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prohibition took place. The occurrence of further cases of anthrax from infected shaving brushes induced
the Ministry of Health to issue a circular (No. 172) in January, 1921, to medical officers of health,
drawing attention to the risks of the spread of anthrax from this source and suggesting that retailers
should be prevailed upon either to destroy any Japanese brushes in their possession or to return them
to the wholesalers with an appropriate explanation. In this connection Dr. James Fenton, Medical
Officer of Health of Kensington, reported that there was nothing to prevent brushes, so returned to the
wholesalers, from being put on to the market again, and stated that a number of brushes seized had been
retained by him. The Ministry pointed out that the only obstacle to wholesalers re-selling the brushes
was a possible claim for compensation in the event of a purchaser contracting anthrax; further, that
the borough council must pay compensation for any brushes retained. Dr. Fenton, thereupon, advised
that the appropriated brushes should be destroyed and compensation paid as the only safe means of
preventing spread of the disease. The borough council agreed to his recommendation and their decision
was circulated to the councils of other metropolitan boroughs in the hope that similar action might
be taken.
The death rate from pulmonary tuberculosis in the civil population of London during 1920 was Tuberculosis.
1.05 per 1000 lis ing, the deaths numbering 4,791, as compared with 5,332 in 1919 and 7,048 in 1918.
Tuberculosis other than phthisis caused 954 deaths, as against 992 in 1919 and 1,398 in 1918.
The total number of deaths from phthisis given above does not properly represent the movement
of the phthisis mortality in the past three years for the disease is largely incident upon males of military
age. In some cases active service may actually have inhibited incipient phthisis, while in others the
hardships of war undoubtedly lowered resistance to attack. The figures given above relate to civilian
deaths only, except in cases of deaths occurring after discharge from the army. Further, in order to
arrive at a true picture of the changing incidence of tuberculosis, it is necessary to know the agedistribution
of the population concerned. The latest available data on this point are for the year 1911,
and cannot, owing to changes brought about by the war, any longer be relied upon. When the results
of the forthcoming census are to hand, and figures are published relating to the strength of the army at
various periods of the war, the movement of the phthisis mortality can be more accurately appreciated.
The number of "primary" cases of tuberculosis notified in London during 1920 (52 weeks) was
13,163 as against 15,587 in 1919 (53 weeks) and 19,178 in 1918 (52 weeks). These figures do not relate
exclusively to the civil population. Of the total "primary" cases notified in 1920 there were
10,670 cases of pulmonary tuberculosis, and 2,493 of other forms of tuberculosis.

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