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contacts were examined at clinics. This is a 46% increase over the 1957 figure.
250. The follow up of defaulters from treatment continued and of 291 defaulters visited 30.2% returned for treatment. There were only !! unco-operative patients; the remainder, totalling 192, could not be traced.
251. 21 cases of leprophobia, a most intractable form of anxiety neurosis, were referred for investigation from clinics throughout the Colony.
Dermatology
252. Patients with skin disease may attend any of the Social Hygiene Clinics, and in addition there are six consulting sessions cach week for cases referred for a specialist opinion. These specialist sessions are held at the Kowloon Hospital twice each week and once at the Shek Kip Mei out-patient clinic; on Hong Kong Island there are two sessions at the Queen Mary Hospital and one at the Sai Ying Pun Oul-patient Department. There were 2,895 attendances at the specialist sessions and 8,701 at the Social Hygiene Clinics.
253. Female in-patients are treated at the Wan Chai Social Hygiene Hospital. 254 in-patients (38% of all admissions to this hospital) were admitted during the year. Male patients are treated in the Lai Chi Kok Hospital and five beds have been permanently available for this purpose since November 1958.
254. At Appendix 6 is a table of classification and frequency of the skin diseases seen at the Wan Chai Hospital and Clinic and at the University Dermatology out-patient clinic at the Sai Ying Pun Out- patient Department. Primary irritant contact dermatitis constitutes the most frequent diagnosis. Two years ago an interesting contact dermatitis of the foot was common due to the wearing of clogs with rubber straps. This has now receded in incidence due to a change in fashion of foot- wear and to propaganda initiated by the Industrial Health Officer amongst factory workers. It has been replaced in frequency by dermatitis of the hands. due to the use of certain proprietary detergents.
255. Cases of tuberculosis verrucosis cutis continue to occur, particularly in children, as a result of direct and massive inoculation by sputum. Where 2% of the population have active tuberculosis and where habits of personal hygiene leave much to be desired, this is not unexpected.
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256. The development of corticosteroids with fewer side effects and which can be used in the treatment of psoriasis, and the knowledge that cobalt is required in greater quantities for patients with this complaint have given scope for new and useful methods of therapy. Long term cortisone therapy in small doses as applied for infantile eczema in Hong Kong appears both effective and to be without side effects.
257. The use of triamcinolone for both scleroderma and sclerodactyly has been proved to give an easily obtained remission of symptoms and can be expected to give an increased expectancy of life.
258. Boils and cutaneous abscesses showed the usual seasonal rise from May to September. This very common complaint, particularly evident amongst infants and young children, is very intractable to treat- ment as the infecting staphylococci are almost invariably resistant to penicillin. Constant sampling carried out during the year yielded penicillin-resistant staphylococci in 85% of cases, and there is evidence also of the staphylococcus becoming increasingly resistant to other anti- biotics-a striking example of natural adaptation.
259. Thirty-three cases of industrial dermatitis and an additional 76 of non-industrial dermatitis were notified to the Industrial Health Officer.
260. The institution at the Queen Mary Hospital of two weekly sessions for the treatment of skin complaints by superficial X-ray therapy has resulted in a considerable increase in the number of patients referred for treatment.
DISTRICT MIDWIFERY SERVICES
261. Apart from the hospital midwifery services, the Department maintains maternity home and domiciliary midwifery services through- out the Colony. Forty-nine midwives, an increase of five over the pre- vious year's figure, were employed at twenty-ons district centres; fourteen of these centres have maternity homes attached, providing a total of 133 maternity beds. The great majority of these beds are in the New Territories since the policy in the more crowded urban districts has been to use the maternity facilities available in general or specialized hospitals. The remaining eight centres have resident midwives doing domiciliary deliveries. One new centre was opened during the year, on Peng Chau Island (South). This centre has six maternity beds.
262. The total number of cases attending in 1958 was 13.740, of which 9,741 were maternity home patients and 3,999 domiciliary cases, Live births totalled 13,467, approximately 12.5% of all registered births;
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