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90
SPECIAL REPORT ON THE DISTRIBUTION OF TUBERCULAR
DISEASE IN THE CITY OF WESTMINSTER.
In accordance with the instructions of the Public Health Committee,
I beg to submit certain particulars relating to the distribution of
tubercular disease in the City.
Maps.—I have endeavoured to reproduce the maps which I have
prepared in the office each year, showing approximately the neighbourhood
to which the persons belonged who died from this complaint.
The small size of the map and the number of deaths in the three years
has prevented the position of the house or even of the street being
localised; but I have been able, with the co-operation of the Assistant
City Engineer, Mr. Ventris, to mark out a number of small (enumeration)
areas, of which the actual population at the last census is known,
and we have shown it in each of the areas by green spots, each of which
represents one hundred persons, living at the time of the census in the
respective areas. Each red spot represents one death from consumption
or other tubercular disease, and in certain neighbourhoods where space
is limited or deaths many, a red cross has been inserted to represent ten
deaths. Thus the population of each enumeration area can be ascertained
in round numbers (fractions of 100, less than 50 persons, are not
shown; between 50 and 100 are shown as 100) and the number
of deaths from tubercular disease which have occurred in connection
with that area during the three years 1901, 1902, and 1903.
The number of divisions (enumeration areas) into which the City is
divided is 145, and thus closer enquiry into the distribution of cases can
be made than is possible with parishes or even wards.
Death-rates.—It may first be useful to compare the death-rates of
past years as it affected the old divisions of the City. For this purpose
I have gone through the reports for ten years, and have calculated out
the rates at per 100,000 of population. I have taken this standard,
as thereby fractions are dispensed with in respect of the smaller
numbers. For some years the deaths for consumption of the lungs only
are available, but for the last seven years the rates for all deaths from
tubercular diseases are given.
It has been the practice to compare only the phthisis rates, but
although the bulk of deaths from tubercle are ascribed to lung affection,
yet it is extremely difficult to state which part of the body is the
primary seat of the disease. Post-mortem examination generally reveals
that in the end glands and organs in various parts of the body have
been affected. Hence in dealing with the prevalence of the complaint