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14
TUBERCULOSIS.
In 1913, 33 . of the new cases were certified by private practitioners, 20 . by the
Poor Law Medical Service and 18 by Tuberculosis Dispensaries. Last year the corresponding percentages
were 12, 15 and 23 respectively.
In addition to the 312 certified (" definite ") new cases, 115 persons were reported as under observation
at the Dispensaries on account of suspected tuberculous disease. That number is 25 in
excess of the figure for 1921, but otherwise the lowest for any year since 1909, when " suspects " were
first reported to the Department.
Of the 312 new cases, tuberculosis was reported to be present in one part of the body in 309 instances,
and in 2 in 3—the latter counting as " pulmonary cases." As regards the 108 cases of non.
pulmonary tuberculosis, the disease was reported to be in the lymphatic system in 59 cases, osseous,
20, digestive, 14, head and neck, 8, generative and urinary systems, 3 each. In 4 instances of " repeat"
notifications of non.pulmonary tuberculosis extension of the disease to the lungs was reported in
4 cases, and to head and neck (following lymphatic infection) in 2. In 2 " repeat " notifications of
pulmonary cases extension to the osseous and digestive systems (one each) was reported.
An examination of the numbers of cases of pulmonary tuberculosis reported during the triennia
1914.16 and 1920.22 shows that the sex distribution (all ages) has varied to so small an extent as to
be insignificant. The percentage distribution of the cases among men shows that there have been
in the second period reductions in the age groups 0-1, 1-5, 5-10 and 10-15, and in the 2 highest, viz.,
65-75 and 75 and over, the proportions in the age groups lying between 15 and 55 years being higher.
In the case of females the only age groups showing higher percentage proportions are those of 15-25
and 25.35 years.
A similar examination of the numbers of cases of other forms of the disease shows that at all ages
there has been an increase among females by a little more than 5 per cent. The percentage distributions
for each sex shows in both sexes declines in the proportions at ages under 5 years, but increases
in nearly every age.group above that limit.
Each year a few of the notified cases cannot be allocated to any Ward, chiefly among those notified
by the Poor Law Medical Service and from Lunatic Asylums, the "home address" being given as
"Workhouse" or a Common Lodging House. During 1913.17 such cases averaged 17 per annum—
12 of males and 5 of females—while during 1918.22 the average decreased to 7—5 of males and 2
of females.
On examining the averages for the periods 1913-17 and 1918-22 it has been found that the annual
average of cases (all forms of tuberculosis) for the second period among males has diminished by 39,
and that of cases among females by 35 per cent. The average (persons) recorded in Lancaster Gate,
East, Ward during 1918.22 is the only one in excess of the corresponding average for 1913.17, the
increase being limited to males (40 per cent.) the average for females showing no change. The reductions
observed in the averages in other Wards varied (for persons) from 43 per cent. (Queen's Park)
to 8 (Lancaster Gate, West), the range in the averages for males being from 46 per cent. (Queen's
Park) to 26 (Lancaster Gate, West), and that among females from 51 per cent. (Church) to zero (Lancaster
Gate, West).
The mean morbidity rate in the Borough during 1920-22 was 2-38 per 1,000 persons. The mean
rates for Westbourne and Church Wards (3.01 in both) were in excess of the rate for the Borough.
In the other Wards the means varied from 2.32 (Queen's Park) to 1.22 (Lancaster Gate, West).
Institutional Treatment.—Non.Residential: Dispensary.—Excluding 146 persons of all
ages under observation at the two Dispensaries at the close of 1921, the patients presenting themselves
at those Institutions during the year numbered 839, 52 less than the totals for 1920 and 1921, and the
smallest total for any year since the first year for which complete figures are available (1917). The
844 patients comprised 223 adult males (183 being insured males), 272 adult females (108 insured)
and 344 children aged 0-15 years. It should be noted here thg,t the age limit for children has been
reduced from 16 to 15 years in the pro forma issued by the Minister of Health last year.
The total number of patients for diagnosis was 985, comprising 546 adults—males 242, females
304—and 439 children—males 224, females 215. Of that total 8 ceased attendance before a diagnosis
was made. Of the remaining 977 persons, 197 (20.1 per cent.) were found to be tuberculous. The
percentage of the tuberculous adult males was 31.6, that of adult females, 22.8, and that of children
(both sexes), 12.0—all those percentages being notably below the figures hitherto reported.
Of the insured males 27.7 were found to be tuberculous—24.7 with the pulmonary
form and 3.0 with other—and of the females 28.0—23.2 pulmonary, 4.8 other. Of uninsured males
50 were tuberculous—45.2 pulmonary, 4.7 other—and of females 18.9—13.4 pulmonary,
5.5 other. Of the children 1.6 . were found to have pulmonary tuberculosis and 10.3 other
forms of the disease.
Last year 416 ""contacts" were examined comprising 202 adults (males 87, females 115) and
214 children, among whom 43 cases of tuberculosis were found, 34 of pulmonary (8.1 per cent.),
and 25 of other forms, 42 other individuals being kept under observation pending diagnosis.