

5,887

　　　104. These figures represent almost the maximum capacity of the clinics. The small number recorded as having completed treatment during the year results from the policy of extending treatment duration in all cases and in some for as long as 2 years. Of those who failed to complete treatment almost one- third had been under continuous treatment for a period of six months before their attendance lapsed. Included also in the total of those who failed to complete treatment are a number who took advantage of easier travel arrangements to China to visit relatives but who have subsequently resumed treatment. The total numbers handled in Kowloon were higher than in Hong Kong by about 14% but the lapses in attendance were also higher.

Collapse Therapy.

　105. It is felt that collapse therapy still has a place in the treatment of pulmonary tuberculosis but confidence in the efficacy of simple pneumoperitoneum as a treatment measure is rapidly evaporating. Artificial pneumothorax is still considered good treatment but it appears that since the introduction of prolonged preliminary chemotherapy the chances of establishing satisfactory collapse are considerably reduced. As a result of these findings temporary collapse measures appear to be on the way out but established cases still continue treatment at the clinics.

Artificial Pneumothorax

Pneumo-peritoneum

Table 10

Induction Refills

LILI

Abandoned

Inductions Refills

Abandoned,

1955.

1956.

4,511

2,922

Unsatisfactory Completed treat-

ment

442

139

...

20,502

17,866

239

י.

Unsatisfactory Completed treat-

ment

106

　106. The number of refills at the end of the year had con- siderably fallen and it has since been found possible to reduce the number of sessions set aside for the work. The time thus made available has been set aside for the purpose of dealing with X-ray survey cases in special groups apart from the normal sessions as it would appear that the demand for X-ray surveys is likely to increase.

Hospital Treatment.

　107. The beds maintained in government hospitals for the diagnosis and treatment of chest disease are as follows:

Queen Mary Hospital, mainly surgical Lai Chi Kok Hospital, mainly medical &

convalescent

202

St. John Hospital, Cheung Chau, mainly medical

and convalescent

320

　108. These beds are widely scattered in general hospitals under the administrative control of the respective medical super- intendents. The facilities provided are not suited to the needs

of the long-term tubercular patients and the presence of tuber- cular patients in these hospitals is not always welcome. In addition frequent transfer of patients between the various hospitals according to the needs of the patient necessitates much unproductive work. The difficulties of medical supervision need

no emphasis.

109. These beds are, for statistical purposes, regarded as a Details of admissions and discharges were as

single unit.

follows:-

Table 11

1955.

1956.

Beds occupied as at 1st January, 1956

314

298

Admissions

507

498

Discharged:

(1) Completed treatment

{

Improved Unchanged Worse

451

438

(2) Discharged against medical advice (3) Died

(4) Transferred to other hospitals Beds occupied as at 31st December

　　　110. The fall in admission is due to stagnation of patients awaiting surgical treatment, and the number of patients on the waiting list is steadily increasing.

　　　111. Details of treatment of patients in hospitals are as follows:

298

314

LI.

Table 12

1955.

1956.

Artificial Pneumothorax {

Induction Refills

132

2,062

1,165

Thoracotomy

Thoracoplasty (Stages)

IL-LI

Plombage

Pneumonectomy

Lobectomy

Resection

Thoracoscopy

Pneumo-peritoneum { Induction

Phrenic nerve operation

Bronchoscopy

Refills

2,358

1,349

115

112. There has been a substantial fall in the temporary collapse measures which has affected pneumoperitoneum more than pneumothorax. A greater proportion of pneumoperitoneum cases are now combined with phrenic nerve operations. Phrenic

nerve operation is also used as an accompaniment of resectional surgery. Thoracoplasty is losing popularity in favour of re- section so that, while the total number of major operations performed is not greatly changed, a larger number of patients have been dealt with by reason of the fact that resection is normally a one stage operation. Compared to the position twelve months ago the number of cases in hospital listed for and awaiting surgical treatment has increased sevenfold and the waiting time for operation has increased from less than one month to six months and is steadily increasing. With the success of the ambulatory treatment in the clinics, the waiting list for admission is now made up almost entirely of surgical

cases.

Ruttonjee Sanatorium.

113. As previously stated, hospital treatment is available to clinic patients free of charge at Ruttonjee Sanatorium. Members of the general public and orthopaedic cases admitted through the Government Chest Clinics. The admis- sions for the year were as follows:

Priority eases

Orthopaedic cases

General public (pulmonary)

123

363

531

are

　114. Further details may be obtained from the report of the Hong Kong Anti-Tuberculosis Association.

The Tuberculosis Almoner Service.

　115. The Almoner's section, consisting of the Tuberculosis Almoner, Assistant Almoners and the Tuberculosis Visitors is responsible for all social work in connexion with patients attending the clinics and in hospital; both have substantially increased during the year. This increased work has had to be undertaken despite staff shortages which prevailed during the greater part of the period. In order to offset the increase in work at least in part, it has been agreed to appoint full time clerical staff to the almoner's department in future.

　116. Every diagnosed case of tuberculosis or other chest disease in need of treatment is interviewed by the almoner at

the commencement of treatment and periodically thereafter as necessary, and also according to the agreed scheme, as further treatment is recommended. Details of social and economic background are recorded at first interview, as also are the home circumstances after the visit of the tuberculosis visitors, the record being amended from time to time as necessary. The total number of interviews with patients during the year was 23,340, an increase of 30% on last year's figure.

117. Hospital waiting lists are maintained, patients being divided into various categories, chest medical, chest surgical, and orthopaedic cases, admission being arranged according to the various priorities of the patients and according to the type of bed available. Details of work done in connexion with hospital treatment were as follows:

Admitted to hospital {

Government Hospitals Ruttonjee Sanatorium

498

531

304

232

Transfers between hospitals

Awaiting admission as at 31.12.56

Referred to Chinese Charity Hospitals

　　　118. The number of patients awaiting admission at the end of the year is much lower than for any previous year, and is made up almost entirely of cases awaiting admission for surgical treatment. As almost one quarter of the cases at present occupying beds in hospital are also awaiting surgical treatment, further admission of such cases serves no useful purpose. The policy regarding admission has had therefore to be changed, and medical cases, who could be expected to respond satisfactorily to ambulatory treatment, are being admitted instead.

　　　119. The Almoner has at her disposal a sum for the provision of assistance to tuberculosis sufferers and their families. This sum is used in several different ways.

120. Assistance in kind is provided in the form of milk powder to patients undergoing treatment at the clinics. The normal issue of one pound per week per patient was reintroduced at the beginning of the financial year, and has been available to all patients, despite the increases in the number of patients in the treatment scheme. Considerable savings have been possible during the year as in the first instance a number of patients of better social status did not wish to avail themselves of this free issue, and in the second place 5,785 C.A.R.E. parcels, each

containing 13 lbs. of dried milk powder in addition to other contents, became available for issue. As a result of these savings the total quantity of milk powder issued during the year was 21,250 lb. as compared to 34,013 lb. in 1955.

　121. Assistance in cash in the form of weekly grants may be paid to patients who have been obliged to give up work in order to undergo treatment. This treatment allowance is used mainly in connexion with patients in hospital, but is available also to patients on ambulatory treatment. The amount paid is fixed by the almoner in accordance with a scale of agreed maxima and bears relation to the previous earnings of the patient and his responsibilities. During the year assistance was provided in this way to 184 families at a total cost of HK$68,400. The calls on the fund by Government servants during the year fell sharply as a result of the amendment of sick leave provisions.

　122. Rehabilitation grants may be made in order to enable patients, at the successful termination of their treatment, to take up suitable work. These grants are normally made to provide hawkers' licences and a small capital sum to start off the business. It appears that there has been a falling off in the potentialities of such business, with a consequent reduction in demand by patients. The total sum spent in this way was HK$910.

123. Miscellaneous calls were made on the fund for such purposes as repatriation and travelling expenses of patients travelling to Hong Kong from the St. John Hospital, Cheung Chau, for X-ray.

124. Contact between the patient in his home and the clinic is maintained through the Tuberculosis Visitors. The Tuber- culosis Visitors differ from their counterparts elsewhere in that emphasis during training is made upon the lay approach to the patients and previous training as a nurse is regarded as a dis- advantage, instead of, as elsewhere, being a basic qualification. A further difference is that they are responsible, not to the medical staff, but to the Almoner through a Senior Tuberculosis. Visitor in each clinic. This arrangement was introduced in the first instance as an experimental measure, but has proved to be

an unqualified success, and is at present attracting attention from other authorities in the area who have similar problems.

125. Home visiting is normally conducted in the afternoons, so that the Tuberculosis Visitors are available for other duties. in the first half of the day, mainly in connexion with reception of patients. The calls upon their time have been steadily increasing with the introduction of additional clinical sessions. in outlying areas, in evening clinics and in special clinics. As a result the time available for home visiting has been curtailed, and must remain so until it is possible to distribute the load to additional staff, who will become available when new clinics are opened.

126. The work done in connexion with home visits is as follows:

First visits to patients

Revisits

Total visits

Contact cards issued

Contacts examined

Table 13

1955.

1956.

12,149

9,550

6,002

5,021

19,094

15,621

16,518

13,836

12,954

10,857

　　127. The details of the clinical findings in contacts are set forth elsewhere in this report.

128. The Almoner is designated as the officer responsible for the contact between private firms wishing to have X-ray surveys of employees, the X-ray Department who do the X-ray in connexion with the surveys and the Chest Clinics who do the clinical assessments and issue the survey reports. This work on the part of the Almoner is purely administrative. The results of surveys are set forth in the appropriate section.

B.C.G. Vaccination.

129. B.C.G. vaccination was started in 1952 under the sponsorship of U.N.I.C.E.F. and W.H.O. and an intensive campaign was started and continued until 1955, when the campaign as such was discontinued, and the personnel dispersed and absorbed into other sub-departments, particularly those of Maternal and Child Health and School Health, in which a regular programme of vaccination is continued.

130. The function of the Central B.C.G. office is now mainly that of a supply and coordinating organization, though two

vaccinators are retained for visiting hospitals to offer B.C.G. vaccination to new-born babies.

131. The B.C.G. figures since the beginning of the campaign are as follows:

Table 14

Tuberculin Test

B.C.G. Vaccination

Year

Completed

test

Negative vaccinated

New-Borns

vaccinated

Grand total vaccinated

1952

176,728

38,173

3.120

11,293

1953

77.422

27,024

4.883

31.907

1954

52,620

15.234

3.050

18.284

1955

58,606

15,775

9,587

25,362

1956

38.523

5,629

23,418

29,047

Total

403,899

101,835

44,058

145,893

132. It will be seen that there has been a progressive fall in the number tuberculin tested and subsequently vaccinated, while the number of new-born babies vaccinated after 1954 has risen rapidly. This has been a deliberate policy, in view of the high proportion of tuberculosis deaths occurring in infants and the need for protection at an age as early as possible. The present B.C.G. work is therefore divided into two parts which are considered separately.

133. B.C.G. vaccine strength 20 mgm., cc., prepared in individual doses for administration by multipuncture inocula- tion is made available free of charge at various distribution points in the urban and rural areas for the use of private practitioners and midwives for the vaccination of new-born babies. A circular letter was sent to all practitioners at the start of the scheme and all midwives have been trained in its use. B.C.G. vaccination is now included as part of the routine training of midwives.

134. Although only a small number of births are conducted by private practitioners there is a small but constant demand for vaccine from this source.

135. The majority of non-hospital births are conducted by registered midwives, either government or private.

　　　　　　　　　　　　　　　　　　　　　　　　　　　Of the total of 45,444 births conducted by midwives 5,349 babies were B.C.G. vaccinated, more than one half being done by government staff. This scheme is still in its early stages and the numbers were rising fairly rapidly towards the end of the year. It is antici- pated that the figure will be considerably greater next year.

136. Visits were made to all the principal hospitals with maternity wards twice a week in order to ensure that all mothers have the opportunity to have their babies vaccinated. Vaccina- tion is carried out on a voluntary basis. Out of a total of 41,893 births taking place in these hospitals, 18,069 or 43% were B.C.G. vaccinated.

　　137. For reasons that can be attributed only to changes in the vaccine the number of complications resulting from vaccina- tion has substantially dropped since this form of vaccination was first introduced, and is now in the region of four per thousand. It has been found that these complications can easily be controlled by the administration of INAH.

138. Thus, out of a total of 96,746 babies born in the Colony during the year, 24% were known to have been vaccinated against tuberculosis. The number vaccinated has been rising month by month, and higher figures can be confidently antici- pated next year.

139. Vaccination of individuals other than new-born babies is carried out by the classical intradermal route, using vaccine of a strength of 1 mgm. 'c.c. The tuberculin test in use is the Mantoux test of 5 international tuberculin units of purified protein derivative obtained from Copenhagen in bulk. Vaccina- tion is carried out as a routine measure in the chest clinics in connexion with tuberculosis contracts, in the School Health Service and in the Maternal and Child Health Service. A B.C.G. clinic is maintained by the Hong Kong Anti-Tuberculosis Association on a full time basis. The total number of persons. tuberculin tested by all these bodies for the year was 38,523 of which 5,629 were subsequently vaccinated. This represents a very considerable drop in the totals as compared with previous

years.

X-ray Surveys.

　140. No general population X-ray surveys were carried out. during the year on the ground that the facilities for subsequent diagnosis and treatment are already overstrained to such an extent that limitation of numbers of first attenders has been in force throughout the year. Certain special groups were examined.

　141. All Government servants are now X-rayed on first appointment and thereafter at annual intervals. This annual examination has been in force for several years and is paying handsome dividends in the form of reduction of total sick leave, considerable reduction in the numbers invalided as a result of tuberculosis each year, and considerable improvement in the prognosis of cases found. A few individuals still are not regularly examined, but the number is small. The results of survey for the past few years were:

Total X-rayed

Table 15

1957. 1954. 1955. 1956. 24,915 26,255 26,574 27,842

Examined at clinic

New active cases

LJ LILIP

2,746 0.722 64

3.282 3,751 1.017

4,347

1.272

1.34

101

Active tuberculosis percentage

　142. It will be seen that not only has there been a steady increase in the totals examined, but there has also been a dis- proportionate increase in the numbers subsequently requiring assessment. The increase in the incidence of active disease is a finding which has been noted elsewhere. The number of new cases found each year is fairly constant, and most are minimal

cases.

　143. X-ray survey of employees of private bodies is carried out free of charge under certain guarantees covering the protec tion of the patient, with special reference to sick leave on pay and security of tenure of office. Employees found to be suffer- ing from tuberculosis have complete freedom of choice as to where they obtain treatment,

　144. The number of firms participating and the totals of those examined have shown a substantial drop compared with previous years on account of the fact that the Mobile X-ray unit was not available for the greater part of the year.

　　145. The findings for the year with comparative findings for previous years were as follows:

Table 16

1955.

1956.

Total X-rayed on 35 mm. film

9,182

2,870

Reported normal

8,291

2,547

Clinically examined

783

322

Active Tuberculosis

100

Percentage of active tuberculosis

1.2%

1.04%

146. The smaller percentage of active tuberculosis found this year cannot be regarded as an indication of reduced local prevalence as the total number was small and the groups were selected in that they were made up of a disproportionately large proportion of students in schools and in Hong Kong University. 147. All inmates of Stanley Prison are X-rayed as soon as possible after arrival, assessed and treated if necessary by a medical officer from the chest clinic, who visits the prison weekly. Hospital treatment is available on a scale considerably greater than is available to law abiding citizens, and in fact, any prisoner whose case justifies it can be admitted to hospital. More than one ex-prisoner has deliberately sought re-admission to prison in order that he can be admitted to the prison hospital for treatment of his pulmonary tuberculosis.

148. The results of examinations were as follows

Total number X-rayed

Number of cases of active tuberculosis found

School Teachers.

3,036 78

　　149. Teachers in government schools are examined annually in the course of the annual X-ray of government servants. Teachers taking up first appointment in private schools have compulsory pre-registration X-ray of the chest before permis- sion to teach is given. The Medical Department is the official agency for certification. The findings in cases that attended the chest clinics for assessment and certification were:

150.

Referred to the Chest Clinics Unfit to teach on account of

pulmonary tuberculosis

г..т г- го .

School teachers found unfit to

1954. 1955. 1956.

288 348

456

teach are permitted to

resume work as soon as it appears that they can do so without

prejudice to the health of their pupils. They have complete freedom of choice as to where they may have treatment, but they are accorded priority right of treatment at the chest clinics and admission to hospital if necessary.

Future Outlook.

151.

　　　　　The results achieved from the use of ambulatory chemotherapy have exceeded all expectations. As a result of these findings the whole tuberculosis treatment scheme has changed, emphasis now being made upon this form of treatment, with hospital treatment taking a secondary but essential part in the programme. Such a scheme is within the means of the community to implement, as the bed provision required is reduced to about one eighth of what would be required with orthodox treatment. A substantial increase in the facilities for ambulatory treatment will be made within the next eighteen months with the opening of two new chest clinics, so that the total resources of the chest clinics should be capable of dealing with about 10,000 patients on continuous treatment, the duration of treatment varying according to the case but not being in any case less than nine months, and in the majority being twice as long. This total represents only about 20% of the total of the estimate of active cases in the Colony. In order to keep the scheme properly balanced, the number of hospital beds should be increased also, and the facilities for thoracic surgery should be adequate to keep these beds in full and efficient use. At present the beds available are insufficient to deal with the needs of the existing clinics, and no immediate prospect of an increase is in sight. The situation will be improved some years hence; if the existing Kowloon Hospital is turned over for the treatment of tuberculosis, when the new hospital is completed, but that is still some years distant, and the needs are already urgent.

　152. The results of the B.C.G. vaccination are not yet obvious but it is hoped that the present downward trend of infant tuberculosis will continue. Efforts must be redoubled in this direction as this probably offers the best prospect for the future.

Malaria.

　153. Due to new commitments and extension of work under- taken during the year the Malaria Bureau staff has been

　increased by one Malaria Inspector and 45 temporary or daily- rated workers.

　　154. In August, 1956 the Bureau's Kowloon Office moved to the new District Branch Offices Building at Un Chau Street, thereby relieving the congested conditions which prevailed at the former premises and improving laboratory facilities.

　　155. Construction of temporary Coolie Quarters and one oil store was completed in December 1956 at the new Castle Peak Hospital site. In addition, two other new oil stores--one at Kun Tong and the other at Cha Kwo Ling-were handed over to the Bureau in March 1957. These new structures provide the storage facilities necessary to cope with the extension of work in these areas.

156.

Control relies mainly on anti-larval measures. Areas at present under active control consist of the populated portion of Hong Kong Island, Kowloon and New Kowloon, which roughly corresponds to the urban areas of the Colony in which the main bulk of the population (about 90) is concentrated. In addition, in the New Territories, the southern inhabited portion of Cheung Chau Island, the Tai Lam Chung Reservoir Site, Rennie's Mill Camp, the Castle Peak Hospital area and the new Chimawan Prison on Lantao Island are similarly protected.

　　157. At Hay Ling Chau Leprosarium the necessary insecti- cides have been supplied by the Bureau, and anti-malaria work is undertaken by the staff there.

　　158. As in previous years since 1950, "Gammexane" disper- sible powder, P520, has been in use as the larvicide for field work. Results have been satisfactory, and from field observa- tions, no resistance of the local species of anopheline mosquitoes to this insecticide has so far been noticed, although the Bureau has been very watchful for its possible development.

　　159. Numerous checking catches and surveys were made by the Bureau in the controlled areas of Kowloon and Hong Kong and, except in one or two instances, no anophelines, either larval or adults, were found. Vector mosquitoes, however, abound on the borders of the controlled areas, and given a favourable opportunity, can increase rapidly at any time. It needs no emphasis that constant vigilance is necessary,

160. In order to avoid as far as possible the danger of enhancing development of resistance of anopheline species to insecticides, it has been considered advisable since the beginning of the year to discontinue DDT residual spraying in the villages on the perimeter of the larval-controlled areas.

161.

The total number of cases of malaria notified for the year 1956 was 496, compared with 431 in 1955. The Table in Appendix 4 gives details of the source of the notifications, whether from the protected areas or elsewhere, the type of infection, and whether the cases are new cases or relapses.

162. During the year, 4 deaths from malaria were recorded, as compared with 9 in the preceding year. Of the 4 deaths, the diagnosis in two cases was not confirmed by blood examina- tion.

163.

In the New Territories malaria surveys were carried out during the year at San Wai (Shatin), Kam Tsin, Cheung Shu Tan, Wong Toi Shan, Leung Tin, Kei Lun Wai, Ho Chung, Wo Mei, Nam Wai, Kai Ham, and Pak Kong Au villages. During these surveys, spleen examinations of children up to ten years, were performed. Altogether, a total of 706 children presented themselves for spleen examination and 804 for blood examination. The spleen rates varied from 0% to 12.0% and the parasite rates from 0% to 11.5% among individual villages.

164. With the assistance of the Medical Officer of Health New Territories and the Government Pathologist, blood smears were taken for, examination for malaria parasites from all infants under 1 year of age attending clinics or health centres. Results are detailed in Appendix 5.

　165. From this Appendix it is seen that the degree of malaria endemicity varies in different parts of the New Terri- tories, the Saikung area shows the highest infection rate with Tsuen Wan the next most affected. Infection is practically all of the Benign Tertian (Vivax) variety.

Leprosy.

　166. The vast majority of patients with this disease con- tinued to be treated at out-patient clinics with the object of rendering them non-infective as quickly as possible by modern treatment. This is justified by the proved fact that the infec- tivity of leprosy is extremely low.

167. Two additional weekly clinics were commenced during the year, one at Cheung Chau and the other at Shamshuipo Public Dispensary. Total attendances at clinics were 25,789; cases attending for the first time numbered 751. The number of lepers under active treatment at the close of the year was 1,670. 165 cases were admitted to Hay Ling Chau Leprosarium compared with 98 the previous year and 28 in 1954. 280 cases were also treated in Stanley Prison.

B.C.G.

　　　168. Familial contacts of infectious cases were followed up, and 195 such contacts were examined during the year. vaccination continues to be given for child contacts.

169. For treatment "dapsone" orally or by injection (20% suspension in oil, or "Avlosulphon Soluble") remains the stand- ard method. An average case requires a total dosage of 180 millilitres of this drug before conversion to negative smears is achieved.

　　　170. Rehabilitation of cured cases continues to be difficult; the process of re-acceptance into the general community is a slow one.

171. An unofficial settlement of leprosy patients squatting at Sandy Bay near Pokfulam was cleared in July 1956 to allow completion in that area of a new convalescent hospital for crip- pled children.

　　　172. Infectious cases were sent to Hay Ling Chau Lepro- sarium. Most of the non-infectious were accommodated in new multi-storied resettlement housing estates in Kowloon and the remainder, who were physically disabled, were cared for by the Social Welfare Office.

Social Hygiene.

　　　173. The incidence of venereal diseases continued to show a satisfactory decline in 1956 as the following table covering the previous three years shows:

Table 17

Year

Total No. New Patients

Total No. Attendances

Total No. new Syphilis Cases

1954

36,652

223,031

6.825

1955

34,853

203,701

4.232

1956

32,490

180,148

3,711

　174. The number of clinics in operation remained the same as in 1955. Two additional posts of Female Social Hygiene Visitors were filled in July 1956 to deal with the increased number of contact notifications and follow-up visits to de- faulters.

　175. 3,435 contact notifications were received during the year. Approximately half of these were from the Armed Services; none was forwarded by private medical practitioners.

　176. A high percentage of success in contact tracing was maintained (81%), though similar success with the follow-up of defaulters from treatment at clinics is not yet apparent.

177. Antenatal blood tests for expectant mothers showed a lower positive rate than has yet been recorded in these investi- gations. 3.8% of 26,083 such tests carried out during 1956 were positive compared with 4.5% of the previous year's total. 178. Special services for seamen, and for cases referred by the sterility clinics of the Family Planning Association continued to be provided on an increasing scale.

　179. Several new investigative procedures were introduced during the year. The quantitative V.D.R.L. (Venereal Disease Research Laboratory) test became routine in all positive qualita- tive tests, and cultures for gonococci combined with a penicillin sensitivity test were made on a large group of prostitutes reported as contacts.

　180. In treatment the use of Benzathine Penicillin tended to replace procaine penicillin preparations and "Triplopen" (a combination of crystalline penicillin, procaine penicillin and benzathine penicillin) was commonly employed for all-purpose infection therapy. Penicillin V was introduced for oral treat- ment in selected patients.

　181. The Social Hygiene Specialist attended the First Inter- national Conference on Venereal Disease at Washington, U.S.A. in May 1956 prior to his overseas vacation leave.

182. A table showing details of new cases seen at Social Hy- giene Out-patient Clinics during 1956 is given in Appendix 6.

Maternal and Child Health Services.

183. The Government midwifery service has 37 district midwives working from 19 widely scattered centres in the urban areas and New Territories.

184. 12 centres, all in the more rural areas, have attached maternity homes with a total of 105 beds. The remaining centres provide a domiciliary delivery service only.

185. 11,013 deliveries were conducted during 1956 by the Government midwifery service, 7,660 in the maternity homes and 3,353 in private houses. There were 143 still births, a rate of 13.2 per 1,000 live and still births. 159 cases were sent to hospital because of complications of pregnancy and child birth.

186. The average annual "case load" per midwife of 314 in 1956 was happily a little less than in 1955 (323) and varied from 83 at Silver Mine Bay to 854 at Yuen Long.

187. Ante-natal attendance figures again showed an improve- ment over the previous year. Over two thirds of all cases delivered received some pre-natal care. Average attendances per case were 3.11. 299 of the cases delivered had no ante-natal supervision of any kind; the great majority of these were in the New Territories and among the "floating" population.

188. There are 209 midwives actively engaged in private practice. 179 of these maintain small maternity homes, the remainder do domiciliary work. Live deliveries by midwives in private practice totalled 34,619 during 1956, ie. over one third of the Colony's total registered births. The number of ante- natal attendances per case still remains disappointing (average 2.9 attendances per case) though the proportion of cases deliver- ed that receive supervision is 81.5%.

　　189. Regular inspection of the 133 registered private maternity homes is carried out. A total of 788 visits was made during the year. Special attention is paid to records and equipment.

190. 77 private midwives attended special classes in B.C.G. vaccination technique held at the Tsan Yuk Hospital and Alice Ho Miu Ling Nethersole Hospital.

　　　191. Successful efforts to increase the number of infants receiving B.C.G. vaccination have been made, and the steady improvement in the returns for this immunization has been

encouraging. A new procedure of this nature takes some time to gain general acceptance.

　192. Maternal and Child Health clinics provide the public with free ante-natal, post-natal, infant and child welfare services. Their aim is to promote and maintain the health of expectant mothers, and of infants and young children. No therapeutic treatment of sick cases is undertaken. During the year 5 full-time centres and 14 subsidiary centres holding clinic sessions provided these services. In addition, sessions providing maternal care only were provided in 5 other centres.

　193. One new full-time centre was opened in September 1956 at Homantin, the staff for which included 2 midwives for domiciliary maternity work. The centre in the Chai Wan Resettlement area was put on a full-time basis in November 1956 to meet the growing demands in this area.

　194. The service is in the charge of a medical officer with a staff of 7 doctors, 2 health sisters, 2 nursing sisters, 14 health visitors, and 23 health nurses. A notable improvement in the service during the year was the establishment of "Toddlers Clinics" in the 5 main Maternal and Child Health Centres for pre-school children of 2 to 5 years of age for whom no special care had been previously available outside general out-patient clinics. Considerable increases were also possible in the number of post-natal sessions provided, an additional 6 sessions each week being held in the more outlying clinics.

195. Immunization programmes were organized with particu- lar reference to tuberculosis (B.C.G.), diphtheria, and small- pox. Diet supplements and vitamin preparations were dis- tributed to all under-nourished patients.

196. A summary of the figures for the year's attendances and other activities is given below:

Type of work

Ante-natal care

F 11

Post-natal care

Infant & Child care

Table 18

No. of sessions held

JLL

2,231 796 2,614

No. of Home visits paid 25,225.

Cases referred to Family Planning Association, 3,520.

Total No. of attendancea

105,031

9,623

241,591

School Health.

　　　197. In 1956 the School Health Service has had to remain limited owing to lack of premises and staff. No new entrants except from previously existing Government schools have been accepted during the year.

198. The number of pupils participating in the service in December 1956 was 36,196 from 400 schools. 43 of these were Government schools, 87 were subsidized schools, and 268 were private and grant-in-aid schools.

199. The medical staff remained the same as during the previous year. Two health visitors were appointed in October 1956. One small new clinic attached to a new Government primary school was completed at Tsuen Wan; this is the first school clinic built in the New Territories.

　　　200. A summary of the medical inspection and clinic work is given in the following tables:

Table 19

Medical Inspections of pupils 1956

New Entrants...

Periodica! Inspections

Re-inspections

Total

Table 20

Attendances at School Clinica 1956

4,881

12,145

39,373

56.399

General

Dental

Attendances

Clinica

Ophthalmic Clinics

E. N. T.

Clinics

New Cases......

54,651

9,047

1,916

954

Revisits...

---

23.708

23,313

1,567

1,545

Total

78,359

32,360

3,483

2,499

201.

Additional services included the free issue of 2,234 pairs

of spectacles to children following refraction, 261 operations in

hospital for tonsilectomy, and 153 admissions to hospital for other causes.

　202. 792 cases of notifiable disease were reported during the year and 3,156 contacts of these cases were put under observa- tion.

203. Prophylactic immunizations are arranged for all school children as part of the general health services of the Colony irrespective of participation in the School Health Service. During the year a total of 197,999 immunological procedures were carried out for school children. Particular emphasis is

on the measures against diphtheria, typhoid fever, smallpox and tuberculosis.

204. Sanitary inspection of all school premises is a duty of the two Health Inspectors of the School Health Service; 2,648 such inspections were made in 1956.

205. In relation to children the health of teachers, particu- larly in regard to tuberculosis, is of primary importance and all applicants for registration as teachers are required to have chest X-rays prior to acceptance; during the year 3,956 pro- spective teachers (exclusive of Government teachers) were X-rayed and of these 461 were referred to Chest Clinics for clinical examination. Of those referred 49 (plus a further 25 who fell sick during the year) were found to have active infective pulmonary tuberculosis and for this reason were not permitted to teach.

206. Health visitors and school nurses attached to the School Health Service carry out most important functions as health educators, advisors and co-ordinators establishing contact between teachers, parents, and the pupils on all health matters. Stimulation of interest in personal and community health is the main objective and the appointment of a Health Education Liaison Officer by the Education Department has been of great assistance.

207. A revision of the Health Education Course for use in the Teachers' Training Colleges was completed during the year and 18 lecture periods are now undertaken by Medical Depart- ment staff in each course of 60 lecture periods.

208. A special nutrition survey was carried out in 1956 on 18,948 children to assess standards of nutrition and the follow- ing results were obtained:-

New entrants

Already in School

Total

Table 21

Total No.

Normal

Examined

Slightly below normal %

Poor

6,803

59.29

35.09

5.65

12,145

43.24

50.89

5.86

18,948

49.0

45.25

5.78

209. A dental survey with the provision of complete dental treatment including fillings, scaling, and periodical re-examina- tion was carried out in 3 Government Primary Schools. The following findings are recorded:

No. examined

No. requiring treatment

No. of visits for treatment No. rendered dentally fit

------

2,702

1,800

3,996

670

　　　210. The dental condition was worst in the lowest classes though 46% of the cases with dental caries involved permanent teeth.

Health Education.

　　　211. Considerable increase of work in this field is to be recorded during 1956. Though there is no general programme of health education by the Medical Department as a whole, each sub-department of the health section conducts campaigns of this nature limited to its own special needs. The School Health Service gives courses of lectures by doctors to teachers in training and the School Nurses and Health Visitors continually endeavour to instil principles of elementary hygiene in pupils. Maternal and Child Health clinics hold planned series of talks, demonstrations, and discussions on matters of health interest to mothers concerning themselves and their babies. Social hygiene advice on venereal diseases and the value of blood tests for expectant women has been distributed by means of pamphlets.

　　　212. Tuberculosis visitors are able to spread knowledge of the means used to limit the spread of tuberculosis by infectious patients when they visit contacts and families in their homes.

213. The whole process of health education is necessarily a gradual one since it depends upon arousing sufficient interest in the people to produce a striving for better health as opposed to mere avoidance of disease.

IV. THE WORK OF THE MEDICAL DIVISION General Survey of Hospitals.

　214. Apart from nursing homes, and excluding the Armed Services' facilities, there are 28 hospitals in the Colony. Eleven of these are the responsibility of the Medical Department, and the other seventeen are run by various private organizations. Seven of the institutions in this latter category receive sub- stantial assistance from Government in respect of the charitable services which they offer. Details of all these institutions are attached at Appendix 7. More specific information of the actual work done in Government hospitals and in the assisted hospitals are given at Appendix 8, in which the classification of diseases follows the International Standard Classification (International list of 150 causes). Details of in-patients treated in all hospitals during the year are shown at Appendix 8A.

　215. The eleven Government hospitals provide a total of 1,999 beds, the Government-assisted hospitals 2,477 beds, and private hospitals 1,172 beds. In addition, various Government Dispensaries provide a further 98 beds, mainly in the New Territories and practically all for maternity cases, and there are 520 beds in private maternity and nursing homes. There is therefore in the Colony a total of 6,266 beds for all purposes including the mentally ill and those suffering from infectious diseases. Excluding the 1,197 beds set aside for tuberculosis, the 141 beds for the mentally ill and the 803 beds for the treatment of infectious diseases (including leprosy), there are therefore 4,125 beds available for all general purposes, including maternity. Assuming the population to be about 2,500,000 this gives a figure of 1.65 beds per thousand of population, a number which is far from adequate.

　216. The eleven Government Hospitals comprise two large general hospitals, one mental hospital, two maternity hospitals, one large hospital for both long-term cases and infectious diseases, one isolation hospital, two prison hospitals, one small

hospital for the treatment of venereal diseases and the St. John Hospital on Cheung Chau Island.

　　217. The two major general hospitals are the Queen Mary Hospital (598 beds) on the Island and Kowloon Hospital (247 beds) on the Mainland. The former is the largest and best- equipped hospital in the Colony at present and is the main teaching centre for medical students. The Kowloon Hospital is considerably smaller but is an extremely busy and efficient institution. These two hospitals, besides catering for all types of general work, deal with practically all the casualty cases (injuries, accidents, etc.) occurring in the Colony.

　　218. The Mental Hospital, with original provision for 140 beds only, is the sole institution of its kind in the Colony and houses never less than 300 patients at any one time, usually considerably more. It is antiquated and inconvenient and is to be replaced by a new and modern institution at Castle Peak- now partially completed.

　　219. The two maternity hospitals, both on the Island, differ dramatically. One, the Eastern Maternity Hospital, is a small but very popular and busy institution of 24 beds carrying on in premises which are a relic of former times. The other, the Tsan Yuk Hospital, has 200 beds and is most modern in both planning and equipment. It is the main training centre for medical students in obstetrics and gynaecology and is also a leading school for midwives.

220. The only other large Government hospital is at Lai Chi Kok, on the Mainland. It is an institution of 476 beds, accommodated in premises that have had to be adapted for the purpose. Of the beds, 202 are for tuberculosis cases, 94 for infectious diseases, and the remainder for convalescent and long-term cases. This arrangement is possible only because the various buildings are well separated from one another. Since it is comparatively near to the Kowloon Hospital the availability of its convalescent beds allows many patients to be removed from the latter institution at an early stage in convalescence and thus facilitates a much quicker turn-over. The long-term cases are largely orthopaedic and come from both Queen Mary and Kowloon hospitals.

　　221. The Isolation Hospital (for infectious diseases) on the Island is housed in antiquated premises, once part of the original

Government Civil Hospital, and possesses 88 beds. Though far from being ideal it renders most useful service and the quality of the work done is high.

222. The prison hospitals are located within the two prisons Stanley (male) and Lai Chi Kok (female). The male hospital has 82 beds and the female hospital 14, including 2 cots for babies. In both these institutions a considerable proportion of the work done is concerned with the treatment of tuberculosis and drug addiction.

　223. The Social Hygiene Hospital for women occupies prem- ises once a private Japanese hospital, and is equipped with 28 beds. With improved modern treatment for venereal disease the necessity for hospitalization diminishes and the beds are being used more and more for cases of skin disease.

　224. The St. John Hospital on Cheung Chau Island, owned and formerly operated by the St. John Ambulance Association but now run by Government by special agreement, serves both as a rural general hospital and as a tuberculosis sanatorium for less severe and convalescent cases of this disease. It provides. 102 beds but facilities are rather restricted, especially as regards surgery.

Assisted Hospitals.

　225. The Government subsidizes the three hospitals of the Tung Wah Group, (1,239 beds), the Ruttonjee Sanatorium (336 beds), run by the Hong Kong Anti-Tuberculosis Association, the Alice Ho Miu Ling Nethersole Hospital (272 beds) run by the London Missionary Society, the Pok Oi Hospital (50 beds) at Yuen Long in the New Territories, which is run by a Board of Directors on a similar basis to the Tung Wah Group of Hospitals, and the Hay Ling Chau Leprosarium for the treat- ment of lepers. This last is run by the Mission to Lepers, Hong Kong Auxiliary. The number of lepers accommodated is 580.

　226. With the exception of the two specialized hospitals the others all deal with general medical and surgical cases, the Tung Wah hospitals being particularly useful by virtue of the fact that they take in a very large number of long-term patients. The maternity section of the Kwong Wah Hospital is perhaps the most popular and certainly the busiest in the Colony.

Specialist Services.

　　227. Government provides specialist services in medicine, surgery, obstetrics and gynaecology, ophthalmology, dermatol- ogy, radiology, tuberculosis, venereal diseases, dentistry and pathology. In addition, members of the staff of the University, mainly the professors, offer consultative services in medicine, surgery, obstetrics and gynaecology, pathology and orthopaedics.

Medical and Surgical Services.

　　228. As may be seen from the statistics concerning in- patients, the work of these services has continued to expand. Not only has it expanded, in regard to numbers, but the con- tinual advance in knowledge and technique has found a parallel in the complexity and extent of procedures undertaken. A notable example of this, and also of the co-operation between medical, surgical and radiological branches, is found in the new Lewis Laboratory which has recently been established in the Queen Mary Hospital. This is a cardio-respiratory unit in which, among other procedures, cardiac catheterization is car- ried out for the investigation of cardiac lesions and the selection of suitable cases for surgery.

229. A considerable amount of research work is also being carried out, and valuable articles have been published in the scientific journals.

Obstetrical and Gynaecological Service.

230. The specialist obstetrical and gynaecological service on the Island is provided by the University Unit at Queen Mary Hospital and Tsan Yuk Hospital. The Government Obstetrical and Gynaecological Specialist is based on Kowloon Hospital and is, in general, responsible for Government obstetrical and gynae- cological services on the Mainland.

231. Ante-natal and post-natal clinics are a feature of the work, and attendances continue to increase. One of the main difficulties is to ensure regular attendances. Numbers of admis sions continue to increase and bookings have at times to be severely limited. The standard of the work may be judged from the fact that in the Tsan Yuk Hospital, where there were 7,553 deliveries, there were only 4 maternal deaths. Of these

four, one was from a cause unconnected with pregnancy and another was of a patient who had been delivered elsewhere. Radiological Sub-Department.

Radiodiagnostic Section.

　232. This section with its headquarters in the Queen Mary Hospital runs a diagnostic service in each of the following hospitals and clinics:

Hong Kong: Queen Mary Hospital, Tsan Yuk Hospital, Medical

Examining Board, Wanchai Chest Clinic;

Kowloon : Kowloon Hospital, Kowloon Chest Clinic, Lai Chi

Kok Hospital.

In addition, there is a mobile Mass Miniature Radiography Unit. which operates throughout the Colony.

　233. The quantity of work performed by the service continues to increase, the number of investigations carried out during the year having risen to 252,691. Increases have been most marked in the more specialized and time-consuming types of investiga- tion.

　234. Research has been continued on two projects, one being "The Morphology of the Female Chinese Pelvis" and the other on the relative efficiency of various types of contrast media.

Radiotherapeutic Section.

235. This is entirely centred on the Queen Mary Hospital. It is equipped with the following facilities:

Deep Therapy-including a Telecobalt Therapy Unit Superficial Therapy

Contact Therapy Radium

The demands on the services of this section have become much in excess of its capabilities. Altogether 6,437 treatments were given, largely to patients suffering from carcinoma of the nasopharynx. This condition, which is very common in Hong Kong, is the subject of continued research in the department.

　236. During the year the section has been fortunate enough to obtain the services of a physicist. His help is most essential both in working out dosages and in training students for the Diplomas in Medical Radiology and Therapeutics. During the year the Examining Board in England granted the sub-depart- ment recognition as a training institution for these diplomas.

　　237. Another important part of the work is the training of radiographers, and students have been very successful in their examinations for Membership of the Society of Radiographers. Ophthalmic Service.

　　238. The expansion of this sub-department continued during the past year. During 1956, the Government eye clinics dealt with 85,710 attendances for treatment, of which 42,432 were new cases. These figures represent an increase of about 30% on those recorded last year.

　　239. About 2,900 major or intermediate type operations were performed in the hospitals and ophthalmic centres.

　　240. School health attendances totalled 4,797. 2,657 pairs of spectacles were glazed and issued from the department's own optical workshop.

Dental Service.

　　241. The Dental Sub-department is organized into two distinct branches providing:-

(a) The General Dental Service

and (b) The School Dental Service.

　　242. The General Dental Service is responsible for the treat- ment of monthly-paid Government officers and their families, a commitment which brings an estimated total of over 80,000 persons within this service. Only nine dental officers, including the Dental Specialist, are available for this commitment, and it has been inevitable that considerable delays have been experienced in providing comprehensive treatment. During the year a scheme has been introduced whereby Government officers and their families who so wish could go to private dentists and claim a rebate of 50% of the fees charged. In spite of this, numbers seeking treatment from the service have shown no notable falling off.

　　243. During the year 1956 Government employees made 15,499 visits to dental clinics for examinations and treatment (an increase of 3,085 over 1955); members of families made 12,538 visits (an increase of 1,650).

　　244. The General Service, in addition to its treatment of Government officers and their families, is also responsible for the treatment of in-patients in Government hospitals, and prisoners in the Victoria, Stanley and Lai Chi Kok prisons.

A restricted service is also provided for poor people in the urban and rural areas. Special clinics are held for these members of the public; twice a week in both Hong Kong and Kowloon and once a month in Tai Po, Yuen Long, Cheung Chau and Tai O. At these special clinics treatment is directed solely towards the relief of pain and consists largely of extractions.

245. During the year, 31,014 teeth were extracted and 12,729 teeth filled or crowned.

The School Dental Service.

246.

With no increase in the professional staff during the year, it was inevitable that the six dental surgeons employed should be so swamped with work as to find it impossible to do more than scratch at the problem presented by a population of over 250,000 school children, even though only about 40,000 of them participated in the scheme during the year. It has proved necessary to limit the numbers of new entries to the scheme. until future policy has been decided.

247. The dental surgeons have worked on the principle of relieving suffering as a first priority, leaving conservative treat- ment to take a second place. In spite of this, 11,351 teeth were filled as against 23,737 extracted. Admittedly this is a very unsatisfactory ratio, but it has been unavoidable and is consider- ably better than in 1955.

Voluntary Dental Services.

248. Welfare organizations operated a number of dental clinics either for their own members or for the poor in their respective districts. The Hong Kong Dental Society continued to staff 3 free evening clinics per week in Hong Kong and one in Kowloon, together with a fortnightly clinic at the Hong Kong Anti-Tuberculosis Association's Ruttonjee Sanatorium. Every Sunday the St. John Ambulance Association and Brigade des- patched a squad, which included a dentist, to the more remote areas in the New Territories, bringing free treatment to poor persons unable otherwise to obtain it.

Government Dental Scholarships.

249. The Dental scholarship scheme began in 1954 in order to ensure that, in the absence of a dental school in Hong Kong, a sufficient number of well qualified dental surgeons will be available in the Colony to replace the natural losses suffered by

　Dentists' Register. In September 1956 6 students were sent to Singapore to take up their studies in the Dental School of the University of Malaya, making 15 in all. Owing to changes in the entry requirements of the University of Malaya it has been decided to send future students to Australia. The first group of 5 students departed for Melbourne in March 1957 and will spend 5 years there on a degree course in dental surgery.

Control of Dental Practice.

　　250. Two dental inspectors were employed on duties in con- nexion with the control and supervision of private dental practice in the Colony. They regularly inspected premises used, or proposed to be used, by dentists.

　　251. There were no cases of illegal dental practice during the year.

Out-Patient Services.

252. By far the greatest volume of medical work done in the Colony is handled by the out-patient centres, a large proportion of which are operated by the Medical Department. These centres consist of (a) three major general polyclinics, two on the Island and one in Kowloon, (b) one specialist polyclinic in Wanchai for chest diseases, physiotherapy and dentistry, (c) one large chest diseases clinic in Kowloon, (d) twenty-two smaller dispensaries, ten in the urban areas and twelve in the New Territories. In addition, travelling dispensaries pay weekly visits either by road or by sea to various isolated areas.

　　253. Many of the smaller dispensaries and rural centres are conducted in adapted premises quite unsuitable for the purpose and they are gradually being replaced with properly designed modern clinics. None were so replaced during the past year, but work has been in progress on two and plans have been approved for some others. In all, it is hoped that five will be completed during 1957, three of these being completely new ventures.

254. Details of the work carried out in the various clinics will be found at Appendices 9, 10, 11 and 12.

The Pathological Service.

　　255. The Government pathology service for the Colony comprises work carried out in the Pathological Institute on the

Island and in a subsidiary institute at Kowloon Hospital on the Mainland. In addition, small clinical laboratories are in opera- tion at the Queen Mary Hospital, the Lai Chi Kok Hospital and the Tsan Yuk Hospital. From January 1957, a part-time service in clinical pathology was extended to the Sai Ying Pun Hospital. The Institute's responsibilities also include supervi- sion of the Blood Bank and daily post-mortem examinations in the Victoria and Kowloon Public Mortuaries.

256. Specimens examined in 1956 numbered 331,267. This represents an increase of 43,944 over the previous year's figures, and the increase spreads over every branch of the work. following comparisons are noteworthy: -

Haematological examinations

Culture of sputa for M. tuberculosis Sections for histological diagnosis

1955.

1956.

24,223

46,726

2,652

3,552

680

1,102

The

257. The value of vaccines produced during the year amount- ed to $224,900. Sale of vaccine to dispensaries in Hong Kong and Macao realized a sum of $12,126, although it is issued free to hospitals, clinics and registered medical practitioners if for use in the Colony.

258. The vaccines produced in 1956 were:

Anti-smallpox vaccine. Anti-rabies vaccine (2%)

Anti-plague vaccine

Rinderpest vaccine

Diluted Tuberculin

The Public Mortuaries.

(4%)

28,810 ml.

49,900 ml.

52,760 ml.

20,960 ml.

40,500 ml.

14,470 ml.

259. There are two public mortuaries, one in Victoria and one in Kowloon. Both are located in antiquated premises, that in Kowloon having the additional disadvantage of being situated on a main thoroughfare. Plans are at present in hand for its

removal to a more suitable site.

260. At the Victoria Mortuary 953 post-mortem examina- tions were performed, including 244 medico-legal cases. Of these latter 66 were dealt with by the Forensic Pathologists. 23 specimens of post-mortem materials, mostly stomach contents, were sent to the Government Chemist for examination in cases of suspected poisoning.

261. In the Kowloon Mortuary 3,260 post-mortem examina- tions were carried out. This figure includes 409 medico-legal

　cases, 129 of which were examined by the Forensic Pathologists. 61 specimens were sent to the Government Chemist.

262. A statistical summary of the work done is attached at Appendix 13.

The Forensic Medical Service.

263. To assist the police in investigating the medical aspects of suspected crimes, 2 medical officers with special experience in forensic medicine are seconded to the Police Department. The work falls into 3 categories:-

(a) Forensic

(b) Laboratory

The forensic work covers:

(a) The examination of victims and suspects connected with

violent and unnatural crimes;

(b) Calls to assist at scenes of crimes especially in murders

and sudden deaths;

(d) Medico-legal post-mortems covering both Hong Kong and

Kowloon;

(e) Raids on unregistered medical practitioners, unregistered dentists, sellers of poisons, and manufacturers of dan- gerous drugs.

264. The laboratory work deals mainly with examinations of blood and seminal stains, hairs and fibres, weapons and articles connected with crimes. In addition the laboratory staff blood-group all police recruits before they pass out of the Police Training School.

265. Short lectures and demonstrations, illustrating the medico-legal aspects of certain crimes, are given from time to time to police officers at the laboratory. Lectures are also given to the medical students at the University.

The Chemical Laboratory.

266. The Government Chemical Laboratory carries out analytical and consulting work for Government departments,

the Services, and the commercial community. Government work is done free, but for other work fees are charged according to a prescribed tariff.

267. Examples of the work done may be quoted:

(a) 1,626 examinations of a chemico-legal nature were per-

formed, mainly at the request of the Police;

(b) 12,608 biochemical examinations were carried out; (c) 19,088 examinations were performed in connexion with the Dangerous Drugs Ordinance, the Dutiable Commodi- ties Ordinance and the Importation Exportation (Prohi- bition) (Specified Articles) Order.

268. An interesting example of the work of the laboratory occurred about the middle of the year when many deaths resulted from methyl alcohol poisoning as a sequel to the drink- ing of adulterated Chinese wines. Action was immediately taken by the Department of Commerce and Industry and thou- sands of bottles of wine were sent to the laboratory for analysis. The upshot was that many local wine merchants were success- fully prosecuted on charges of adulteration and the large scale adulteration was eventually stamped out.

269. Another notable feature has been the development of a textile analysis section. In this connexion, most of the work was done on behalf of the Department of Commerce and Industry, and its volume reflects in yet another way the growth of the Colony's trade.

270. Another innovation was the beginning of a close liaison with the Stores Department in respect of samples submitted under tender. Chemical examination of these samples serves a two-fold purpose: to yield information for the guidance of Tender Boards, and to check that goods subsequently delivered in bulk accord with the samples originally submitted.

Special Ancillary Services.

271. Under this heading are listed those para-medical services without which it would be impossible to run a medical service the medico-social or almoner service, the pharmaceu- tical and dispensing service, the physiotherapy and occupational therapy services, the stores and supplies service, and the blood bank.

Castle Peak Hospital Chronic Wards.

280

HME

甫

North Lamma Clinic.

The Waiting Room of the Hong Kong Jockey Club Clinic, Tai Po.

The Hong Kong Jockey Club Clinic, Tai Po.

The Medico-social Service.

272. The assessment of fees is part of the work of the medico-social service but it is certainly not the chief function of an almoner: her duties include the investigation of the social conditions under which patients live; helping them to overcome the domestic problems which make it difficult for them to benefit from medical treatment; and occasionally providing financial or other assistance where it is needed.

273. In a place like Hong Kong where the average income of the poorer classes is barely sufficient for their basic needs the work of the almoners is even more important than it is in more fortunate countries. For this reason the Almoner service is expanding and will continue to do so.

274. While the work of the service has followed the usual pattern during the year, and has expanded with the increasing numbers of patients treated in the hospitals, it may be mentioned that recent developments have included an increasing attention to work among the blind, and also among lepers.

The Pharmaceutical Service.

275. This service, under the direction of the Chief Phar- macist, is responsible for the purchase of bulk supplies of pharmaceuticals, dressings, and surgical instruments, and for the production of medicinal preparations for use in the various institutions. The Chief Pharmacist also has certain legal res- ponsibilities in connexion with the control of narcotics and dangerous drugs in the Colony.

276. Careful supervision of the importation and movements of dangerous drugs in the Colony continues to be maintained and routine inspections of all premises where poisons and anti- biotics are handled are undertaken. Comparative figures for 1955 and 1956 in respect of licences issued are:-

1955.

1956.

Wholesale Dealers' Licences

333

321

Listed Sellers' Licences

229

213

Licences issued to Authorized Premises

(Pharmacies)

Anti-biotic Permits

183

171

Restricted Anti-biotic Permits

Premises inspected

1,159

1,024

277. It may be of interest to note that in 1956 over a million pounds of bulk mixtures were made up in the Central Medical Store for issue to the various hospitals and clinics; during the same period, almost three tons of bulk ointments were made up. Again, in order to meet the ever-increasing demands of the hospitals for intravenous fluids, 49,000 litres of these liquids were produced under sterile conditions.

Physiotherapy.

　　278. Thanks to the arrival of three more Physiotherapists the Physiotherapy Service has this year for the first time been able to carry out full-time duties in all of the four hospitals and clinics to which physiotherapy units are attached. In addition, the increase in staff has given rise to a great improvement in the standard of work. Group activity is now taking place at the Wanchai Polyclinic; this means that many patients with similar injuries or disabilities can be grouped together for combined intensive specialized exercises. It also encourages keenness and competition between patients, and the games introduced mean that patients and staff alike enjoy the treat- ment.

　　279. The four units mentioned above are located at the Queen Mary Hospital, the Kowloon Hospital, the Lai Chi Kok Hospital and Wanchai Polyclinic. At Queen Mary Hospital work is limited to in-patients and patients are transferred, on discharge, to Wanchai Polyclinic which deals with all out- patients on the Island. Patients from Sai Ying Pun Hospital, the Tung Wah Hospitals and the Mental Hospital are also treated here as soon as they are fit to be moved. The branch at Kowloon Hospital deals mainly with cases from that hospital and from out-patient departments on the Mainland, while at Lai Chi Kok Hospital cases are mainly orthopaedic and patients recovering from major chest surgery.

Occupational Therapy.

　　280. This service has had a most unfortunate year. At the beginning of the year there were two full-time occupational therapists. One left to get married and the other unfortunately contracted severe poliomyelitis and had to return to England. Since then no full-time staff has been available, but fortunate- ly the services of some well qualified ladies were obtained

on a part-time basis. In these circumstances it has naturally proved impossible to do as much as had been hoped, but it is remarkable how much was actually done.

　　　281. In the Queen Mary Hospital it has been possible to carry on with therapy every forenoon, mainly for in-patients. A Balkan Beam has been provided which enables suitable patients to weave, but the most popular crafts are rattan work, and string and plastic knotting. The making of teddy bears and cotton gloves are new techniques, and carpentry is taught in suitable cases in the hospital carpenters' shop.

　　　282. In the Mental Hospital three classes have been held regularly every day and more patients are attending under medical prescription. Rattan work, comparable with anything to be bought locally, is carried on under a full-time instructor; carpentry is extending and such articles as stool frames and rocking horses are manufactured. String bags, plastic string animals and crochet work are done by other male patients, and lampshade making has been introduced. Government orders for brooms, waste-paper baskets and crutches are carried out as before.

　　　283. In Lai Chi Kok Hospital the scope of the work has steadily increased, occupational therapy being particularly suitable for the long-term patients who occupy so many of the beds in this institution. String and rattan work are still the most popular crafts but it has been possible to introduce some toy-making, embroidery, tapestry, crochet and weaving. Blood Banks.

　　　284. There are no major changes to report in the facilities offered by the blood transfusion service. The greatest difficulty has continued to be the reluctance of the local population to be blood donors, and very little progress has been made in over- coming this factor. The demands for blood increase, but, as in the past, the main source of supply has been the Armed Services. Stores and Equipment.

　　　285. Manufacture of special items of surgical furniture continues within the department with very great saving of public money, and a considerable amount of work has been carried out in connexion with investigations into new and more modern types of equipment. Among the projects successfully

carried out was the conversion of an ordinary domestic electric cooker to a large hot air sterilizer for orthopaedic instruments; others were the working out of a formula for a satisfactory method of painting hospital beds and cots, and the design of a padded room for mental patients.

　286. A very great deal of work has been done on the manu- facture and repair of various items of surgical equipment, such as the sharpening of knives, scissors and needles; the repair of dressing drums; the servicing of items such as diathermy machines, atomizers, etc.; and the manufacture of instrument stands, trolleys and similar items of hospital furniture. No less than 2,188 items such as beds and surgical equipment have been repainted.

Auxiliary Medical Service.

　287. The Auxiliary Medical Service is established under the provisions of the Essential Services Corps Ordinance to supple- ment the normal medical services during an emergency. Although, therefore, technically a part of the Essential Services. Corps it is to a large extent autonomous, the Director of Medical and Health Services exercising, in respect of the Service, the functions of Unit Controller. It is not intended that the Service should operate as an independent unit but that it should be integrated into the regular medical service.

　288. During the year recruitment was satisfactory, keeping pace with the inevitable wastage due to members leaving the Colony, reaching the age limit for service, etc. Training was stepped up and about 150 members received a full course of 16 lectures in basic first aid. Another 137 members attended a course of similar duration in basic auxiliary dressing. Full time courses lasting 4 days were attended by 129 members, and well over 550 members attended 5-day refresher courses. In addition, driving instruction was given to over 70 ambulance and lorry drivers, and courses in message writing were held for telephonists.

　289. Courses of 14 days duration in hospitals were arranged for Auxiliary Nurses; in addition there was evening instruction for over 100 members of this group.

　290. Classes on the preparation of sterile intravenous fluids were held on most Sundays by the Chief Pharmacist.

　　291. A regular evening training programme in the applica- tion of first aid principles, attended by over 1,000 members, continued throughout the year. It is pleasing to note that, at the annual civil defence exercise, the performance of the members taking part received commendation from the umpires who reviewed the exercise.

Medical Examination Board.

292. During the year the Board has continued its work of examining candidates for Government employment, Government officers for promotion and transfer, and members and recruits for Auxiliary Defence Units.

　　293. The total number of persons examined during 1956 was 12,782, an increase of 485 as compared with 1955. Government candidates accounted for 7,768 of this figure, Auxiliary Defence Units for 4,870, and there were 144 not included in either category.

　　　294. The Board now has records of the examination of 52,000 persons examined since March 1952. It has still not proved possible to make an exact analysis of the causes which have led to persons being found unfit for employment, but by far the most frequent of such causes has been pulmonary tuber- culosis. During the year 8% of all candidates presenting them- selves for examination were found unfit from this cause.

295. An innovation this year has been that, in the case of candidates for posts in the Medical Department, Schick and Mantoux tests have been carried out and, when found necessary, the appropriate immunizing injections have been offered. date approximately 380 persons have been examined and it is interesting to note that only two have been found to be Mantoux- negative; neither of these two was born in Hong Kong. 53 persons have been found Schick-positive, and here it is of interest to note that nearly all were of the middle classes. It is evident that very few persons of the poorer classes reach adulthood without exposure to diphtheria.

V. TRAINING PROGRAMME

296. Medical Services in Hong Kong have reached a stage where a very large proportion of the total training in the various branches of medicine can be carried out in the Colony itself, and this process of "self-support" is developing further from year to

year. The University of Hong Kong has been producing doctors of a high standard of training for many years; nurses trained in many hospitals in the Colony can, by passing the local examinations, received full recognition by the Nursing Council of the United Kingdom. This, however, is by no means all. Candidates for the Membership of the Society of Radiographers can now sit their examinations locally; the X-ray department at the Queen Mary Hospital has been recognized as a training centre for the Diploma in Radiology; similar recognition has been given by the Royal College of Obstetricians and Gynae- cologists to training for the Diploma of Membership in the Tsan Yuk and Queen Mary Hospitals; candidates receiving most of their training in the Colony have been successful in obtaining the M.R.C.P., F.R.C.S., F.F.A.R.C.S. and other diplomas. The list is a long one, and it is yearly growing longer. This past year a start has been made in the training of Mental Nurses, and soon it is hoped to train Physiotherapists locally.

297. In spite of all this, or in some cases because of it, it is still necessary to send selected candidates abroad to receive specialized training, for teachers of a high standard are needed. Again, the new Kowloon Hospital (of 1,300 beds) will call for an increase in specialized staff. During the past year members of the staff have been abroad studying, amongst other things, surgery, mental diseases, mental nursing, anaesthetics, physio- therapy, radiology and public health. Dentistry in particular has accounted for a large number of scholarships, for as yet there is no school in the Colony.

298. In all these schemes of training the University of Hong Kong has naturally played a large part. The Queen Mary and Tsan Yuk Hospitals are the main centres of training for medical students in medicine, surgery and obstetrics, and the University professors and lecturers are included among the staff of both institutions. In this way, students receive the benefit of train- ing from both University and Government staff and the Govern- ment service benefits from the experience of the University staff, five of whom hold positions as Consultants to Government. On the other side of the ledger, many Government officers act as part-time lecturers in the University.

299. Co-operation between Government and University is not limited to staffing hospitals and training medical students.

　There is also the question of post-graduate training. Both Government and University have schemes for such training, but every effort is made to ensure that these schemes do not overlap or compete with one another. For this reason a Panel on Post- graduate Education has been formed, with representatives of both University and Government. Meetings have been most amicable, and much is being done to co-ordinate this important subject.

Nursing Training.

　　300. An important part of the work of the Medical Depart- ment is the training of nurses (male and female) and midwives. The major nursing training schools are attached to the Queen Mary Hospital and the Kowloon Hospital, while the main school for training midwives is the Tsan Yuk Hospital. Excellent schools of nursing are also provided at the Tung Wah Group of Hospitals and the Alice Ho Miu Ling Nethersole Hospital, insti- tutions independently run but largely assisted by Government, and the Hong Kong Sanatorium and Hospital, a private institu- tion. Owing to the gradual increase in the nursing establish- ment over the past few years, particularly as a result of recruit- ment with a view to training staff for the new Kowloon Hospital, a greater number of nurses are graduating each year.

　　301. In this important sphere of activities the year has been one of steady progress, although there is little specifically new to report. The recruitment and training of student nurses, both male and female, continues satisfactorily, both for the normal expansion of the department and for the new Kowloon Hospital.

　　302. The policy of the promotion of locally trained nurses to higher posts continues. Five have been promoted to the grade of Sister during the year. I am glad to say that relationships between local and expatriate staff continue to be excellent.

Health Visitors.

　　303. The second Health Visitors' Training Course with an enrolment of ten specially selected candidates was successfully completed in September 1956. All ten sat for and passed the examination held under the auspices of the local Examination Board of the Royal Society for the Promotion of Health, London.

　　304. The third Course commenced on 1st October 1956 and the same number of candidates is attending this course of training.

　　305. The school continues to be conducted at Harcourt Health Centre and lectures are given by members of the Medical Department and specialists and officers of Government Depart- ments.

306. A variety of institutions and factories continues to be visited and the candidates to be assigned to all of the health services operated by the Department for a certain period of time in order to gain practical experience.

Technical Training.

307. In addition to training nurses, the Medical Department trains technical assistants in pharmacy, radiography, laboratory techniques, physiotherapy and medico-social work.

308. The following Table lists the work done in this field during 1956:

Table 22

Appointment Resignation

i Strength

at 31.3.57

Passed

Probationer Assistant

Physiotherapist

Probationer Radiographic Assistant'

Student Dispenser

Probationer Laboratory Assistant

Probationer Assistant Almoner

Probationer Nurse

Probationer Dresser

Pupil Midwives

184

------

Health Visitor

Fellowships and Scholarships.

309. In addition to Government providing financial assist- ance to certain selected persons to take special courses of study abroad, and to officers proceeding abroad for courses of study at their own expense, the World Health Organization provided a number of fellowships to enable members of the Department

to obtain advanced training and do research studies in overseas countries. The following Table sets out the nature of the appointment and courses of the study of the officers sent abroad for special study during the year:-

Table 23

Appointment

Course of Study

Source of Fund

Senior Medical Officer Diploma in Public Health

Government

Medical Officer

Oesophageal Surgery

Medical Officer

Diagnostic Radiology

Medical Officer

Diploma in Anaesthetics

Commonwealth Fund

Government

Own expense

Medical Officer

--------

Orthopaedic Surgery &

Own expense

Woman Medical Officer

Assistant Medical Officer.

Medical Officer

Assistant Medical Officer....

Woman Medical Officer......

Licenciats, Medical Council of Canada

Diploma in Psychiatry Diploma in Public Health

Diploma in Anaesthetics

Licenciate, Medical Council

of Canada

Diploma in Anaesthetics

Own expense

W. II. O.

Own expense

Licenciate, Medical Council

of Canada

Own expense

Dental Surgeon

Diploma in Public Dentistry

Conservative Dental Surgery

Government

Nursing Sister ....

Nurse

Sister Tutor's Diploma

Midwifery & Premature badly nursing & Plastic surgical nursing

Government

Own expense

Assistant Physiotherapist... Membership of the Chartered

Own expense

Society of Physiotherapy

Nurse

Midwifery & Premature baby

nursing

Own expense

Liaison with International Organizations.

310. The exchange of epidemiological information with the World Health Organization's Epidemiological Intelligence Station, Singapore, continued.

　　311. Close liaison with the Western Pacific Regional Office of the World Health Organization was maintained. The Director and his advisers visited Hong Kong from time to time for dis- cussions with the Department on World Health Organization projects and fellowships.

312. Consultants from various regions, who were awarded World Health Organization fellowships, visited Hong Kong and were given every assistance by the Department.

313. A list of the visitors is set out below:-

(a) Dr. F. J. Dy, Regional Malaria Adviser of the Regional Office for the Western Pacific, visited the Colony from 7th to 22nd May, and 1st to 2nd July 1956 to assess the malaria problem in the Colony and to make recommenda- tions regarding the problem of malaria control in the Colony.

During his stay here, he was shown various areas so that he could see for himself, on the spot, the extent of the infestation and the work being carried out by the Medical Department.

(b) Dr. Shi Ryong Choi of the National Veteran's Leprosari- um, Wonju, Korea, and Mr. Moon-won Chin of the Korean Ministry of Health and Social Affairs, arrived in the Colony on 10th May, 1956. Dr. Fraser arranged for them to visit the Hay Ling Chau Leprosarium. (c) Dr. Kanapathypillai Sivam, Port Health Officer in Singa- pore, who had been awarded a three-month World Health Organization Technical Assistance Fellowship to study port health administration and modern quarantine procedure in the United Kingdom, the Netherlands, Egypt, India, Japan and the Phillipines, visited Hong Kong for a week in September.

(d) Dr. Cha, a Preventive Medical Officer of the Bureau of Health and Social Affairs of Seoul, Korea, allowed for a week's visit to the Colony on 4th August. During his stay, he visited the leprosarium at Hay Ling Chau and clinics where leprous out-patients were treated.

(e) Dr. J. R. Snell, a World Health Organization consultant, visited the Colony to study local problems connected with the "Collection, Disposal and Utilization of Organic Wastes".

(f) Dr. Ba Nyun, Port Health Officer at Rangoon, on a World Health Organization Fellowship to study Port Health Administration and quarantine, visited the Colony from 14th to 26th October 1956. He was shown all the Port Health activities including the fumigation of a ship by Hydrogen Cyanide.

(g) Dr. Denis D. Hilton of the Medical Department of Northern Nigeria, was in the Colony as a short-term consultant of the World Health Organization from 15th to 21st November 1956. During his stay he was shown

the Hay Ling Chau Leprosarium and other institutions that were of interest to him.

(h) Dr. L. O. Roberts, Tuberculosis Adviser of the World Health Organization visited Hong Kong from 4th to 9th December 1956, and discussed-

(i) the progress of the domiciliary chemotherapy scheme

for tuberculous patients;

(ii) the progress of the B.C.G. Vaccination Campaign; (iii) leprosy control in Hong Kong.

(i) Dr. James E. Perkins, Director of the National Tuber- culosis Association of the United States of America and President of the National Citizens Committee for World Health Organization, and Dr. Floyd E. Feldman, Medical Director of the National Tuberculosis Association of the United States of America were in Hong Kong from 25th to 28th January. They visited the Government Tuber- culosis Service and were introduced to the officials of the Anti-Tuberculosis Association.

(j) Dr. A. W. A. Brown, biologist of the Division of Environ- mental Sanitation of the World Health Organization Regional Office for the Western Pacific was in the Colony on the 17th February to investigate the resistance of insects to insecticide.

(k) Dr. D. Y. Yung, Director of the Institute of Environ- mental Sanitation, Taiwan, came to the Colony on a World Health Organization fellowship on 16th March 1957 on a study programme to observe methods and practices of countries in South East Asia and the Western Pacific in Environmental Sanitation.

(1) Miss Wong Mei-hei, a World Health Organization nursing

fellow from Taiwan, is in the Colony on a six-week fellowship to observe Venereal Disease control work and Maternal and Child Health Service.

(m) Dr. Jue-yan Peng, who is connected with the World Health Organization and the U.N.I.C.E.F. - assisted Maternal and Child Health project in Taiwan, paid a visit to the Colony in July while en route to Taiwan

from the United Kingdom. He saw the Maternal and Child Health work that was being carried out here.

U.N.I.C.E.F. Milk Feeding Schemes.

314. The U.N.I.C.E.F.-assisted Milk Feeding Programme continued to operate. In continuation of the Second Addendum to the Plan of Operations for the Programme which provides dried skim milk from U.N.I.C.E.F. to the Department up to the end of 1957, the Government of Hong Kong and U.N.I.C.E.F. have agreed to the Third Addendum whereby U.N.I.C.E.F. will further supply the Department with a total of 310,000 pounds of milk powder which will be used to extend distribution to mothers and children who are in need of supplementary diets for the years 1958 and 1959.

315. During the year, the U.N.I.C.E.F. representative visited many institutions of the Department to observe the activities of the Maternal and Child Health Scheme and the Milk Feeding Programme.

VI. BUILDING PROGRAMME

316. Very few buildings have actually been opened during the year, but work has been in progress on a considerable number and it is expected that many will be completed in the coming year. These include:-

(i) Dispensaries in Tai Hang Tung and Li Cheng Uk Re-

settlement Estates;

(ii) a Clinic in the North Point Housing Estate;

(iii) a Dispensary and Maternity Home at Yung Shue Wan on Lamma Island, built by the Rural Committee with assistance from the District Administration;

(iv) a Maternity Home and Health Centre at Tai Po, built

under a donation from the Jockey Club;

(v) a Ward Block at Kowloon Hospital, to provide about 45

more beds;

(vi) the first stage of the Castle Peak Hospital for mental

patients,

(vii) new Health Centre at Shek Kip Mei, to include a general clinic, an M.C.H. centre, and a chest clinic complete with the necessary X-ray facilities.

All the above should be in operation before the end of 1957.

317. In addition, work in active planning includes:

(1) A large new teaching clinic at Sai Ying Pun, to include a general clinic, dental clinic, and chest clinic. The building will also accommodate a much enlarged Patho- logical Institute to replace the present inadequate premises.

(ii) A large new wing to Queen Mary Hospital to provide better operating theatre accommodation, radiological facilities, and about 150 more beds.

(iii) A new dispensary in the Central district to replace the

present cramped facilities.

(iv) A new dispensary and maternity home at Hung Hom. Planning of the new Kowloon General Hospital and the new Mental Hospital continues.

VII. PUBLICATIONS

　　318. The following articles were published by members of the Department in the publication shown:-

Title of Article.

1. Hong Kong Social Hygiene Service,

2. Some Observations

Infective Skin Condi- tions in Kowloon.

3. A Preliminary Report on the Treatment of Acute Gonorrhoea in the Male by Aureomycin Triple Sulfas.

1. Medico-Social Work in

Hong Kong.

Publication.

British Journal of

Venereal Disease June, 1956. Bulletin of Hong Kong Chinese Medical Associa- tion, Vol. 8, No. 1. Bulletin of Hong Kong Chinese Medical Associa- tion, Vol. 8, No. 1.

The Almoner,

September, 1956.

Name & Title of Author,

Dr. G. M. Thomson,

Social Hygiene Specialist.

Dr. G. M. Thomson,

Social Hygiene Specialist.

Dr. G. M. Thomson,

Social Hygiene Specialist.

Miss M. Benhanı,

Principal Almoner.

Title of Article.

5. Guest Editorial.

Publication.

Bulletin of the Hong

Kong Chinese Medical Associa- tion (1956).

6. Physiotherapy in Hong Physiotherapy.

Kong.

7. Single Ectopic Ureter joining the vagina as- sociated with Hypo-

ing Kidney.

British Journal of

Urology.

plasia of Correspond-

8. On Plasma Fibrinolytic Activity in Cryptoge-

Scottish Medical

Journal.

netic Splenomegaly.

9. Review Articles describ- Chemical Products.

ing recent application of fine chemicals as reagents in analytical chemistry.

10. Ambulatory Treatment of Pulmonary Tuber- culosis in Hong Kong. 11. Ophthalmic Disease in

Hong Kong.

12. Natal and Neonatal Teeth A Study among Chinese in Hong Kong. 13. A Self-Built Obturator.

Tubercle (1956), 37,

451 December. 1956.

British Journal of

Ophthalmology.

Dental Journal.

the

Bulletin of the

14. Some Views

Pharmacological Prop- erties and Uses of Muscle Relaxants.

15. Some Aspects of Twin

Pregnancy.

Chinese Medical Association Hong Kong.

Bulletin of the

Chinese Medical Association Hong Kong.

Name & Title of Author.

Dr. P. M. Yap, Psychiatric Specialist.

Miss Marjorie Fogg,

Superintendent Physiotherapist.

Dr. James Cook.

Senior Surgical Specialist, with Professor Hau Pao Chang. Dr. James Cook. Senior Surgical Specialist, with Dr. H. C. Kwaan and

Professor A. J. S. McFadzean,

Dr. A. J. Nutten,

Government

Chemist.

Dr. A. S. Moodie.

Tuberculosis Specialist.

Dr. G. C. Dansey-

Browning, Ophthalmic Specialist. Mr. Walter C. Allwright,

Dental Specialist. Mr. Walter C. Allwright,

Dental Specialist. Dr. Z. Lett.

Anaesthetic Specialist.

Dr. H. G. Page,

Obstetrical and Gynaecological Specialist.

K, C. YEO,

Director of Medical & Health Services.

OCCUPATIONAL THERAPY FUND

STATEMENT OF RECEIPTS AND PAYMENTS FOR THE YEAR ENDED 31ST MARCH, 1957

Description

RECEIPTS

Amount

Description

PAYMENTS

Amount

To Balance brought forward (on de-

posit with Accountant General)..

$1,139.42

Cash in hand

1- г- гт

586.68

1.726.10

By Purchase of materials, gumes & sports.....

Incentive payments

-----

Honoraria to voluntary workers.

4,673.93

1.037.37

400.00

Sales of rattan articles and materials

6.445.50

Refund of overpayment of honorariu for the period 7.7.56-31.7.56 in respect of Chau Ming

80.65

Deposits transferred to Colony Revenue Balance (on deposit with Accountant General)

Revenue...]

2.140.95

Nil

$8.252.25

Certified correct.

(Sgd.) 1. AGAFUROFF,

p. Director of Medical and Health Services.

7. 6, 56,

(Sgd.) M. M. SWAN,

Secretary, Occupational Therapy Committee. 7. 6. 56.

The above statement has been examined in accordance with Condition 7 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N. No. A. 114 of 26th June, 1950). I have obtained all the information and explanations that I have required, and I rertify, as a result of this audit, that in my opinion the statement is correct.

AUDIT DEPARTMENT,

Hong Kong, 28th June, 1957.

(Sgd.) F. E. L. Carter. Director of Audit.

SAMARITAN FUND

STATEMENT OF RECEIPTS AND PAYMENTS FOR THE YEAR ENDED 31ST MARCH, 1957

Description

RECEIPTS

Amount

Description

PAYMENTS

Amount

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

8,077.80

$10,874.14

1,546.82

Incidental expenses for individual patients Balance carried forward. (on de- posit with Accountant General)

1,532.65

12,421.26

Fund

$14,286.64

11,490.00

Pensions and other monies held on behalf of in-

2,018.60

dividual patients

2,032.77

16,319.41

$25,929.86:

$25.929.86

To Balance brought forward (ou de- posit with Accountant General)

Fund

Pensions and other monies held on behalf of individual patients

Donations

Pensions and other monies received

on behalf of individual patients.

Certified correct.

(Sgd.) I. AGAFUROFF,

p. Director of Medical & Health Services.

25. 6. 57.

(Sgd.) MAURA BENHAM,

Principal Almoner, Medical Department.

25. 6. 57.

The above statement has been examined in accordance with Condition 6 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N. No, A. 113 of 26th May, 1950). 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 statement is correct.

AUDIT DEPARTMENT,

Hong Kong, 28th June, 1957.

(Sgd.) F. E. L. Carter. Director of Audit,

NURSES REWARDS AND FINES FUND

STATEMENT OF RECEIPTS AND PAYMENTS FOR THE YEAR ENDED 31ST MARCH, 1957

Description

RECEIPTS

To Balance brought forward (on deposit with Accountant General)

Balance of an advance of $600.00 for the purchase of prizes for Nurses and Dressers.

Amount

Description

Amount

PAYMENTS

2,853.02

By Advance for purchase of prizes, etc. for Nurses and Dressers

JJ LILJ

222.75

Forfeiture of deposits from Misses Joan Liu. Emily Fan, Dorothy Sun, Susan Leung, Amy Tsang and Jeannette Chung

1,200.00

$4,276.57

Provision of tea for 280 persons on the occasion of presentation of certificates and prizes to Nurses and Dressers..

200.00

H H

700.00

Balance carried forward (on deposit with Accountant General)

3.376.67

$4,276.57

Certified correct.

(Sgd.) I. AGAFUROFF,

p. Director of Medical & Health Services.

7.6.57.

(Sgd.) M. L. EVERETT,

Principal Matron, Medical Department,

7. 6. 57.

The above statement has been examined in accordance with Condition 5 of the Schedule to Legislative Council Resolution dated 24th May, 1950 (G.N. No. A. 115 of 26th May, 1950). 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 statement is correct.

AUDIT DEPARTMENT,

Hong Kong, 28th June, 1957.

(Sgd.) F. E. L. CARTER, Director of Audit.

COLONY OF HONG KON

MEDICAL FACILITIES

ខ

CHINESE

RITORY

DEEP

BAY

"CASTLE PEAK HOSP.

CASTLE

PEAK

POK ON

HOSP.

KAM

TIN

YUEN LONG DISPENSARY.

SHA TAU KOK

DISPENSARY

TA KU LING

LOK MA CHAU

SHEUNG

SHUI

HO T

DISPENSARY

FAN LING

TAI PO

DISPENSARY

SAN HUI

NEW

TERRITORIES

DISPENSARY

MAURINE GRANTHAM HEALTH CENTRE

SHATIN

MATERNITY HOME)

SILVER MINE BAY. DISPENSARY

TALO

DISPENSARY

LANT.

HONG

KONG

(HAY LING CHAU PLEPER SETTLEMENT

(See Japarate (Map)

CHELING CHAU

ET. JOHN HOSPITAL

ŠAL KUNG, DISPENSARYE

HAN TABLE +

SHELTER

HÙNG KONG ISLAND

MEDICAL FACILITIES

+25

HONG KONG

ILING YUET SIN INFANTS' HOSPITAL

2 TSAN YUK HOSPITAL

3 MENTAL HOSPITAL

SANDY BAY CONVALESCENT HOME

5 SALYING PUN HOSPITAL & OUT-PATIENT DEPT

TUNG WAH HOSPITAL

7 ALICE HO MIU LING NETHERSOLE HOSPITAL PORT HEALTH INOCULATION CENTRE

1 CENTRAL PUBLIC DISPENSARY

ID POLICE MÉDICAL POST

H. K. FAMILIES CLINIC

12 STATUE SQUARE INOCULATION CENTRE

13 H. K. CENTRAL HOSPITAL

14 MILITARY HOSPITAL

IS ST. FRANCIS HOSPITAL

16 VIOLET PEEL POLYCLINIC

IT EASTERN DISPENSARY & MATERNITY HOSPITAL

MATILDA HOSPITAL

RUTTONJEE SANATORIUM

19 WANCHAI SOCIAL HYGIENE HOSPITAL

HARCOURT HEALTH CENTRE

21 ST. PAUL'S HOSPITAL

22 ST. JOHN AMBULANCE BRIGADE CENTRE

TUNG WAH EASTERN HOSPITAL

24 H K SANATORIUM & HOSPITAL 25 NAVAL HOSPITAL

QUEEN MARY HOSPITAL

ABERDEEN PUBLIC DISPENSARY

29 SHAUKIWAN PUBLIC DISPENSARY

30 STANLEY DISPENSARY & MATERNITY HOME

31 STANLEY PRISON HOSPITAL

32 NORTH POINT MATERNAL & CHILD HEALTH CENTRE CHAIWAN MATERNAL & CHILD HEALTH CENTRE

34 WAN CHAI CLINIC

I LAI CHI KOK HOSPITAL

2 FEMALE PRISON HOSPITAL

3 PRECIOUS BLOOD HOSPITAL

4 SHAM SHUI PO PUBLIC DISPENSARY

5 MONGKOK CLINIC

MILITARY HOSPITAL

LI KEE MEMORIAL DISPENSARY

8 ST. TERESA'S HOSPITAL

9 KOWLOON HOSPITAL & OUT-PATIENT DEPARTMENT

KOWLOON CHEST CLINIC

II KWONG WAH HOSPITAL

12 YAUMATI PUBLIC DISPENSARY

KOWLOON PENINSULA MEDICAL FACILITIES

HUNG HOM PUBLIC DISPENSARY

TSIM SHA TSUI HEALTH CENTRE

KOWLOON POLICE MEDICAL POST

IS ASHLEY ROAD SOCIAL HYGIENE CLINIC

17 KOWLOON-CANTON RAILWAY STAFF CLINIC

18 NGAU TAU KOK MATERNAL & CHILD HEALTH CENTRE GOVERNMENT OPHTHALMIC CLINIC-ARRAN STREET

20 HOMANTIN MATERNAL & CHILD HEALTH CLINIC

KOWLOON BAY

APPENDIX 1

ESTABLISHMENT OF THE MEDICAL DEPARTMENT AS AT 31.3.1957

Director of Medical and Health Services

Deputy Director of Medical and Health Services

Assistant Director of Medical Services

Assistant Director of Health Services

Senior Medical Officers

Senior Health Officer

Senior Surgical Specialist

Senior Radiological Specialist

Medical Specialist

Tuberculosis Specialist

Dental Specialist

Gynaecological and Obstetrical Specialist

Social Hygiene Specialist

Ophthalmic Specialist

Psychiatric Specialist

Anaesthetic Specialist

Chief Port Health Officer

Government Pathologist

Malariologist

Medical Officers, Assistant Medical Officers, Women Medical Officers,

Assistant Women Medical Officers and House Officers

262

Dental Surgeons and Assistant Dental Surgeons

Pathologists

Radiologists

Government Chemist

Chemists, Assistant Chemists, Biochemist, Assistant Biochemist

Principal Matron

Nursing Staff

Principal Almoner

Almoners and Assistant Almoners

Executive Officers

-----

Clerical Staff

1,012

LIL

8 230

------

Chief Pharmacist, Pharmacists, Dispensers, and Dispensary Super-

visors

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

Superintendent Radiographer, Senior Radiographers, Radiographers,

and Radiographic Assistants

Superintendent Physiotherapist, Physiotherapists, and Assistant

Physiotherapists

Physicist

Occupational Therapists

Chief Laboratory Technician, Laboratory Technicians, and

Laboratory Assistants

Chief Hospital Secretary, Hospital Secretaries and Assistant

Hospital Secretaries

Health Inspectors and Malaria Inspectors

Dietitians

Public Vaccinators

Other staff

----

2,161

TOTAL

J ----J

L-JILL+

4,035

APPENDIX 2

NOTIFIABLE DISEASES

REPORTED CASES AND DEATHS 1955 AND 1956

No. of Notifications

No. of Deaths

1955

1956

1955

1956

Amoebiasia

Bacillary dysentery

Cerebro-Spinal Meningitis

210

182

524

560

21:

Chickenpox

380

273

Cholera

Diphtheria

840

714

Enteric fever

735

789

Malaria

431

- - - - - - - - L

496

Measles

543

709

Plague

Poliomyelitis.

Puerperal fever

Rabies-human

animal

Relapsing fever

Scarlet fever

Smallpox

Tuberculosis

14,148

12,155

2,810

2,629

*Typhus

213

119

-ILL

Whooping Cough

Yellow fever

+FTI

• Non-epidemic type.

APPENDIX 3

ANTI-EPIDEMIC PROPHYLACTIC IMMUNIZATIONS 1955 AND 1956

Immunological Procedure

Anti-Smallpox Vaccination Anti-Cholera Inoculation

Anti-Diphtheria Inoculation:

1st Dose

2nd Dose

-------

Booster Dose

Anti-Typhoid Inoculations:

1st Dose

2nd Dose

Booster Dose

Anti-Plague Inoculation

Anti-Typhus Inoculation Anti-Rabies:

1955

1956

862,834

1,404,669

ILI LJ L

31,247

28,713

99,448

74,082

03,647

58,197

46,144

46,303

133,641

150,282

82,975

95,920

86,002

137,232

238

260

3,215

1,444

3,171

2,885

14,260

14,189

A-PIL

38,959

30,681

9,587

19,616

15,775

5,629

1st Dose

--¬----➖➖ ➖ ➖ ➖ ----

Other Doses....

Anti-Tetanus

T1☐☐ --------

Anti-Tuberculosis (B.G.G.) Vaccination:

Infants

Others

APPENDIX 4

MALARIA NOTIFICATION

1956

SOURCE OF CASES

Reported us

FRESH CASES

RECURRENT CASES

UNSTATED

Reported from

V. M. Mixed T.U. Total

F. M.

Mixed T.U. Total V.

M. Hi

Total

TOTAL

Unprotected Area.

239

Protected Area

340 40

நம்

н-

428

Address not correctly

given

Imported cast

TOTAL

260 100

7 360 56

vivar

falciparum

M = malariae

Mixed

T.U.

6 106

mixed infection type unspecified

]

10 496

APPENDIX 5

INFANT BLOOD SURVEY NEW TERRITORIES, 1956

SAI KUNG

TAI PO

MONTH

No.

pos-

Laed

itives

No. No.

pca iped itives

ΤΑΙ Ο

No. No.

YUEN LONG

TSUEN WAN

CHEUNG CHAU

No. No.

No.

+X+0-

P-00-

ров

incd itives

Lord itiver

ined

% CXLI-

iard

pos. %

itives

January

4.3

February

11.8

March

April..

May

June

4.8

July

4.5

August.

19.0

September

5.3

October

7.1

November

33.3

3.4

Berember

11.1

- |

TOTAL

213

6.5

104

1.0

349

0.3 162

0.6

169

2.4

197

N.B.

•

falciparum infection; all other positives vivax infection.

APPENDIX 6

COMPOSITE TABLE TO SHOW INCIDENCE OF VENEREAL DISEASE IN HONG KONG AND OTHER WORK DONE BY SOCIAL HYGIENE SUB-DEPARTMENT

New Cases

Total Attendances

Admissions to Hospital.

1952

1953

1954

1955

1956

23,565 37,392

36,652 34,853 32,490

149,237

213,091

223,031

203.701

180,148

1,306.

741

588

704

515

Total Syphilis (except Congenital).

3.216

6,969

6,825

4,232

3,711

Primary Syphilis

672

634

393

153

Secondary Syphilis..

180

132

Early Latent Syphilis

882

2,298

2,209

1,044

733

Late Latent Syphilis

...

1,275

3.727:

3,983

2,853

2,616

Congenital Syphilis (under 1 year).

Congenital Syphilis (over 1 year)...

111

Gonorrhoea..

Chancroid

- 1 - . гт

Lymphogranuloma Venereum

Non Venereal Disease

New Cases of Leprosy

Lepromatous

Tuberculoid.

Mixed Type..

8,546

11,625

10,785

11,309

10,609

2.400

2,507

2,365

2,468

1,614

LILJ

111

6,596

200

286

249

140

13,616 ·

14,526

14,788; 14,682

LEPROSY OUT-PATIENT SERVICE

Total Attendances

Number of Cases Admitted to Hay Ling Chau.

1955

1956

762

751

170

160

198

262

22,012

25,789

165

APPENDIX 7

NUMBER OF HOSPITAL BEDS IN HONG KONG - 1956

Government Hospitala

Queen Mary. Kowloon

Mental

Sai Ying Pun

Tian Yük.

Lai Chi Kok

Eastern Maternity

Hanchui Social Hygiene

St. Joho

----------

Stanley Prison....

Lai Chi Kok Female Prison

Grant-In-Aid Hospitals,

Tung Wah

Medical

Surgical

Gynaecol- Tuber- ogical culosis

Mental

Mater-

nily

191

(a) 232

(6) 203

Infectious

Observa- Mincel- tion lencour

Total

140

-------

137

202

1 | 2

200

}

བྷཱཝཱསཌ

日

2 cola

4 358

502

ווד

342

195

9T1

Tung Wab Eastern.

184

Kwong Wah

140

Alice Ho Miu Ling Nethersole

(d)6]

8269

134

The Hong Kong Anti-T.B. Association,

Ruttoujee Sanatoriuma

-------LL

336

ཝཱཎ། སྱཱ ཎྜཝཱཎྞ ༷

4 cole

cradler

{<}) +

594

247

140

200

476

102

"ד

141

321

240

1,999

495

340

130

404

Pok Oi

Hay Ling Chan Leprosarium

655

296

Private Hospitals

Hong Kong Sanatorium & Hospital.....()220

Precious Blood

St. Teresa'

St. Francis

---------

St. Paul'................

The Hong Kong Central Ling Yuet Sin Infants' Matilda & War Memorial

Haven of Hope

Sandy Bay

.....

FIL

540

272

540

]]

(A) 45

(4) 12

**+++-----------

-------++++TU

102

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

(e) 16

272

336

580

603

.477

דוי

300

(7) 18

172

501

554

181

וד

8P282838.

501

252

122

1,172

- г - - г г г

Private Maternity Homes

Private Nursing Homes.

Government Dispensaries i

Stanley.

Tai Po

Yuen Long

Sbu Tau Kok

Họ Tung

Sai Kung

Tai O

APPENDIX 7-Contd.

Medical

Surgical

Gynaecol- Tuber- ogical culosis

Mental

Mater.

nity

Observa

Infectious

tion

Miscel-

laneous

Total

· |-·

489

-180

-----

S■o Bui

Sha Tin Maternity Home

Silver Mine Bay Maternity Home

Maurine Grantham Health Centre

Tai Lan: Chung Hospital

1 i

Government Hospitals

358

502

342

141

321

240

L.999

Grant-In-Aid Hospitals

655

296

603

272

540

2,477

Private Hospitals..........

55-4

181

252

122

1,172

Private Maternity Homes

189

Private Nursing Homes

Government Dispensaries

GRAND TOTAL

1,613

979

187

1,197

141

1,287

B-01

6,266

(a) Including 32 beds for medical cases.

(5) Including 8 beds for Auxiliary Medical Service Training.

(d) Including 22 beds for childern (used for either medical or surgical cases as required).

(e) - Private ward beds used for either medical or surgical as required.

(S) Including beds for surgical & gynaecological cases. (g) Private Rooms.

(A) Including 37 beds in Private Rooms used for medical, surgical, gynecological & jufectious cases.

(4) Including beds for gynecological cases.

(7) Baby Ward.

APPENDIX 8

IN-PATIENTS TREATED IN GOVERNMENT AND GOVERNMENT ASSISTED HOSPITALS, 1956 CLASSIFIED ACCORDING TO INTERNATIONAL STANDARD CLASSIFICATION

INTERMEDIATE LIST OF 150 CAUSES

Inter-

mediate

List

Number

Detailed

List

Nurnber

Cases

Treated 1956

Deaths 1956

Cause Groups

Govern

ment

Govern-

ment

Govern-

Whole Colony

Hospitals

ment Assisted

Hospitale

Assisted

Hospitals

Male Female

Sex Un-

known

Total

001 - 008

A 2

010

Tuberculosis of respiratory system... Tuberculosis of meninges and

1,338

2,764

994

1.304 597

1,901

central nervous system....

139

690

472

263 295

558

A 3

011

Tuberculosis of intestines, peri-

toneum and mesenteric glands.

ہے۔ ہے ہے کے ہے

A 4

012 - 013

Tuberculosis of bones and joints.....

185

A 5

014 - 019

Tuberculosis, all other forms

232

117

020

Congenital syphilis.

021

Early Syphilis.

024

Tabes dorsalis..

ז י '

A 9

025

General paralysis of insane

A 10

022, 023

All other syphilis

114

026 - 029

A 11

030 - 035

A 12

040

Typhoid fever........

A 13

041 - 042

Salmonella infections..

A 14

043

Gonococcal infections

Paratyphoid fever and other

Cholera

430

203

21 26

A 15

044

Brucellosis (undulant fever).

A 16 (0)

000

045

Bacillary dysentery

415

046

Amoebiasis

133

047, 048

A 17

A 18

050

051

Other unspecified forms of dysentery.

Scarlet fever

Streptococcal sore throat....

1120m

blen

Carried forward.

3,088

4,318

146

1,553 1,745 1,022

2,767

APPENDIX 8-Contd.

Inter-

mediate

Detailed

Cases

Treated 1956

List

Number

List

Number

Cause Groups

Govern-

mest

Deaths 1956

Govero-

ment

Deaths 1956

Govern.

Whole Colony

1020

ment

| Assisted

Hospitals

Amisted

Hospitals

Male

Female

Sex Un.

known

Tutni

Brought forward.

יי

3.088

4,318

146

1,553

1,745 1,022

2,767

A 19

052

Erysipelas

A 20

053

Septicaemia and pyaemia.

A 21

055

Diphtheria

730

A 22

056

Whooping cough

A 23

057

Meningococcal infections

]

A 24

058

Plague

A 25

060

Leprosy

564

A 26

061

Tetanus

112

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

211

A 33

091

Yellow fever

| | |

A 34

092

Infectious hepatitis

A 35

094

Rabies

A 35 (0)

(6)

(c)

(e)

A 37 (6)

08000 38

100

Louse-borne epidemic typhus

101 Flea-borne epidemic typhus (murine).

104

Tick-borne epidemic typhus.

...

(d)

105

| 106 - 108

102, 103

110

111

Mite-borne typhus.

Other and unspecified typhus

Vivax malaria (benign tertian) | Malariae malaria (quartan) Carried forward.

4,330

5,052

332

1,639 1,930 1,188

| . | ¦

3.118

Inter-

mediate

List

Number

APPENDIX 8-Contd.

Cases

Treated 1956

Deaths 1956

Detailed

List

Cause Groups

Number

Govern-

mrat

Hospitals

Govern-

ment

Assisted

Hospitals

Govern-

ment

Hospitals Hospitals

Covero-

meat

Amiated

Deaths 1956

Whole Colony

Male

Female

Sex Un-

known

Total

▬▬

4,330 5,052

332 1,639

1,930 1,188

| ... 3,118

tertian)

A 37 (c)

112

(d)

115

(e)

113, 114

116, 117

A 38 (0)

€

123.0

(6)

123.1

(4)

123.2

€

()

123.3

Brought forward..

Falciparum malaria (Malignaot

Blackwater fever

тггг-

Other and unspecified forms of malaria

Schistosomiasis vesical (S. haema- tobium)

Schistosomiasis intestinal (S. Man- soni).

Schistosomiasis pulmonary

(S. Japanicum)

Other and unspecified schis-

tosomiasis

A 39

125

Hydatid disease

A 40 (0)

(6)

(c)

A 41

A 42 (a)

€ 3000

127

Onchocerciasis

127

Lojasis

127

Filariasis (bancrofti)

--+

ד י

127

Other Glariasis

129

Ankylostomiasis...................

126

(6)

130.0

Ascariasis

(d) .124, 128,

130.1, 130 2

A 43 (0)

037

(b)

038

Tapeworm (infestation) and other

cestode infestations

Guines Warm (dracunculosis) Other diseases due to helminths.

Lymphogranuloma venereum Granuloma inguinale, veneres). Carried forward.

-----

105

4,46]

5,321

]

333

1,640 1,931 1,190 i

3,121

APPENDIX 8-Contd.

Inter-

mediate

List

Number

Cases

Treated 1956

Deaths 1956

Detailed

List

Cause Groups

Govern-

Number

ment

Hospitala

Govern-

ment

Amisted

Hospitals

Govern-

Tent

Hospitals

Govern-

ment

! Aminted

Hospitals

Whole Colony

Male

Feniale

Sex Un-

known

Total

Brought forward...

4.46]

5.321

333 1,640 | 1,931 1,190

3,121

A 43 (e)

{d}

(g)

())

(k)

0 € OS 938S39€

039

Other and unspecified venereal

diseases

049

Food poisoning infection and

intoxication

071

072

Relapsing fever

Leptospirosis icterohaemorrhagica

(Weil's disease)

073

Yawa

087

Chickenpox

| [ས

090

Dengue

-----|

095

Trachoma

▬

096.7

0 120

(m)

121 (0)

(5)

(n)

131

(0)

135

Sandfly fever

Leishmaniasis

Trypanosomiasis gambiensis. Trypanosomiasis rhodesiensis

Other and unspecified

trypanosomiasis

Dermatophytosis

Scabies

· ·

(p) 036,054,059, All other diseases classified as

063,064,070, infective and parasitic

074,086,088,

089,093.

1 1

096.1,096.6.

096.8,096.9,

122,132-134,

136-138

Carried forward.

4,562

5,346

333 1,640 1,932 1,193

3,125

Inter-

mediate

List

Number

Detailed

APPENDIX 8-Contd.

Cases

Treated 1956

List

Number

Cause Groups

Gov eru+

Deaths 1956

Covera-

Deaths 1956

Govern-

Govero-

Whole Colony

ment

Hospitals Hospitals

nent

Assisted

mtat

Hospitali

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward.

---

4,562 5,346

333 1,640

1,932 1.193

3,125

A 44

140- 148

A 45

150

A 46

A 47

151

152,153

Malignant neoplasm of burcal

cavity and pharynx

ILI

Malignant neoplasm of oesophagus... Malignant neoplasm of stomach. Malignant neoplasm of intestine,

except rectum..........

118

154

108

172

164

187

L..

A 48

A 49

A 50

995

154

Malignant neoplasm of rectum

12'

161

Malignant neoplasm of larynx

162,163

Malignant neoplasm of trachea,

and of bronchus and lung not specified as secondary

A 51

170

A 52

171

A 53

172 - 174

Malignant neoplasm of breast.. Malignant neoplasm of cervic uteri Malignant neoplasm of other and unspecified parts of uterus

129

233

156

INO

130

388 *

128

130

A 54

177

A 55

190, 191

Malignant neoplasm of prostate...... Malignant neoplasm of skin....

]

A 56

196, 197

Malignant neoplasm of bone and connective tissue

A 57

155 - 160

Malignant neoplasm of all other

164, 165,

and unspecified sites.

268

256

155

23.6

142

378

175, 176,

178 - 181,

192 - 195

198, 199

A 58

204

Leukaemia and aleukaemia.

Carried forward.

5,640

6,549

524

2,223

26 10

2,571 1,852

4.423

APPENDIX 8-Contd.

Cases

Inter-

mediate

Treated 1956

Detailed

List

Number

List

Nunber

Cause Groups

Govern

Hospitals Hospitals

Govern

meat

Assisted

Deaths 1956

Govern-

ment

Deaths 1956

Hospitals

Govern

ment

Assisted

Hospitals

Whole Colony

Male Female

Sex Un-

kdown

Total

5,640 6,549

$24❘ 2,223

2,571 1,852

4.423

Brought forward.

A 59

200 - 203

205

Lymphosarcoma and other

neoplasms of lymphatic and

haematopoietic system .....

A 60

210 - 239

Benign neoplasms and neoplasms

of unspecified nature.

540

327

A 61

250, 251

A 62

252

Nontoxic goiter

-------

Tyrotoxicosis with or without goiter..

113

A 63

260

Diabetes mellitus

A 64 (0)

280

Beriberi

LILLAJJ

------

(5)

281

Pellagra

(e)

282

(4)

283 - 286

A 65 (c)

290

(b) |

291

Scurvy

Other deficiency states.

Pernicious and other hyperchromic

anaemias

Iron deficiency anaemlus

343

Jor ! | 2

17.

--L

(hypochromic)

(c)

292, 293

Other specified and unspecified

Anaemias

182

A 66 (a)

241

Astbma

131

291

(6)

240,

242 - 245

253, 254

270-277

287 - 289

| 294 - 299

All other allergic disorders, endocrine, metabolic and blood

diseases

238

127

18!

---------

Carried forward....

7,029

8,028

582

2,312

2,736 1,973

4,709

Inter-

mediate

Detailed

APPENDIX 8-Contd.

Cases

Treated 1956

List

Number

List

Number

Cause Groups

Govern-

mont

Hospitals

Govern-

Beat Assisted

Hospitals

Deaths 1956

| Govern

Deaths 1956

Whole Colony

Hospitals

ment

Assisted

Hospitals

Male Female

Sex Un-

known

Total

Brought forward.

7,029 8.028

A 67

A 68

300 - 309

Psychoses

885

582

• 18

2.312

2,736 1,973

4,709

310 - 324.

Psychoneuroses and disorders of

326

personality

316

325

Mental deficiency

A 70

330 - 334

Vascular lesions affecting central

nervous system

210

701

།ཥྱོ

123

433

487

367

854

A 71

340

Nonmeningococcal meningitis

A 72

345

Multiple sclerosis

A 73

353

Epilepsy

]

A 74

370 - 379

Inflammatory diseases of eye

A 75

385

Cataract

187

115

A 76

387

Glaucoma

JILJ

A 77 (0)

390

Otitis externa.

---

-W

(6)

391 393

Otitis media and mastoiditis

-IPLI.

(0)

394

A 78 (a):

380 - 384

386, 388,

Other inflammatory diseases of ear..... All other disease and conditions

389

of eye

Carried forward...

105

9.031

9,070

745

2,759

* Among there, I died of A2-Tuberculosis of meninges and ceutral nervous systeon.

1 died of A3-Tuberculosis of intestines, peritoneum and mesenteric glands.

1 died of A48-Maligaant neoplasm of rectum.

I died of A63-Diabetes mellitus.

1 died of A64-(d)-Other deficiency states.

2 died of A70-Vascular lesions affecting central nerv-

one system.

3,251,2,366

2 died of A81-Arteriosclerotic and egenerative heart diseases.

1 died of A90--Bronchopneumonia.

5,617

I died of A91-Primary atypical, other and unspecified pneumonia.

1 died of A99-Ulcer of stomach.

1 died of AE148-Suiçide and self-inflicted injury.

† I died of A66(b)-All other allergic disorders, endorzine, metabolic and blood diseases.

Inter-

mediate

List

Number

Detailed

List

Number

Cause Groups

APPENDIX 8-Contd.

Cases

Treated 1956

Govern

Deaths 1956

Govero-

Govern-

Govern.

Deaths 1956

Whole Colony

Fuent

Hospitals

meat

Assisted

Hospitala

ment

Hospitals

Assisted

Hospitals

Mule

Female

Sex Un- Total

known

Brought forward.

9,031

9.070

745

2,759

3,251 2,366

A 78 (6) 341 341

344

350 - 352

All other diseases of the nervous system and sense organs

167 1

17 13

5,617

354 - 357

360 - 369

395 - 398

A 19

400 - 402

Rheumatic fever

]

ILLI

JIL-IN

410 - 416

Chronic rheumatic heart disease

284

382

A 81

420 - 422

Arteriosclerotic and egenerative

heart disease

281

A 82

A 83

430 - 434

Other diseases of heart..........

184

659

440 - 443

Hypertension with heart diseases

143

377

365 8

116

103

163

266

148

252

271

523

130

218

161

106

267

444 - 447

Hypertension without mention

of heart

195

A 85

450 - 456

Diseases of arteries

100

A 86

460 - 468

Other diseases of circulatory

207

607

system

A 87

470 - 475

A 88

480 - 483

Acute upper respiratory infections.. Influenza

517

675

5, 2

765

14:

A 89

490

Lobar Pneumonia

116

351

167

246

A 90

491

Bronchopneumonia

433

4,039

169

1.704

1,630; 1,598

3.228

A 91

492. 493

Primary atypical, other and

unspecified pneumonia

53*

271

A 92

5.00

Acute bronchitis.

234

207

75.

120

A 93

501, 502

Bronchitis, chronic and unqualified.

504

168

A 94

510

Hypertrophy of tonsils and

adenoids

330

A 95

518. 521

Empyema and abscess of long

771

116

Carried forward.

12,000

18,627

1,093

5,119

6,1104,980

11,090

Inter-

mediate

Detailed

List

Number

List

Number

Cause Groups

Covera-

meat

Hospitals

APPENDIX 8-Contd.

Cases

Treated 1956

Govern-

Deaths 1956

Govern-

ment

Matat

Assisted

Hospitals

Hospitals !

Govero-

meat

Assisted

Hospitals

Deaths 1956

Whole Colony

Male

Female

Sex Va

known

Total

Brought forward..

12,000 | 18,627

1,093 5,119

6,110 4,980

A 96

A 97 (0)

519

Pleurisy

33.

11.090

523

Pneumoconiosis

(6)

511 - 517

All other respiratory diseases

369

223

520, 522

524 - 527

A 98 (a)

530

Dental Caries

(b)

531 - 535

All other diseases of teeth and supporting structures

176

A 99

A 100

540

Ulcer of Stomach

LIILLJ

383

783

541

Ulcer of duodenum

326

100

A 101

543

Gastritis and duodenitis

383

A 102

550 - 553

Appendicitis

752

442

A 103

560, 561,

Intestinal obstruction and herniu

546

367

570

A 104 (0)

571.0

Gastro-enteritis and colitis,

between 4 weeks and 2 years.....

381

1,248

975

907

936

1,843

(6)

571.1

Gastro-enteritis and colitis, ages

2 years and over

300

2,164

137

233

215

448

(c)

A 105

572

581

Chronic enteritis and ulcerative colitis

221

Cirrhosis of liver

217

284

153

189

A 106

584, 585

Cholelithiasis and cholecystitis.

227

107

A 107

536 - 539

Other diseases of digestive system....

699

660

80 $2

132

542, 544,

545

573- 500,

586, 587

Carried forward.

16,513 25,714 1,363

6,818 7,780 6,365

14,145

582 - 583,

Inter- !

APPENDIX 8-Conid.

Cases

Treated 1956

Detailed

mediate

List

Number

List

Number

Cause Groups

Gover

Deaths 1956

| Govern-

Deaths 1956

Govern-

Govern

Whole Colony

meat

10700

Hospitals

Assisted

Hospitals

ment

Assisted

Hospitals

Mole Female

Sex Do-

known

Total

Brought forward.....

16,513

25,714

1,363

6,818

7,780 6,365

14,145

A 108

A 109

590

591 - 594

Acute nephritis

165

nephritis

--------

A 110

600

Chronic, other and unspecified

Infections of kidney

138

397

123

202

142

344

A 111

602, 604

Calculi of urinary system

209

A 112

610

Hyperplasia of prostate

步

A 113

620, 621

Diseases of breast.

A 114(0)

613

Hydracele

(b)

634

Disorders of menstruation

(c)

601, 603,

All other diseases of the

605 - 609

genito-urinary system

1,436

1,458

611, 612,

614 - 617

622 - 633

635 - 637

A 115

640-641.

Sepsis of pregnancy, child-birth

681, 682,

684

and the puerperium

A 116

642, 652,

Toxaemias of pregnancy and the

685, 686

puerperium

462

191

A 117

643, 644

Haemorrhage of pregnancy and

670 - 672

childbirth

415

319

A 118

650

Abortion without mention of

sepsis or Loxaemia.......

552

1,815

A 119

651

Abortion with sepsis.

५

Carried forward.

20.088

30,393 1,413

7,030

8,022 6,615

14,637

Inter-

inediate

List

Number

Detailed

List

Number

Cause Groups

APPENDIX 8-Contd.

Casca

Treated 1956

Deaths 1956

673680,

A 120 (a) 645-649

Brought forward...

Other complications of pregnancy, childbirth and the puerperium

Govero-

ment

Hospitals

Covera

cent

Assisted

Hospitals

Govern.

Govern-

Whole Colony

ment

Hospitals

Assisted

Hospitals

Male

Female

known

Sex Un Total

20,088

г- - - гт

30,393 1,413

7,030

8,022 6,615

14,637

MIL

4,404

814

683

687 - 689

(6)

660

Delivery without complication

11,504 31,416

A 121

690 - 698

Infections of skin and

subcutaneous tissue

546

$38

יוי

A 122

A 123

720 - 725

726, 727

Arthritis and spondylitis Muscular rheumatism and

212

ILI

rheumatism, unspecified

A 124

A 125

730

737,

Osteomyelitis and periostitis

| N

Ankylosis and acquired

745 - 749

musculoskeletal deformities

A 126(0)

715

Chronic ulcer of skin (including

tropical ulcer).......

298

700 - 714,- All other diseases of skin

447

225

716

(c); 731 - 736

All other diseases of

738 - 744

musculoskeletal system...

129

A 127

A 128

751

Spina bifida and meningocele

754

Congenital malformations of

circulatory system

A 129

750, 752,

All other congenital malformations...

179

164

66.

101

753,

755 - 759

A 130

A 131

760, 761

762

Birth injuries

47:

Postnatal asphyxia and atelectasis...

231

108

140 108

248

Carried forward..

37,815 | 64,322

1,525

7,222

8,341 6,832

15,173

Inter-

mediate

List

Number

Detailed

APPENDIX 8-Contd.

Cases

Treated 1956

List

Nurnber

Cause Groups

Govero-

Deaths 1956

! Govern-

Govern-

ment

Hospitals

Govern-

ment Assisted

Hospital:

Deaths 1956

Whole Colony

Hospitals

mtat

Assisted

Hospitale

Male

Female

Sex Un-

known

Total

Brought forward.

37,815

64,322 1,525

7,222

8,341) 6,832

A 132(a)

764

Diarrhoea of newborn

(under 4 weekɛ).

182

143

109! 76

15,173

185

(b)

765

Ophthamia neonatorum ....

222

153

1991

136

'. 133

770

Haemolytic disease of newborn

201

37 10

335

A 134

769,771,772 All other defined diseases of early

infancy

222

101

131 66

134

A 135

773-776

Ill-defined diseases peculiar to early infancy

405

610

143

524

5281 466

994

A 136

794

Senility without mention of psychosis...

226

128

[13: 224

337

A 137(a)

()

788.8

Pyrexia of unknown origin

793

Observation, without need for

788.1-788.7

further medical care. All other ill-defined causes of morbidity

248

835

142

402

590 $12

8 1,110

יווי--

1788.9.

.789 - 792

795

Carried forcard.

39,090 67,013 1,765

8,266

9,990 8,322

818,320

Inter-

mediate

APPENDIX 8-Contd.

Cases ! Deaths 1956 Treated 1956

Detailed

List

Number

List

Number

Cause Groups

Govern

quato

Hospitals |

| Govern-

meat

Assisted

Hospital.

Govern-

ment

Deaths 1956

Whole Colony

Hoepital

ment

Assisted

Hospitals

Mule

Female

Sex Un-

known

Total

Brought forward...

-----יייי

39,090

67,013

1,765

8,266

9.990 8,322

8·18,320

AE 138 E810 E835 Motor vehicle accidents

AE 139 E800 - E802 Other transport accidents E840 E866

AE 140 E870 - E895 Accidental poisoning.

813

107 40

147

128

AE 141 E900 E904 Accidental falls

AE 142 E912

Accident caused by Machinery

AE 143 E916

Accident caused by fire and explosion of combustible material...

121

1,075

15,

AE 144 E917, E918. Accident caused by hot substance,

corrosive liquid, steam and radiation

AE 145 E919

Accident caused by firearmi

283

AE 146 E929

Accidental drowning and submersion

103

Carried forward.

41,732 67,087 1.982

8,26610,339|8,464

|10,339

9 18,812

Inter-

Detailed

mediate

List

Number

List

Number

APPENDIX 8-Contd.

Cares

Treated 1956

Cause Groups

Govern.

Govern-

ment

Deaths 1956

Govern.

meat

| Govern. meat Assisted ment Assisted Hospitals Hospitala Hospitals Hospitals

Deaths 1956

Whole Colony

Mole

Female

Sex Un-

known

Total

AE 147

Brought forward..

41,732

6-7,087 1.982

8,266 10.339 8,464

9 18,812

(a) E920

Foreign body entering eye and adnexa.

(6) E923

Foreign body entering other orifice...

Accidents caused by bites and

stings of venomous animals

and insects

(d) E928

Other accidents caused by animals...

(e) E910, E911. All other accidental causes

569

E913- E915,

100

E921-E922, E924- E926. E930 - E965

AE 148 E970 E979

Suicide and self-inflicted injury

303

180 110

299

AE 149 E980 - E985,

Homicide and injury purposely inflicted by other persons (not in war)

388

79 10

AE 150 E990-E999 Injury resulting from operations

of war

----|

GRAND TOTAL.

43,118

67,178

2,071

8,267 10,667' 8,619

19,295

APPENDIX 8-Contd.

Inter-

mediate

Cases

Treated 1956

Deaths 1956

Detailed

List

Number

List

Number

Cause Groups

Govero-

Ficht

| Govern-

Govern

Govern-

Whole Colony

Hospitals

ment

Assisted

Hospitals

mcat

Hospitals

orot

Assisted

Hospitals

Male

Female

[Sex Un-

known

Tota

AN 138

N800- N804 Fracture of skull

AN 139

N805 N809 Fracture of spine and trunk

AN 140

N810 N829 Fracture of limbs

AN 141

N830 - N839

AN 142 N840- N848

Dislocation without fracture Sprains and strains of joints and adjacent muscle.

300

255

937

--------

101

103

AN 143

AN 144

N850 N856

Head injury (excluding fracture).

720

116

N860 N869

Internal injury of chest, abdomen and pelvis

127

.ז.

AN 145

AN 146 N910 N929

N870 - N908

Laceration and open wounds

534

175

220

141

177

Superficial injury, contusion and crushing with intact skin surface...

228

↓

Burns

AN 147 N930 N936 Effects of foreign body entering through orifice

AN 148 N940 - N949 AN 149 N960 N979 Effects of poisons

108

389

316

109

AN 150

N950 N959 N980 - N999

All other and unspecified effects of external causes

192

104

297

TOTAL

4,028

165

306

677

291

975

APPENDIX 8 a

IN-PATIENTS ADMITTED INTO GOVERNMENT, GOVERNMENT ASSISTED AND PRIVATE HOSPITALS IN 1956, INCLUDING CASES REMAINING

IN HOSPITALS FROM THE PREVIOUS YEAR

NAME

Government Hospitals:

Quena Mazy..

Kowloon

Sai Ying Pun

Tean Yük.

Mental

Stanley Prison

Eastern Maternity

Tsuchi Sociul Hygiene

Lai Chi Kok

St. John

----➖➖➖➖➖---

Lai Chi Kok Female Prison

TOTAL...

------LIL

Government Assisted Hospitala:

Tung Wab Group

|11111-1-0

Alice Ho Mia Ling Netherole

Ruttonjea Sanatorium

Pok Of

Hay Ling Chau Leprosarium

TOTAL..

Bed.

General Caste

lu. Tuber- Mater- fections culosis nity

Camer Carr Carer

Mental

Total

Cases

598

10,124

123

542

2.075

12,866

247

7,047

104

3,867,

10,123

266

993

1,297

200

901

8,507

9,408

140

1,207

1,036

139

142

1,341

2.503

2,599

261

275

536

476

140

900

546

1,686

102

1,296

153

454

1,977

1,999 21,213

2,601

1,644

16.411

1,249

43,118

1,239

23,908

238

3,147

272

4,727

29,337 3,063

56,620

6,950

336

730

720

1,622

702

2,324

580

561

564

2,477

30,257

856

3,963

32,102,

ין

67,178

Private Hospitals ;

St. Paul

Ling Yuet Sin Infants' Precious Blood

Hong Kong Sanatorium

St. Francis

LL. - - -

St. Teresa...

Hong Kong Central

Matilda and War Memorial..

Haven of Hope

Sandy Bay

P----------ILI

-------

172

1,456

202

615

616

3,009

125

324

155

455

2,536

197

2,891

300

4.663

152

332

1,280

112

6,539

1,420

тиггГІ

1,431

1,927

001

125

348

2,500

2,954

143

169

3,303

911

105

1.05 L

105

168

TOTAL......

1,172 | 16,229

659

1.516 2,900

112

21,416

GRAND TOTAL

----

5,648

67,699

4,116 7.123 $1,413 1.361

131,712

102

APPENDIX 9

OUT-PATIENTS - 1956

TOTAL ATTENDANCES AT GOVERNMENT AND GOVERNMENT ASSISTED HOSPITALS,

CLINICS AND DISPENSARIES

INSTITUTIONS

Dress.

ings

General Out- dren's patients Clinics

Chil

natal

Ante- Port- Gynaeco-Social ontal : fogical | Hygiene

Bar,

Eye

Nowe &!

Throut!

Tuber-

culosis

Mental

Total

Hospitals

Queen Mary

Kowloan

Too Yuk

St. John

Stanley Prison

Lai Chi Kok Female Prison

----LI

285,083

7,692

5,671

6,135

45,19]

6,502

22.136

170,859

2,775

465

7,648

800

13,593

893

3.218

213

6.723

156,

41,755

181,169

12,610

39,179

3,962

351

63,794

29,102 22.151

$55

975

58,780

.825-

1,592

56,043

6,502

Mental

2,75?

2,757

Clinics and Dispensaries = Sai Ying Pun

40, 110

103,505

77,330

4,769

123

1,583

(a) 1,552

(6)_1,42])

1,773

211,166

L7,624:

393,793

Violet Peel

Wanchai Chest Glinic....... Kowloon Chest Clinic.....、------- Social Hygiene Clinics..

175,247

L05.279

93,017

1,605

2,626|

1,605

· 196,733

196,733

208,765

180.148

10 Public Dispensaries

Hong Kong & Kowloon 14 New Territories Disps. Families Clinic, Hong Kong Hong Kong Police Med. Post..

ILLIIJI

104.938

69,995

210,478

75,526

6,461

299,417

11,772

1,515

6,707

72,082

21,638 1,235

2,978

481

6,218

422

3,585

639,313

9,763

259.435

6,461

5,443

11,336 15.247

417

305)

715

688

34,222

Kowloon Police Med. Post. Victoria Remand Prison..

1,959

8,191

18,032

255

636

107

436

1,496

150

31,767

1,611

40,282

135

230

1.18

130

42,556

Harcourt

Victoria Remand Prisou

Family Clinic

Port Health

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

Kowloon Canton Railway Clinic

Government Ophthalmic

Clinic Arran Street

Health Centres i

10111

199

гг.

2,160

1,237

1.195

2,512

וד

46,257.

46,257

13,525

1,706

211

45.442

InstitutionE

Western

Kowloon

Chai Wan Homantin

Total of Govermbient

Tung Wah Group of Hoaps, Alice Ho Miu Ling Netharsole Hospital

Buttonjer Sanatorium

Pok Of Hospital

44,953 3.468

767

49,188

48,616

3.169

+01

32,186

12,823

1,267

120

14,210

5,906

270

6.176

LLL

712,087

28.678

142

838,908 767,784

200,644 89,165

18,02 1 9,201

105,136

20,554

9.717′ 23,123 186,224

3,012

84,023

29, 105

14,095 421,255

2.757

3,165,109

14.764

385,922

11,420

1,397

19.072

$9,258

10.469

10,46"

54,620

1.866

1,476

1.490

59,452

GRAND TOTAL.

740,912 1,112,193 866,150: 138,976.

(4) Patients seen in Government Eye Clinic.

(b) Patients seen in Hong Kong University Eye Clinic. Government Servants and dependant, seen by Government Ophthalmologist.

12.590' 46,697, 186,224. 113,128 14,095; 446,488

2.757

3,680,210

103

104

APPENDIX 10

OUT-PATIENTS - 1956

NEW CASES AT GOVERNMENT AND GOVERNMENT ASSISTED HOSPITALS, CLINICS AND DISPENSARIES

INSTITUTIONS

Hospitals

Queen Mary

Kowloon

Tian Yok

St. John

Stanley Prison

General Chil-

ings

Out- dren's patients Clinic

Ante- Post Gynaeco Social Detal natel

logical Hygiene

Eye

Ear

Nose &

Tuber.

culosis

Mental

Totni

Throat

7,757

285,083

14,223

148,373

411

610

2,146

2,135

2,915

9,452

696

3,000

745

1,352.

138

107

23,366

2,566

440,826

238

18,048

4,771

23,868 10.686

416

520

48,297

2,647

21,581

674

569

25,471

----

6,502

719

6,502

717

Lai Chi Kok Female Prison

Mental

Clinics and Dispensacier i

Sai Ying Pun

5.989

69,356

60.835

1,558

2,101

[·{2) 911 (b) 2,073)

461

Violet Peel.

86,293

75,002

8,865

60,563

925.

689

Wanchai Cheat Clinic

---

Kowloon Chest Clinic

TIT

143,378

231,648

489

17,751

17,75]

14,525

Social Hygiene Clinics 10 Public Dispensacine (Hong Kong & Kowloon) 14 New Territories Disp. Families Clinic, Hong Kong Hong Kong Police Med. Post... Kowloon Police Med. Post Victoria Remand Prinoz. Victoria Remand Prison

Family Clinic

Port Health

Kowloon Canton Railway Clinic

Government Ophthalmic

Clinic Arran Street

32,490

32.490

40,994 124,910 230,130 25,573, 57,466 58,281 308

4,792

6,165

1,252

2,364 7,502

713, 6,530

8,885

282

13,423

250

959- 14,325

1.939

1.173

1,170

260

2.987

399

368

142

405,982

די

521

4.155

1,877

155,290

388

J&T

358

293

478

351

20.08L

692

965

120

23,104

118

110

15,662

117

יוו

1,939

2.415

22,425

Health Centres i

Harcourt

--ו

2,900

218

160

3,278

Western

Kowloon

3,337

690

258

4,285

3,893

598

287

Chui Wan

Homentin

843

544

4,778

1,475

1.659'

Netherole Hospital.

Puk Oi Hospital

GRAND TOTAL.

Total of Government

Jostitution

Tung Wah Group of Hospitals.

Alice Ho Miu Ling

TIL

1,753

r-----ווווו

465,662 27,619 10,680 81,639 43,175, 18,555 6,303) 1,955/ 2.401 34,715!

573,176: 468,185

7,105❘ 7,736 33,811 41,344 1,426, 11.787

5.892 35,433

719

1,666,682

1,613

168,877

1.049;

476,342| 695,633) 513,315| 49,624:

1,397

8181

9,320|| 15,075|

5,651!

260

17,707

36,842

33,811

53,131 5,692 37,046

719

1,890,108

(a) Patients seen in Government Eye Clinics.

(b) Patients seen in Hong Kong University Eye Clinic. Government Servants and dependants seen by Government Ophthalmologist.

APPENDIX 11

ATTENDANCES AT PUBLIC DISPENSARIES (HONG KONG AND KOWLOON)-1956

Out-Patients

Deliveries

Public Dispensaries

Children

Adults

Vaccina Inocula-

New Cases

Total Attend-

ances

New Cases

Total Attend-

In-pa- Dom- tioni tions

tients iciliary

ances

Central

18,537 27,195 [0,49]

18,282

4,317 3,024

Eastern

Shaukiwan

20,226 23,351 11,337 43,153 52,732

20,139

11,878

253

25,815

51,357

470

7,537

2,281

Aberdeen ..

ILLI

Shamshuipo

Yaumati

Hung Hom Stanley.

13,208 15,209

7,778 16,978

553

4,777

2,420

...

39,698 107,856

564 8,361

1,309

14,554 22,093

7,017

12,579

187

6,264

2,056

18,927 19,288

9,441

12,797

3.731

1,222

1,469 1,732

4.036

9,207 266

1,194

1,468

53,996 66,678 31.416 46,162: 46,060 71,139 28,823 44.541

Li Kee Memorial...

Mongkok

TOTAL 230,130 299,417 175.852 339,898

266 2.625

67,357 22,207

833

19.498

8,174

APPENDIX 12

ATTENDANCES AND MEDICAL CENTRES NEW TERRITORIES 1956

Out-patients

―

Deliveries

Dispensaries

New Cases

Total Attendances

In-patients Domiciliary

Tai Po

22,939

41,794

1,035

Hạ Tung

2,059

4,985

627

Sha Tau Kok

3,455

5,693

250

Yuen Long

18,919

39,520

1,691

San Hui

2,634

6,655

547

Sai Kung Sha Tin

18,303

24,701

297

4,551

9,609

395

Tai O

31,012

44.140

373

Silver Mine Bay Peng Chau

Travelling (East)

7.696

9,012

4,455

5,331

-----

8,387

11,473

Travelling (West).

353

2,000

Centre

- - - - - HJLJI

Maurine Grantham Health

Tai Lam Chung

LIL

25,333 5.094

43,995

1,688

10.547

TOTAL..

155,290

259,455

6.983

222

105

APPENDIX 13

A SUMMARY OF THE WORK DONE AT THE HONG KONG AND

KOWLOON PUBLIC MORTUARIES, 1956

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

4,213

Male bodies examined

Female bodies examined

2,681

1,523

Sex unknown owing to decomposition

Claimed bodies sent from hospital, etc.

Unclaimed bodies, mostly abandoned

Bodies cremated

Chinese bodies examined

Non-Chinese bodies examined

1,407

2,806

307

---

4.196

г. г. 1

Medico-Legal Cases

IJ LILI

653

Mate.

Female. Total.

Bodies under 2 years of age

1,047

882

1,929

Bodies over 2 years of age

1,634

841

2,275

Bodies received from the following sources:-

Hong Kong:

Victoria District

Shaukiwan District

Infant Hospitals

Other Hospitals

Marine Police Station

Cheung Chau Police Station

Tai O Police Station

106

544

110

138

953

APPENDIX 13-Contd.

Kowloon and New Territories:

Shamshuipo Police Station

Kowloon City

Rats:

Yaumati

Mongkok

Tsim Sha Tsui

Hung Hom

Marine

Castle Peak

Takuling Ping Shan

Lok Ma Chau

Sha Tau Kok

Sha Tin

Tai Po

JLLI

Sheung Shui

Tai O

Sai Kung

Pat Heung

...

Tsuen Wan

JOJ LJLI

351

481

ILI

Yuen Long Dispensary

Maurine Grantham Health Centre, Tsuen Wan

Shamshuipo Dispensary

Hospitals, etc.

1,961

3,260

Caught and brought to mortuaries

Examined

Spleen smears taken for examination

Infected with plague

г. г.

266,258

16,604

Nil.

107

୭

HUNG

Code No.: 3039-57