place. For gonorrhoea 400,000 units of penicillin continues to be used for treatment of male patients; for females the routine dose is 1,200,000 units. Chancroid is becoming uncommon with a monthly average now of only 25 cases and the discase still responds to treatment with sulphonamides.
241. The five-year period of freedom from serious penicillin reactions was unfortunately broken by the death of one female patient despite the immediate employment of all the recommended measures. Later in the year a similar but not so severe case occurred which responded to the use of the penicillianse, Nutrapen.
242. The following up of defaulters from treatment by letter was, until 1st September 1958, undertaken by a clerk working part time; since then it has been possible to employ him full time on this work. The percentage of success achieved by this method has averaged 24.9% over the past four years. The staff of Social Hygiene Visitors was increased by two, both women, during the year and they paid a total of 7,486 visits to contacts and defaulters. The percentage of success amongst defaulters was 18.2% amongst prostitutes, 18.6 amongst married women and 13.7 amongst men.
243. Health educational material dealing with venereal diseases, consisting of 9,500 pamphlets. 5,300 timetables, 242 metal posters and 650 seamen's cards, was distributed throughout the year. Pamphlets are now enclosed with letters to defaulters under treatment for gonorrhoea. A monthly lecture on venereal diseases to men, women and officer groups at the Aberdeen Police Training School has been established. A course of lectures has been given to nurses in training for the Health Visitor's Certificate of the Royal Society of Health and student nurses attend the Wan Chai Female Social Hygiene Clinic for clinical instruction.
Leprosy
244. The Social Hygiene Service deals with the out-patient treat- ment of leprosy. This involves case-finding, diagnosis and decisions regarding the regimen of treatment to be followed. A very close faison is maintained with the Mission to Lepers Hong Kong Auxiliary which maintains the Hei Ling Chau Leprosarium referred to in paragraphs 348 - 35I.
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345. The following table shows the numbers of new and total attendances at clinics for the last four years:
New patients reporting
Lepromatous
TABLE 21
1935
1956
1957
1958
762
751
981
976
170
150
173
160
Tuberculoid
198
262
262
214
Mixed Type
I
1
5
Percentage of Lepromatous cases
46%
37.8%
38.7%
41.2%
Total attendances Number of cases admitted to Hei
Ling Chau
22,012
25,789
31.204
36,338
98
163
131
141
246. Out-patient clinics are held at pine centres, at which eleven sessions are held each week; at Tsuen Wan one session is held each month. Oral dapsone and intramuscular avlosuphone are used for standard therapy. Medapsol (diaminodiphenyl sulphoxide) was put into use as an alternative therapy as from 1st September.
247. The facilities for reconstructive surgery at Hei Ling Chau have not been equal to the demand and it was possible to allocate a few beds in the Queen Mary and Lai Chi Kok Hospitals for the surgical treatment of selected non-infectious cases, under treatment as out- patients, who could not be admitted to Hei Ling Chau. In fact the year 1958 has been a notable one both at Hei Ling Chau and within the Government organizations in that surgical rehabilitation has been established on a significant scale in the Colony. Ulnar nerve trans- positions, tendon transplants for foot drop and plastic surgery for the correction of deformities have been carried out in the Government Hospitals on a modest but increasing scale. In this way the earlier cases most suitable for a relatively quick return to work are treated as out- patients until non-infectious and then admitted for comparatively short periods of surgical care.
248. Two almoners, each working part time, between them continuc to provide a full-time service at the leprosy clinics. Full use of this service has been made by the patients. An innovation has been the grant of financial aid to the dependants of necessitous leprosy patients during periods of medical or surgical treatment which have interrupted employment.
249. Contact investigations by the Social Hygiene Visitors have given encouraging results. There were 403 visits to the homes of contacts and as a result 260 contacts reported for examination; altogether 481
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