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28
Annual Report of the London County Council, 1914.
is reasonable to suppose that there was a corresponding actual increase in mortality in London. The
increase due to the addition of miliary tuberculosis to phthisis in England and Wales is found from
the same source (p. 156) to be 23 per cent.
The phthisis death-rate since 1850 (corrected for differences in the age constitution of the
population) in relation to the mean death-rate of the period 1851-1914 (males and females) is shown
in diagram (V). This diagram shows the marked decline of phthisis mortality in both sexes since about
1865, the greater incidence of such mortality on males than on females, and the fact that until recent
years the decline has been more manifest among females than males.

Phthisis
death-rates
in London
boroughs.
It will be seen from the foregoing table (comparing the corrected death-rates) that among the
several sanitary districts, in the quinquennium 1909-13 and in the year 1914, Finsbury (1.99 and 198),
and Shoreditch (1.86 and 2.20) respectively had the highest phthisis death-rates and Hampstead (0.57 and
0.58 respectively) the lowest. The death-rates from phthisis in London in each of the four quarters
of the year 1914 were as follows: first quarter, 1.58; second quarter, 1.28; third quarter, 123;
and fourth quarter, 1.48.
The figures upon which the above table is based, so far as the years since 1910 are concerned,
are those given in the Annual Summaries of the Registrar-General, which represent the deaths of
Londoners occurring within the Greater London area.
The steps taken in connection with the treatment of phthisis are dealt with on page 70, and
reference to the action taken by the Public Health Committee will be found in chapter xxv.
During the year 1911 the system of compulsory notification of pulmonary tuberculosis was completed
and it was in operation during the whole of 1912. This scheme was begun on the 1st January,
1909, as the outcome of the Public Health (Tuberculosis) Regulations, 1908, issued by the Local Government
Board on the 18th December of that year. These regulations provided for the notification of cases of
pulmonary tuberculosis by Medical Officers of Poor Law Institutions, District Medical Officers, Superintending
Officers of Poor Law Institutions and Relieving Officers. The respective duties of these
officers in connection with notification are prescribed in Articles IV to VIII of the Regulations.
Further Regulations were made on 22nd March, 1911, extending the system of notification to
cases occurring among the in-patients or out-patients at hospitals, or other similar institutions for the