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The returns received under the Public Health (Tuberculosis) Regulations,
1924, from the medical officers of health of the metropolitan boroughs show that
there were 32,117 cases of pulmonary tuberculosis (18,069 males and 14,048 females)
and 12,730 cases of other forms of tuberculosis (6,638 males and 6,092 females) on
the registers of the metropolitan boroughs at the end of 1929.
Tu berculosis
mortality of
mental
hospital
patients.
The high mortality from pulmonary tuberculosis observed in mental hospitals
has been the subject of discussion from time to time and has been variously accounted
for. The higher proportion of deaths in which the cause is verified by post-mortem
examination has been suggested as partly accounting for the facts, but while cases
thus come to light of deaths from undiagnosed phthisis, there are also cases in which
a diagnosis of pulmonary tuberculosis is found, post-mortem, to be erroneous.
During the war the mortality from pulmonary tuberculosis increased generally in
mental hospitals, as also did, in a very marked manner, the mortality among patients
of advanced age. The two adverse factors mainly concerned in this change were
thought to be first, the reduction in the scale of diet, and secondly the reduction
in staff, both resulting from war conditions. As the subject of the high tuberculosis
mortality in these institutions is of some importance from the administrative point
of view, the following notes on the relation of the incidence of tuberculosis among
patients in the Council's mental hospitals to that in the London population generally
may be of interest.
The incidence of tuberculosis among inmates of the Council's mental hospitals
as compared with that in the general population of London may be considered
from the point of view either of the attack-rate as shown by the number of cases
at a given time, or of the death-rate in a given period.
Attack-rates.
Figures have been obtained showing the number of persons known to be tuberculous
at the end of each of the three years 1925-1927 in the Council's mental hospitals,
and similar figures for the London population were derived from returns based
upon the tuberculosis registers of the metropolitan borough councils. The revision
of these registers, which was required by the Ministry of Health's Order of 1924,
was not yet fully completed at the end of last year (the latest period for which
returns are available), and further the borough councils' summary returns relate to
total cases on the register only, so that the age-distribution is not available for London
as a whole ; but the grouped ages of all registered cases had been abstracted for the
17710 B 2