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44
I have caused enquiry to be made as to how many
of the tuberculosis deaths during 1924 came under the
notice of the Tuberculosis Dispensary at some period
in their previous medical history. Out of 162 deaths,
85 were at some time or other patients at the Tuberculosis
Dispensary. It should be remembered that in
London there are various other facilities for dealing
with tuberculosis such as general and special hospitals
(e.g., Brompton Hospital) and infirmaries. Particularly
is this the case with regard to patients suffering
from tuberculosis of organs other than the lungs. If
we deduct the 33 such deaths during the year we find
that 83 out of 129 pulmonary cases had previously
attended at the dispensary and I think this can be
looked upon as a fairly satisfactory figure under present
conditions. It should, moreover, be remembered that
while these other patients may not have actually
attended the dispensary their homes have been visited
by the tuberculosis nurses and their general hygienic
conditions and mode of life supervised. Of those
deaths who did not come under the notice of the
dispensary as patients, 15 were attended by private
doctors, the remainder apparently having been in, or
under the care of, hospitals or infirmaries. Of the
162 deaths which occurred during the year, 100 occurred
in institutions and 62 at home. The death rate for
tuberculosis of the lungs is this year 0.80 per thousand
as compared with the rate of 0.92 for 1923 and 1.02
for 1922. This is a very noteworthy fall extending
over the three-year period. From the figures given
above it will be noticed that of the deaths from tuberculosis
of the respiratory system, 11 per cent. had
not previously been notified as suffering from this
disease, while for other tuberculous diseases 11.2 per
cent. had not previously been notified. These figures
are a very great improvement upon the figures for
1923, particularly in regard to other tuberculous
diseases, the unnotified percentage of which during
1923 was 37.5. It will further be noticed that 13.0
per cent. of respiratory cases and 84 per cent. of nonrespiratory
cases were only notified within a month of
their death. This figure for the non-respiratory cases
is unsatisfactory and compares badly with the figure