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TUBERCULOSIS. 19
Malaria.—Since January. 1919, when notification was first required, 89 cases Have been
reported, all save one (a female aged 35-45) in ex-service men. In every instance the disease
was reported to have been contracted abroad. A special card index has been made of these
cases.
Tuberculosis.
Notification.—The number of certificates received annually during the years 1916-20 is
shown in Table IX., Appendix, together with information as to the origins of such certificates.
The new cases (all forms of tuberculosis) added to the Register in 1919 numbered 391 and in
1920, 383. The number added each year has declined from 835 (all pulmonary tuberculosis)
in 1912. During 1914-18 the annual average of new cases (all forms) was 522, the figures for
1919 and 1920 showing reductions of 25 and 27 per cent, respectively. The annual average of
new cases of pulmonary tuberculosis for 1914-18 was 378, as compared with a total of 284 in
1919 and of 277 in 1920—equal to decreases of 25 and 27 per cent. The 1914-18 average of
of other forms of tuberculosis was 144, and the totals for 1919 and 1920, 107 and 106—
equivalent to 26 per cent, reduction.
An informal Register of "suspect" cases—all forms—is also kept. To that Register 130
new cases were added in 1919, and 117 in 1920, as compared with an annuul average of 149 for
1914-18, the total for 1919 being 13 per cent., and that for 1920,22 per cent, less than the average.
Since the informal commencement of notification in 1903, 6,385 entries have been made in
the Register of "definite," i.e. medically certified cases and 2,262 in that of "suspect." After
careful scrutiny of the Registers at the end of 1920, the effective entries were found to be—
of "definite" cases 1,790 (1,267 pulmonary ; 523 non-pulmonary) and of "suspect," 535 (all
forms). Full particulars will be found in Table X., Appendix, of the additions to and removals
from, the Registers trom 1903 onwards.
Sex Distribution-—Below is a tabular statement of the sex distribution, all ages, of the
new cases reported during the past two years. As regards the definite cases on comparing the

averages, greater decreases—30 per cent, of pulmonary and 27 per cent, other forms—are
among males than females—21 and 24 per cent. respectively. In the "suspect" group, there
was a slight increase (2 per cent.) among males and a decrease (30 per cent.) among females.
Ward Distribution.—It will be seen on referring to Table XI., Appendix, that the decrease
in the number of new cases was common to all Wards, except Lancaster Gate, East and
West. In Lancaster Gate, West, Ward, the average (persons) for 1919-20 was 50 per cent,
above that for 1914-18, while in Lancaster Gate, East, the two averages were equal. The
1919-20 average for males equalled that for 1914-18 in Lancaster Gate, West, but was 20 per
cent, higher in Lancaster Gate, East, while that for females was double in Lancaster Gate
West, and 14 per cent, below in Lancaster Gate, East.
Age Distribution. —In comparing the averages for 1919-20 with those for 1914-18
(see Table XII. Appendix), the numbers of cases of pulmonary tuberculosis in all the age-groups
save females aged 65 and upwards, have shown reductions. As regards cases of other forms,
the comparison shows the same result, but the differences are not so great.
Site of Disease.—Of the 391 cases reported in 1919, 379 (nearly 97 per cent, of the total)
were stated to be affected in one part of the body only, the lungs being the affected organs in
276 instances (70.5 per cent, of the total). In 1920, 364 patients out of the 383 reported had
the disease in one part—-equal to 95.0 per cent, of all cases—the lungs being the affected parts
on 266 occasions (69.4 per cent, of ihe total). An analysis of the reported cases with one site
of disease has been made (not included here) and a comparison with the averages for 1914-18.
General reductions are noted in the numbers of cases for all parts of the body except the
generative and cutaneous systems. The numbers of instances in which disease of those parts
is reported alone are too small to make the changes significant.