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10
Hospital region. I understand that Greenwich, with a population of
88,780, had 73 new cases last year. Of the 118 cases in Deptford, 51 were
infective cases from the start, as compared with 13 out of the 73 in Greenwich.
Deptford has a population of 71,840. Brighton, with a population
of 157,000, only produced 118 new cases of tuberculosis last year of
which only 43 were positive, compared with 51 positive in Deptford.
Bromley Chest Clinic, covering a population of 154,110, produced 117 new
cases with 43 sputum positive cases. Even Maidstone Clinic, covering a
population of 124,660 and a register of 1,169, only produced 71 new cases
of which 20 were positive. The tuberculosis register was 1,160 in Deptford
at the end of last year. The morbidity from tuberculosis in Deptford is
relatively high, there being a large proportion of infective cases and of
intermediate or well advanced cases of tuberculosis. Accordingly the
death rate from tuberculosis is still fairly high in Deptford.
Clinic Register
The numbers of notified cases of tuberculosis have increased enormously
in the last two years, owing to the more effective case finding resulting
from the advent of the major X-ray unit at the Deptford Chest Clinic in
1950. At the beginning of 1949 there were 502 notified cases on the
tuberculosis register, but this had grown to 1,160 by the end of 1956,
despite the removal of many hundreds of names from the tuberculosis
register as having recovered, died, or having removed to other areas of
England.
Treatment
The tuberculosis mortality has been greatly reduced by the use of the
modern drugs in treatment, not infrequently combined with major chest
surgery and rest treatment. Drug treatment with rest alone may cause the
disease to heal sufficiently for the patient to resume a normal existence
without further danger of breakdown in health, but where only partial
healing is obtained, the remaining diseased area may have to be removed
or collapsed by surgical means. In advanced cases, however, the patient
may be saved from death by treatment, but still be disabled for a long
period of time, if not indefinitely. In fact, though the mortality from the
disease shrinks, the morbidity remains a problem and more patients
remain "on the books".
Tuberculous Families
Deptford is an area with many large families and much contact examination
is done at the Chest Clinic. In addition these families seem to move
in and out of the Borough a good deal. In 1955, Deptford received no
less than 33 new tuberculous families and transferred out 101 to other
areas. In 1956, 50 families moved in and a further 108 moved out of the
area. By comparison, I understand that there were 41 inward transfers
and 42 outward transfers in Greenwich in 1956.