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74 INSTITUTIONAL TREATMENT.
review the Dispensary so referred 75 patients (20 being insured persons) as well as 267 other
patients for special treatment (including 35 insured persons), and, lastly, 375 patients for
attention to their teeth.
From the Annual Report of the Dispensary for the year 1913 it appears that 725 patients
attended from Paddington during that year, of whom 161 were found to be definitely suffering
with pulmonary tuberculosis, and 247 others were suspected to have the disease. There were
in addition 15 other patients with other forms of tuberculosis. In analysing the cases according
to the sex and ages of the patients a number of non-resident patients have been included, making
the total of the definitely consumptive 174, 77 of them being males and 97 females. The patients at
ages under 15 years numbered 85, 44 (or 51.7 per cent.) being males. At ages over 15 years
there were 89 cases, including 33 males, equal to 37.0 per cent. of all cases at those ages. The
difference between the two proportions is illustrative of the difficulty experienced in convincing
adult males of the urgent necessity of attending to their condition. The present occasion is not
one for any lengthy summary of the Report, and it must suffice to state that in addition to
treatment the Dispensary, through its Case Committee, seeks to help its patients in every
possible way, such as providing country holidays, finding work, etc. The Dispensary maintains
two schools for tuberculous children: one at Kensal House for 90 children, which is staffed
educationally by the County Council, and the other at Poplar Square for 25 children, which is
staffed by the Dispensary. The Dispensary provides a number of shelters in which patients can
undergo out-door treatment without leaving their homes.
There remains for consideration the original question of the alleged influence of the
segregation of the tuberculous on the rate of mortality from the disease. In the following
paragraphs the examination of this question conducted in previous reports is carried a stage
further.
Of the 156 deaths recorded last year as due primarily to pulmonary tuberculosis (comprising
154 of chronic phthisis and 2 of acute), 79 occurred at the patients' homes (41 of males and 38
of females) and 77 in institutions (males, 47; females, 30). The 77 deaths were equal to 49.3
per cent. of all deaths from this cause, the proportion observed in 1912 having been 53.8 per
cent. Below will be found a statement of the institutions (grouped in classes) in which the patients
died during the year, with a comparison of the proportions of such deaths to recorded deaths
during the past four years. A decrease in the proportion dying in Poor Law institutions has to

be recorded from the figures for 1912 and 1911. The new entry for approved sanatoria is
the result of the work under the National Insurance Act. It is rather remarkable that
nearly 6 per cent. of the deaths should have taken place in such institutions, as sanatoria
(as usually understood) are not places where many deaths occur. The proportions of
deaths in institutions observed among the residents of the Wards are shown below. The
very high proportion (66.6 per cent.) observed in Lancaster Gate, East, Ward signifies
nothing, as it represents one death out of a total of three recorded in that Ward. The comparison
of the three years shows that the proportions are subject to erratic fluctuations from
year to year.