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16
TUBERCULOSIS.
At the end of 1922 there were 51 suspect cases on the Register and during the year 189 of this
class of case were "discharged"—32 by transfer to the notified list, 36 by diagnosis of diseases other
than tuberculosis and 128 by clearance, removal, etc.—leaving 28 cases on the Register at the end
of 1923.
Institutional Treatment.—According to the weekly tabulation of admissions to institutions, based
on the Forms "C" received, 386 patients were admitted to institutions during the year, 314 of the
patients having pulmonary and 72 non-pulmonary tuberculosis. Of the 386 admissions reported
127 (32.9 per cent.) were to Poor Law Institutions, 127 (32.9 per cent.) to sanatoria, including M.A.B.
Hospitals with special accommodation for tuberculosis, 70 (18.1 per cent.) to special hospitals, 43
(11.0 per cent.) to general hospitals, and 19 (4.9 per cent.) to M.A.B. Hospitals other than those
above mentioned.
The complete analysis of the Department's records made at the end of the year shows that 316
patients (155 males; 161 females) suffering from tuberculosis in all its forms entered institutions
during the year, of whom 230 (117 males; 113 females) were admitted once, 68 (30 males; 38 females)
were admitted twice, 16 (7 males; 9 females), thrice, and 2 (one of each sex) four times within the
twelve months. The foregoing numbers represent admissions drawn from the total number of tuberculous
patients on the Register of the Department, numbering 1,743 on January 1st and 1,850 on
December 31st. The percentage of those persons receiving institutional treatment during the year
was 17.5. Of the 338 patients placed on the Register during the year, 183 (54.1 per cent.) entered
institutions, 80 being males (48.8 per cent.) and 103 females (59.5 per cent.). Of the 183 patients
in this category, 127 entered institutions once, 43 twice, 12 thrice and one four times. Limits of
space prevent the inclusion of the tables showing the class of institutions to which the patients went.
Action under the Tuberculosis Scheme.—The Scheme provides for treatment (a) in the
patients' homes—Domiciliary—(b) by attendance at the Tuberculosis Dispensaries under the care
of the Tuberculosis Officers—Dispensary—and (c) in residential institutions provided by the County
Council—Institutional. The line dividing (a) from (b) is not very rigid as many patients receiving
domiciliary treatment are seen from time to time by the Tuberculosis Officers either at the Dispensaries
or in the patients' homes. The effective distinction is, that the dispensary group regularly
visit the Dispensaries and are treated there and not by private practitioners.
Dispensary Work.—At the end of 1922 there were 154 patients under observation pending
diagnosis, of whom 32 were adult males (26 insured) and 37 adult females (16 insured). The total
of 154 also included 13 adult contacts (6 males, 7 females), but how many of those contacts were
insured persons cannot be stated. The total also included 85 children under 15 years of age, viz.,
37 boys (including 15 contacts) and 48 girls (17 contacts). The patients attending the Dispensaries
for the first time during the year numbered 1,031—comprising 216 adult males (169 insured); 350
adult females (128 insured); and 465 children under 15 (males, 233; females, 232).
The total dispensary "population" of last year numbered 1,185 persons of all ages, among
whom 228 cases of tuberculosis were found, 132 being pulmonary, and 95 other forms of tuberculosis.
The percentages of the "population" found to be tuberculous were—total (all forms), 19-1; pulmonary,
11-1; and other forms, 8.0, percentages which compare favourably with the means
(percentages) for the five years 1918-22, viz.—total, 23.9; pulmonary, 14.8; and other forms,
9.1. The percentages of adult males found tuberculous were—all forms, 31.4; pulmonary, 26.2;
and other forms, 5.2; and of adult females—all forms, 20.4; pulmonary, 16.7; and other forms,
3.6. All the percentages just quoted are well below the mean percentages (both sexes) for the preceding
quinquennium. Among the adult population, the cases of tuberculosis formed 30.6 in the
insured and 17.8 in the uninsured, 25.6 per cent, of the former and 14.5 per cent of the latter suffering
from pulmonary tuberculosis and 5.0 and 3.3 per cent. (respectively) from other forms of the disease.
Of the insured males examined, 32.8 per cent. were tuberculous, and of the uninsured, 26.4, the proportions
among females being, insured, 27.7, and uninsured, 16.0. Pulmonary disease was found
in 27.1 per cent. of the insured males and 22.6 of the uninsured, the proportions among females
being insured, 23.5 and 12.7. Other forms of tuberculosis were found in 5.6 per cent. of insured
males and 3.7 of uninsured, the proportions among females being insured, 4.1; uninsured, 3.2.
Except in the case of insured males, all the proportions mentioned were not only below those recorded
in 1922 but also well below the average percentages for 1918-22.
Among children under 15 years of age, 12.7 per cent, were diagnosed as tuberculous, 0.3 per
cent, having pulmonary disease and 12.3 per cent, other forms of the disease. In 1922, the percentages
were—all forms, 11.7; pulmonary, 1.5; and other forms, 10.1; the mean percentages
for 1918-22 being—all forms, 16.0; pulmonary, 2.3; and other forms, 13.6. It has to be noted,
however, that prior to 1922 the ages of "children" extended to 16 years, a fact which implies a
risk of a higher percentage of tuberculosis.
There was a remarkable increase in the proportion of the Dispensary "population" reported
as free from tuberculosis. For the five years 1918-22 the percentage of those examined as new cases