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- 66 -
The national figures for tuberculosis mortality similarly
show a striking fall in the mortality of all age groups, which
is generally agreed as being due to improved environmental
conditions. This fall is shown graphically in charts 2A and
2B on page 64.
Apart from this general fall, the most interesting feature
is the change in age distribution and the very distinct
difference between the sexes. For females, the death rate is
greatest in early adult life, whereas for males it is greatest
towards the end of working life. These features are
illustrated in the following table.

This aspect has been reviewed by Dr. V. H. Springett in
his Milroy lecture to the Royal College of Physicians in
1952, in which he pointed out that if the tuberculosis mortality
among groups of people of similar birth date are studied (as
opposed to age groups of people alive in a given calendar
year or group of years), it is found that the graph curves
are essentially similar throughout. The mortality is low in
childhood, then there is a peak in adult life, never at a
greater age than 35-44. There is no tendency for the peak to
pass to an older age group. Indeed in the more recent
groupings the peak tends to occur in younger age groups. He
concludes that a large part of the tuberculosis mortality in
males in later life is due to a final breakdown of disease
originally acquired many years earlier. It is comparatively
seldom the result of recently acquired disease. In fact this
view recalls the opinion of Email von Behring, the centenary
of whose birth occurred this year, that tuberculosis was a
lifelong infection. He stated that "phthisis is but the end
of a lullaby sung at the cradle of the prospective consumptive."
Doubtless also involved are such other factors as
improved facilities for diagnosis, increased examination of
household contacts of tuberculous cases, the increase in longevity,
the different nature of tuberculosis in males and females and
the greater risk of infection at work run by the older male.
Mass Radiography
Since the 5th July, 1948, mass radiography has been
undertaken by Regional Hospital Boards.
On three occasions in 1953 the North-West Metropolitan
Regional Hospital Board provided facilities for mass
radiography of the general public at premises in Kensington.
The number of persons examined totalled 5,957.
The following table gives a summary of the results
obtained:-