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Several tuberculosis officers pointed out that when patients removed from one dispensary area to
another the tuberculosis officer of the latter area was handicapped in dealirg with the case, as he had
no accurate information as to the previous treatment of the patient. It was suggested that when a
patient removed to a new district his case papers should be transferred to the new dispensary. A system
of transfer of records is in operation between the three voluntary dispensaries serving Stepney, and the
system might be extended with advantage. A transferable dossier of each case is undoubtedly the
ideal system, and the work of the dispensaries would be materially helped thereby.
Comments upon Certain Matters Arising Out of the Survey.
1. The number and distribution of the dispensaries required to serve London adequately.
Before this matter can be considered it appears to be necessary to form some opinion as to the
amount of work which can be carried out by a whole.time Tuberculosis Officer; this enquiry furnishes
fairly adequate data for a tentative decision in this respect.
It is evidently more satisfactory that the work capable of being carried out by a Tuberculosis
Officer should be related to the incidence of disease rather than to the size of the population served.
The number of deaths from tuberculosis in any area is probably a better index of the incidence than
the number of primary notifications, as the latter vary markedly from time to time even in the same
area. For the purpose of this report the average number of deaths per annum for the years 1912.16,
inclusive, has been taken as the index incidence of the disease.
Table IV. shows for each Metropolitan Borough the average number of deaths from tuberculosis
per annum, the number of primary notifications during 1914.18, and an estimate of the number of
" home contacts " of cases of tuberculosis notified during each year for the first time.
Table V. gives the same information for each dispensary district where the district is not coterminous
with the borough.
The number of contacts has been arrived at by multiplying the number of primary notifications
by 2.5. As the number of persons per family varied in the Metropolitan Boroughs in 1911 between
3.82 and 4.61, the estimate of " home contacts " obtained by the use of this factor is probably fairly
accurate, as it allows a margin for instances where more than one case occurs in a household.

* Eighty.three males were notified as suffering from non.pulmonary tuberculosis in 1915.