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107
I have visited the New End Hospital frequently during the year,
and have to thank Dr. Reade for his courtesy and help in respect of the
tuberculous patients in that Institution.
There is little to add to the remarks made in preceding reports of
the last few years. The notifications of cases of tuberculosis have been
the lowest since compulsory notification became law, and, coupled with
this, is the important fact that fewer deaths have occurred amongst
those who have been notified during the year.
There seems to be 110 doubt that the incidence of tuberculosis is
becoming progressively less, even allowing for more accurate diagnosis,
and a tendency not to label a patient as tuberculous without adequate
evidence.
Of very great importance is the fact that, although the case
incidence is less, the case mortality remains the same; in other words,
our prophylactic measures have been successful and our curative
measures a failure.
Until some cure for the disease is found our efforts can most
effectively be used in prophylaxis, and again I lay stress on the
necessity for homes for advanced and dying cases in the neighbourhood
Of 23 Dispensary cases who died last year :—
11 died at home,
7 at the Infirmary,
2 at Sanatoriums (not under the L.C.C.),
3 in L.C.C. beds at Sanatoria.
The greater number of the 18 cases in the first two groups should
have been in a local home.
The examination of contact cases during the year has been very
satisfactory. There is always difficulty in getting adult contacts to
submit to examination, and the percentage—60 to 68—is, I think, the
best attainable for "all contacts;" but taking only the child contacts
93 per cent. of the contacts of cases notified during the year have been,
examined.
During the past two years 179 pulmonary cases have been
denotified. These are mostly cases which have been on the Dispensary
Books or Tuberculosis Register for many years. I believe that none
of those denotified has ever had a positive sputum. Many were
notified d at the time when a diagnostic injection of tuberculin was