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48
Annual Report of the London County Council, 1912.
PhthisisMortality
and '' social
condition."

Results
obtained
from the
notification
of Phthisis
during 1912
Tables similar to the above have been published in previous annual reports, and the close
relationship existing between " social condition " and phthisis mortality is conspicuous. It will be seen
that in the lowest social group the death rate from phthisis is more than twice that in the highest group.
During the year 1911 the system of compulsory notification of pulmonary tuberculosis was completed
and it was in operation during the whole of 1912. This scheme was begun on the 1st January,
1909, as the result of the Public Health (Tuberculosis) Regulations, 1908, issued by the Local Government
Board on the 18th December of that year. These regulations provided for the notification of cases of
pulmonary tuberculosis by Medical Officers of Poor Law Institutions, District Medical Officers, Superintending
Officers of Poor Law Institutions and Relieving Officers. The respective duties of these
officers in connection with notification are prescribed in Articles IV to VIII of the Regulations.
Further Regulations were made on 22nd March, 1911, extending the system of notification to
cases occurring among the in-patients or out-patients at hospitals or other similar institutions for the
treatment of the sick which are supported wholly or partially otherwise than by the contributions of
the patients (or of their relatives or guardians) and otherwise than from rates and taxes. These
Regulations are described as the Public Health (Tuberculosis in Hospitals) Regulations, and came into
force on 1st May, 1911.
A further stage in the system of notification of pulmonary tuberculosis was reached by the issue
of the Local Government Board Order of the 15th November, 1911. This Order provided that from the
1st January, 1912, every Medical Practitioner should notify within 48 hours every case of pulmonary
tuberculosis occurring in the course of his public or of his private practice", but it relieved the medical
practitioner of the duty of notifying a case which had to his knowledge already been notified to the
proper authority. The Order was not a consolidating Order but supplemented and to some degree
extended the Poor Law and Hospital Regulations.
Thus, from the 1st January, 1912, a complete system of notification of pulmonary tuberculosis
has been in force. The results for the year, however, cannot be regarded as representative inasmuch as
a large number of old cases among the general population were notified for the first time. This
consideration does not perhaps hold to the same extent as regards the notifications under the Poor
Law Order, inasmuch as this Order had been longer in operation.
From the returns supplied by medical officers of health of the several metropo litan boroughs,
corrected as far as possible for duplicate notifications within each borough, it appears that 21,873 persons
were notified during 1912. Probably this figure exceeds the true number because, owing to removals,
it is possible that some cases have been notified from more than one borough.
The percentage of cases distributed in age periods is as follows:-
Ages 0-5, —15, 25, —35, —45, -55, —65, —75, -85
Percentage 2.32, 14.94, 16.02, 44.45 19.74 2.53

(a) See footnote (a) page 19.
(b) See footnote (c), page 4.