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cases, as there is a lower incidence of the disease in females than in males,
but until the number of persons living at various age periods was known,
it would not be possible to say if the reduction was solely due to this
cause. These figures are now available, and I have calculated out the
rates per 1,000 in each group for the years 1913.14 and 1920.21, not
including therein common lodging house and homeless cases.
–
Males.
Females.
1913.14.
1920.21.
1913.14.
1920.21.
Under 5 0.2 0.8. 0.2 0.4
5-15 0.7 1.4 1.4 0.9
15-25 1.5 2 1 1 1 1.5
25-35 3.4 2.9 1.7 2 1
35-45 _3 1 2.6 2 0 2 0
45-55 3.8 1.7 2 0 1.5
55-65 2.8 2 0 1.6 0.9
65 and upwards 1.8 1.3 1.2 0.6
All ages 2.9 2 0 1.6 1.5
These rates show an increase in the proportion of cases at the younger
ages in both sexes which is, I consider, due to the more thorough examination
of contacts and improved diagnosis, in the latter years compared
with the conditions which obtained in 1913-14 before the Tuberculosis
Dispensary was started. From the age of 25 among males there has
been a distinct improvement in each age group, except between 15 and
25, but among females it is not until the age of 45 that reduction appears;
indeed, between the ages of 15 and 35 there is an increase. Why this
should be so is not clear. One reason may be that the earlier part of this
period covers the time when young women come up to London to be
servants, clerks, shop assistants, and that in 1913-14 these were sent back
to the country when the nature of the illness was discovered, and notification
was not made in Westminster. Another possible reason may be
that it is the result of the home conditions and lessened food, due to lo;s
of work from trade depression. Both these factors would tell more heavily
upon the younger than the older adult females, and in 1922 there is again
an increase to 1.7 between 15 and 25 years, while there is a decrease at
other age periods. It does not apply to males at the same age, for in
1922 tha rates are lower up to 45, above which there is an increase, but
the figures are rather small for reliable conclusions to be drawn.
In both sexes the improvement is doubtless greater than is shown, as
notification is better now than it was in 1913-14, although still diagnosis
might be made at an earlier stage than is sometimes the case.
Tuberculosis Dispensary.—From the following table, taken from
the Report of the Medical Officer, it will be seen that the number of