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Adults mainly come to the notice of the Health Department as contacts with known cases amongst
school children or as cases referred from hospitals or factories or by private doctors. Every effort has been made to
secure the attendance of the men as well as the women in a family and the appointment of a suitably qualified male
attendant at the new Treatment Clinic has greatly contributed to the success of this effort.

Dermatological Department.—H. Hai.din-Davis, m.d., f.r.c.p., f.r.c.s., Dermatologist to the Council.—
The work of the Dermatological Department has proceeded on normal lines throughout the year.
By far the most striking feature of the dermatological cases dealt with at the Clinics is the immense number of
warts that nowadays present themselves for treatment. These were never rare, but during the last few years they
have increased in number so enormously that they exceed all the other cases put together which are brought to the
Dermatologist. Most commonly they occur on the hands, but almost as often on the feet, and a good many are
found on other exposed parts, e.g., on the face and round the knees. The feet may be regarded as exposed parts
because they are often bared when the children parade for bathing and when they change for sports of various kinds.
Although not a dangerous complaint, warts are undoubtedly a great nuisance. Why they should have become so
common of late years is by no means obvious. There is no doubt that they are an infectious condition, but that
does not explain the reason of their great increase during the last ten years or so. Of course, community life and
community activities, such as bathing, gymnastics and organised games, increase greatly the risk of infection. As
yet the problem of preventing warts remains quite unsolved. It is now almost as urgent as the problem of the control
of ringworm of the scalp used to be before the introduction of X-ray treatment. The only difference is that the period
of treatment for warts is usually far shorter than that for ringworm of the scalp used to be, nor is the cosmetic effect
of warts so important. On the other hand, warts on the plantar surface of the feet, where they are quite common,
give rise to much pain and disability.
Otherwise, the commonest complaints to come to the notice of the Dermatologist are birthmarks of varying
degrees of severity. Some of these are treated successfully at the Clinic, and recently the " port-wine marks,"
which used to be extremely refractory, can often be removed by the application of Thorium X solution. This is
a modern development of actinotherapy, which enables the superficial layers of the skin to be brought under the
influence of rays with very slight penetrating power. But it cannot yet be said that the results of Thorium X treatment
are regular. Sometimes they are brilliant, more often they are disappointing, and in any case the solution has
to be employed several times, occasionally a dozen or more, to get real amelioration. Some of the deep-seated
naevi or birthmarks are sent to the Radium Institute at Northwood for X-ray treatment. They usually do well.
Scabies, which was such a problem during the war years, has now subsided and is only occasionally seen.
It is satisfactorily dealt with at the Municipal Centre. Other common dermatoses of childhood, such as impetigo
and teething rashes, are successfully treated by the Medical Officers of the Borough Clinics. Really, the only dermatological
problem which now defies solution is that of the prevention of warts.