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20 TUBERCULOSIS.
Both in 1919 and 1920, twelve first notifications were received certifying the disease present
in two parts of the body. Three cases of "general" tuberculosis were reported in 1920.
Six cases were re-certified in each of the two years with spread of the disease from the
focus originally reported. In eight out of the twelve instances the lungs were the primary focus,
the disease spreading to the larynx (lease), the lymphatic system (5 cases—all "head and neck")
and the osseous and digestive systems (1 case each). In four instances the lymphatics of the
head and neck were first affected, the later foci of the disease being located in the osseous
system (3 cases), and cutaneous system, "undefined" (1 case).
Occupational Distribution.—Table XIV., Appendix, contains a comparison of the average
numbers of persons reported during 1914-18 and 1919-20, distributed according to their
occupations. Taking the averages for each group for 1914-18 as 100, the following Index
Numbers for 1919-20 are obtained. It remains to be seen whether the decline which has taken

place since the "war period" is an accidental one due to the removal of certain factors
specially mimical to those susceptible to tuberculosis, or a genuine diminution in the prevalence
of the disease, signalising the approach of effective control.
Institutional Treatment: Non-Residential.—The number of new cases presenting
themselves for examination or treitment at the two Dispensaries showed slight increases in
each of the years .1919 and 1920. The totals of such new cases in each of the five years for
which full records are available have been :—
1916 602 1917 861 1918 874 1919 877 1920 891
The annual average for 1919-20 was 884 and that for the preceding three years 779,
showing an increase of 13.5 per cent, (approximately). Of the patients admitted during the
last two years 55.5 per cent. were declared to be non-tuberculous, as compared wiih 51.0 per
cent, for 1916-18. There was an increase of 3.2 per cent, in the cases diagnosed as
tuberculous—from 23.9 per cent. 1916-18 to 27.1 in 1919-23—but the percentage found to be
suffering from pulmonary tuberculosis decreased from 17.1 per cent. in 1916-18 to 16.4 in
1919-20. The increase in the proportion found to be tuberculous was limited to cases of nonpulmonary
disease—the proportion increasing from 6.8 per cent, in 1916-18 to 10.7 per cent. in
1919-20. The proportion of "suspects" was 17.4 per cent, in 1919-20 ; 7.7 per cent. less than
in 1916-18. The appended statement contrasts the average proportions for the insured, uninsured
and children, according to sex.