X1000306-1961-62_Part01 — Page 26

160. The numbers of cases seen during the past 3 years and since the inception of these sessions were:

First attendances

Subsequent allendances

Orthopaedic Surgery

Total

Graham

Thoneic Surgeon 1959 1950 19AJ 147 125 144 360 321

Governmen Thoracic Surgeon 1959 1960

133 103

612

891

735

ብዙ 1003 370 409 445

203

161. Outpatient sessions are conducted at the Sai Ying Pun and Kowloon Chest Clinics for patients with bone and joint tuberculosis and are maintained jointly by the University Consulting Orthopaedic Surgeon, who is the Professor of Orthopaedic Surgery, and the Govern- ment Orthopaedic Specialist. Additional sessions are also held by the permanent staff at these two centres for patients requiring routine treat- ment and supervision. The surgery is carried out at the Grantham Hospital. Thereafter routine medical treatment and ancillary services such as physiotherapy, the fitting of appliances and medical social work are carried out by the personnel attached to the relevant clinic.

162. Attendances at these sessions over the past five years have been:

1957

1959 1960 7967 617 441 415 3.503 4.001 4.618

First attendances Subsequent attendances

1958 543 629 768 2,083

Total

1,310 2,712

4,120

4,442 5,033

163. The analysis of the location of bone and joint discase in the new cases presenting has been:

Spine Hip

Other bones and joints

**

1959

1960

1967

303

202

197

125

115

189

145

103

617 441

415

164. There has been a steady fall in the number of new cases attend- ing over the past three years and most of the long standing cases in the Colony have now been dealt with. First attendances are now almost exclusively early cases and as orthopaedic tuberculosis in Hong Kong is principally a disease of children, the downward trend associated with the decline of all forms of tuberculosis in the youngest age groups is considered to be largely due to the greatly increased scale of B.C.G. vaccination.

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Radiology

165. The total number of examinations carried out on behalf of the Tuberculosis Service by the Radiology Branch of the Department was 305,088, an increase of more than 10% over the 1960 total. The largest proportional increase was in the use of 35 mm. and 70 mm. films. The static and mobile X-ray units attached to the Tuberculosis Service are maintained and operated by the Government Senior Radiological Specialist and his staff. There is a very close co-operation and consulta- tion between the Tuberculosis and the Radiological Services in all aspects of the diagnostic and routine supervisory radiology.

Bacteriology

166. The Government Institute of Pathology undertakes all bacterio- logy for the Tuberculosis Service. There is a substantial increase in this work each year and the range of investigations is increasing all the time. During 1961, 47,984 direct smear examinations were carried out, an increase of 4,000 over the previous year. Culture and resistance examina- tions accounted for a further 12,000 procedures. A re-organization and expansion of the bacteriological tuberculosis work is at present under way to ensure the most comprehensive laboratory support possible within the space and facilities available.

Medical Social Work

167. One Senior Almoner, eleven Almoners and 55 Tuberculosis Workers are attached to the Tuberculosis Service. Their responsibilities include the interviewing of patients and their families, arranging hospital admission, hospital visiting, the home visiting and supervision of patients on ambulatory chemotherapy, assistance in money and in kind and rehabilitation.

168. As soon as the diagnosis of tuberculosis is confirmed all patients requiring treatment or supervision are interviewed. The original inter- view is à comprehensive one and is based as far as possible on all future requirements while under treatment. During the year 11,443 new patients were interviewed while the total of interviews rose by almost one thousand to 36,517. Much additional interviewing is done subsequently by the Almoners' clerks, who also maintain treatment record cards and distribute drugs to be taken routinely by mouth.

169. Admissions and re-admissions to hospital from the chest clinics are arranged by the Almoners and this involves documentation, the financial aspects, advice to employers of admissions and the maintenance

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