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furnished to the County Medical Officer of Health under
Article XI (3) of the Regulations of i9l2 and in the
quarterly returns referred to in the succeeding paragraph of
this Circular. If a notification under the Regulations is,
however, subsequently received in respect of such a case, it
should thereafter be classed as a notified case, unless the
notification is one improperly furnished, e.g., a notification
furnished after the notifying practitioner is aware of the
death of the patient.
3. The Minister has decided to require that in the areas
of administrative Counties the District Medical Officers of
Health should furnish quarterly to the County Medical
Officer of Health the particulars as to numbers of cases in
their Registers which are set out in Article 2 of the enclosed
Regulations made by the Minister in supplementation of the
Regulations of 1912 and 1921. Considerable difficulty has
in the past been experienced in obtaining reliable data for
estimating the numbers of tuberculous persons in the country
and its various divisions. Such information is of much
value for administrative as well as statistical purposes, and
the new Regulations have been made with a view to securing
that the needful information is readily available. In regard
to the particulars referred to in paragraph (c) of Article 2,
these are included in order to afford the County Medical
Officer an opportunity of communicating to the District
Medical Officer of Health any supplementary information
available to him as to cases requiring to be removed from
the Register.
As regards the requirement in Article 2 that separate
figures be given for pulmonary and non-pulmonary cases, it
is desirable that all tuberculosis of the respiratory system
should be placed in the former class; and accordingly tuberculous
pleurisy, and tuberculosis of the larynx, nose, throat,
bronchial glands and mediastinal glands, should be classed
under the head of pulmonary tuberculosis.
The Regulations will come into effect on the 1st January,
1925, and the first return to the County Medical Officer of
Health will be that for the quarter ending 31st March, 1925.
It will be appreciated that it is of much importance that
every District Medical Officer of Health should at once undertake
a careful scrutiny of his Register and make any necessary
deletions in order to ensure the accuracy of the Register
when the first return is made. A similar examination of
their Registers should also be carried out by the Medical
Officers of Health of County Boroughs, in order that the
Registers in all areas may be rendered as accurate as possible.
It is proposed to ask the Medical Officer of Health of each
County Borough to furnish the Minister at the end of each