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34
These statistics show the great importance of farther steps being taken for the prevention
of consumption in this Borough.
In London in the ten years 1892 to 1901 inclusive the total number of deaths from
phthisis was 79,615, and if deaths from the other forms of tuberculosis are included the number
of deaths attributable to tuberculosis was 111,761; on the other hand the number of deaths from
the six principal epidemic or zymotic diseases was 83,133.
It is also important to bear in mind that about 90 per cent. of tho deaths from consumption
occur between the ages of 15 and 65, or the period when life is most valuable to the community.
On the other hand over 75 per cent. of the deaths from the six principal epidemic or zymotic
diseases are of very young children under five years of age.
Moreover consumption is generally a very lingering chronic disease lasting for several
years, and a large number of the patients have to be maintained in Poor Law Infirmaries or other
similar institutions at the public expense, and as the patients are very often the bread-winners of
the families, the families also often be comes destitute. In the Holborn Borough last year of the
182 deaths, 103 were in Poor Law or other institutions at the time of their death.
Statistics have recently been published in. Prussia showing that the tuberculosis death-rate
in that country has dropped from 31 per 10,000 in 1886 to 21 per 10,000 in 1900. During the
same period the English tuberculosis death-rate has only fallen from 24- to 19 per 10,000.
In the opinion of the Council of the National Association for the Prevention of Consumption
the causes of this phenomenal drop in the Prussian tuberculosis death-rate are:—(a) the
widespread knowledge as to the infectious character of tuberculosis, which has led to precautions
being taken amongst the working classes ; (b) the provision of a large number of sanatoria for the
working classes; (c) the early and systematic resort to sanatoria which the Workmen's State
Insurance Department in Germany encourages and assists.
voluntary notification.
In order that preventible measures may be carried out by this Council in individual cases
the Council must have information of their existence. Since my Report of March, 1901, the
feeling in favour of voluntary notification in England and other countries has very much increased,
and it has now been adopted in the following eleven of the London Cities and Boroughs:—
City of London, Hammersmith, Southwark,
City of Westminster, Hampstead, Stoke Newingtoa,
Einsbury, Kensington, and
Greenwich, Lambeth, Woolwich.
In the provinces about forty Urban Authorities have adopted this form of notification
.Among the more important of these districts may be mentioned :—
Blackburn, Hnddersfield, Plymouth,
Bolton, Leeds, Salf'ord,
Brighton, Leicestei-, Sheffield,
Cardiff, Liverpool, Southampton,
Derby, Manchester, and
Edinburgh, Nottingham, Sunderland.
As I mentioned in a former Report, voluntary notification was begun in the City of New
York on March 1st, 1894, and in January, 1897, the notification was made compulsory. In New
York the following cases of consumption were notified voluntarily:—In 1694, 4,166; in 1895,
5,824; in 1896, 8,334; so that the system cannot be said to be impracticable or unsuccessful.