View report page

TUBERCULOSIS.
15
TUBERCULOSIS.
(See Tables 3 and 8-11.)
Notification.—Last year 1,093 notification certificates were received, of which 138 were passed
to other districts, leaving a nett total of 955, as compared with 834 in 1922. At the beginning of
August last the Minister of Health appealed to the medical profession to assist him in his efforts to
control tuberculosis, pointing out that complete notification of the disease was essential to the success
of his efforts in that direction. It is probable that some part, at least, of the increase in the number
of certificates received has been due to the Minister's appeal.
The 955 certificates represented 338 new cases (312 in 1922) and 617 (526 in 1922) repeat notifications,
442 of the latter being notifications of admission to, or discharge from, approved institutions.
From private practitioners 130 certificates were received, including 22 repeat notifications. These
certificates formed 13.6 percent. of the year's total. The Tuberculosis Officers sent in 212 certificates
(109 repeat notifications), 22.1 per cent. of the total; the Medical Officers of the local Poor Law
Infirmary, 188 (142 repeats) or 19.6 per cent. of the total and those of General Hospitals, 146 (86
repeats) or 15.2 per cent.
There are four forms of certificates in use, viz., "Form A"—of which 546 were received, 219
relating to cases previously notified; "Form B"—of which 5 were received; "Form C" (admission
to approved institutions)—of which 220 were received, including 196 from sanatoria; and "Form
D" (discharge from such institutions)—of which 178 were received. In addition, 8 cases notified
in other districts were transferred to the local Register.
The 338 new cases comprised 222 of pulmonary tuberculosis (104 in males and 118 in females)
and 116 of other forms of the disease (61 in males, 55 in females). In 1922 204 cases of pulmonary
tuberculosis were notified, 111 in males and 93 in females, and 108 of other forms of the disease, 53
in males and 55 in females. Last year's total (338) represents an increase of rather more than 8 per
cent, above the figure (312) for 1922, but while the cases (all forms of the disease) in males (165 in
1923, 164 in 1922) show an increase of less than 1 per cent., the cases in females (173 in 1923, 148
in 1922) show an increase of 17 per cent. The new cases of pulmonary tuberculosis in males (104 in
1923, 111 in 1922) show a fall of more than 6 per cent., while those in females (118 in 1923, 93 in
1922) show an increase nearly of 27 per cent. The new cases of other forms of tuberculosis in males
show an increase of 15 per cent. (53 in 1922, 61 in 1923), but those in females, no change (55 cases
in both years).
The 338 new cases (all forms) represent a fall of 10 per cent, when compared with the annual
average (374) for the years 1918-22. Last year 12 cases could not be allocated to any of the Wards,
the patients having no fixed addresses. The average annual number (1918-22) of such cases has been
7. The numbers of cases notified from the Wards last year (Table 8) were below the average,
except in Queen's Park (1923, 49; average, 40), Lancaster Gate, West, 11 in 1923 (the same as the
average) and Hyde Park (1923, 24; average, 19). The increase above the the average (26 per cent.)
in the last-named Ward was the greatest observed. In Lancaster Gate, East, the fall in the record
for last year was 62 per cent. of the average and in Church 26.
The sex-age distribution of the cases first reported during the past year will be found in Table 9.
In comparison with the annual average for 1918-22 the cases of pulmonary tuberculosis in males show
a fall of nearly 27 per cent. (1923, 104 cases; Average, 142), smaller numbers being recorded last year
in each age-group except those of 55-65 (1923, 10; Average, 9) and 65-75 (1923, 3; Average, 2).
Among females the shrinkage was less than 6 per cent. (1923, 118; Average, 125), increases being recorded
during the year in age-groups 25-35 (1923, 45; Average, 38), 45-55 (1923, 13; Average, 11)
and 55-65 (1923, 9 ; Average, 6). The cases of other forms of tuberculosis in males (61) were 15 per
cent, in excess of the average (53), the age-groups showing higher numbers, last year being 0-1 (excess
1 case), 1-5 (excess, 3), 10-15 (excess, 6), 25-35 (excess, 1) and 35-45 (excess, 1). The 55 cases in females
were the same as the average, but the cases at the following ages were in excess of their respective
averages—5-10 (excess, 4), 10-15 (excess, 3), 45-55 (excess, 1) and 65-75 (excess, 2).
Among the 338 new cases notified there were 331 in which the disease was reported to be present
in one part of the body only, in 219 of such cases the disease was in the respiratory tract, in 68 in
the lymphatic system, and in 21 in the osseous system. In 4 instances the disease was reported to be
in 2 systems of the body, and in 3 instances in 3. In 4 of the repeat notifications spread of the disease
was reported, the original seat of the disease being stated to be in all 4 patients the cervical glands,
the extension having taken place to the peritoneum (2 cases) and the osseous system (2 cases, spine, 1;
hip, 1).
The occupations of the patients whose cases were reported during the year are set out in Table 10.
Suspected Tuberculosis.—In addition to the 338 persons who were certified during the year to be
suffering from tuberculosis (all forms) 166 others were reported by the Tuberculosis Officers to be under
observation as possibly suffering from that disease, 103 of the cases being of pulmonary and 63 of other
forms of the disease. During 1922 115 persons (all forms) were similarly reported.