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16
TUBERCULOSIS.
In October, 1915, a letter was received from the County Council asking the Council to take
into consideration the formation of a Tuberculosis Care Committee for the Borough, the suggested
constitution providing for representation of the Dispensaries—the Tuberculosis Officers and "several
lay members"—of the Council—the Medical Officer of Health and the Women Sanitary Inspectors—
of the County Council—the Divisional Medical Officer and an Organiser attached to the School Care
Committee—the Insurance Committee and the Board of Guardians.
War conditions made the appointment of a new committee a matter of extreme difficulty and
after much correspondence and conference with the County Council the latter Council decided to
appoint an "Interim Advisory Committee" with a limited constitution. The Interim Committee
for the Borough began work in February, 1916, and was mainly engaged in assessment work in relation
to admission to residential institutions under the County Council's Scheme for such treatment. There
was then little or no visiting of tuberculous patients by voluntary workers as was practised during
1909.14.
In May, 1922, the Minister of Health issued a Circular Letter pressing for the appointment of a
Care Committee by the Borough Council to replace the Interim Committee. In the following July,
the Council adopted a Scheme for submission to the Minister of Health providing for the re.appoint.
ment of the Members of the Interim Committee as members of the Borough Care Committee with
additional representatives from organisations formed to deal with conditions arising out of the war,
and the appointment of a part.time secretary and social worker. The Care Committee, which will comprise
some 30 Members, had not begun work at the close of the year. It is to be regretted that the
Scheme relating to the Care Committee does not provide that Committee with any money to carry
out the duties—outside the powers of the Council—entrusted to the Committee. In Circular No. 194
(received in April, 1921), the Minister of Health intimated that he was prepared to make contributions
in aid (not exceeding 50 per cent.) on expenditure for extra nourishment for tuberculous
patients, provided that such expenditure did not exceed £2 per 1,000 of the population—say up to
£300 per annum for the Borough.
Arrested Cases.—The Department has records of 333 patients whose disease was marked
"arrested" prior to the end of 1920, 35 of those patients having left the Borough in the meanwhile.
Inquiries were made during 1922 as to the health of those patients. Approximately one.third of the
patients—107 including 26 who have left the Borough—could not be traced, and of the remainder—
226 patients including 9 removed—8 (all pulmonary cases) were found to have died, 24—19 with
pulmonary and 5 with other forms of tuberculosis—were still under observation, and 164 (including
8 removed) were apparently "cures" as regards tuberculosis, but 23 were reported to be Suffering
from other diseases. In other words, 72.3 percent. of the patients who had been notified between
1908 and 1919, but marked "arrested" prior to December 31st, 1920, were found during 1922 to be
(apparently) cured of that disease, and 86.4 percent. of those originally suffering from other forms
of tuberculosis. Of the 164 patients noted as "cures" 148—133 pulmonary and 15 other forms—
were entered on the Register during 1910-13.
Mortality.—The deaths from tuberculosis (all forms) during 1922 numbered 143—117 from the
pulmonary disease and 26 from other forms—equivalent to rates (per 1,000 persons) of 0.98, 0.80
and 0.17. The deaths of males numbered 77—69 pulmonary, 8 other forms—with rates (per 1,000
males) of 1.26, 1.13 and 0.13 ; and those of females 66—pulmonary 48, other forms 18—with rates
(per 1,000 females) of 0.78, 0.56 and 0.21.
During the years 1910.12 the rates per 1,000 persons were: all forms, 1.25, pulmonary, 0.99, and
other forms, 0.26; and for the years 1920-22, 0.98, 0.73 and 0.25. The rates recorded during the later
period show reductions of 22, 27 and 4 . respectively. Adhering to the same order the rates
(per 1,000 males) were: 1910-12, 1.71, 1.30 and 0.41 ; 1920.22, 1.29, 0.94 and 0.35—showing reductions
of 25, 28 and 15 per cent. For females the figures are : 1910.12, 0.91, 0.76 and 0.15;
1920.22, 0.75, 0.59 and 0.18—showing reductions in the total and pulmonary mortalities of 18 and
23 per cent., and an increase of 20 percent. in the mortality from other forms.
The incidence of mortality during 1922 on the residents of the different Wards of the Borough
can be briefly summed up as follows : Total mortality, maximum rates (persons, males and females),
Church, 1.52, 1.83 and 1.25; minimum, Lancaster Gate, West, 0.20, 0.32 and 0.15. Pulmonary
tuberculosis, maximum, Church, 1.36, 1.83 and 1.83; minimum, Lancaster Gate, West, 0.20, 0.32
and 0.15. Other forms, no deaths in Lancaster Gate, West, and Hyde Park, 1 death (a male) in Lancaster
Gate, East, and in other Wards, persons, maximum, Harrow Road (0.36), minimum, Maida
Vale (0.13); males, maximum, Harrow Road (0.23); minimum, Maida Vale (0.11); females,
maximum, Harrow Road (0.47), minimum, Westbourne (0.14).
The rates for 8 sex.age groups during the triennia 1910.12 and 1920.22, as well as for 1922, have
been calculated. Among males the highest mortality from pulmonary tuberculosis in both periods
was observed in the age.group 45.55 years, viz., 2.54, during 1910.12, and 1 .72 in the second period
and the lowest mortality (both periods) in the group 5.15, viz., 0.10 and 0.07. In the group 15.25
alone was the mortality during 1920.22 higher than in the earlier period, the increase amounting to
5 per cent. The maximum decrease (73 per cent.) took place at ages 0.5, and the minimum at ages