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I am pleased to report that the death rate from pulmonary
tuberculosis, 0.92, is the lowest ever recorded in the Borough;
this rate is still, however, higher than that in many other metropolitan
districts. There has also been a considerable fall in the
number of deaths from phthisis between the ages of 15 and 25.
In Table II. it will be noted that 9 cases of pulmonary tuberculosis
and 11 cases of non-pulmonary tuberculosis were not
notified to me before death. Of the 9 pulmonary cases, one
death occurred in Guy's Hospital, after a sudden hæmoptysis,
and the other 8 deaths occurred in St. Olave's hospital. The
average age of these 9 patients was 54, and, without exception,
they died very shortly after admission. In two of the instances
there were investigations by the coroner on account of the sudden
death.
Of the 11 non-notified cases of non-pulmonary tuberculosis
8 deaths were due to miliary or meningeal tuberculosis, 6 being in
infants or children under the age of 5 years. It is extremely
difficult, if not impossible, to secure early notification in such
cases owing to the obscure mode of onset and to difficulties in
diagnosis. In the three remaining cases also the precise diagnosis
was in doubt until death. All these 11 patients died in hospital,
with the exception of one who was removed home shortly before
death, after a period in hospital.
The death returns reveal, however, that there are still many
patients who die from pulmonary tuberculosis within a few months
of notification.
On page 32 is a return showing the work done at the Dispensary
during the year.
There has been a decrease in the total number of new cases
examined during the year, and a slight increase in the number of
sputum positive cases on the register, and in the number of contacts
examined.