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It will be seen that the so.called " middle " group formed more than 50 per cent, of the total
number of cases and of these no doubt many were cases which would shortly afterwards have been
transferred to the group of " far advanced " cases.

Dr. Bardswell also points out that in those cases where tubercle bacilli are known to be present
in the sputum, the prospects of permanent restoration to health are appreciably less than those cases
where they have not been found.

Uninsured persons—Adults.—As the Council's scheme for adults was not put into force until
July, 1914, only a small number of cases was dealt with in that year. In the following report an analysis
is made of the results of treatment of all cases in which at least one period of treatment was completed
before 31st December, 1915. Information is given upon reports based upon the conditions of the
patients at the end of December, 1919.
During the period July, 1914, to December, 1915, 549 applications for institutional treatment
of adults were received, and of these 411 cases were treated. It will be remembered that the Committee
decided that no efforts should be made to trace cases in which applications for treatment were not proceeded
with. Of the 411 cases, 312 completed at least one period of treatment before 31st December,
1915. Included in this number were 6 cases of non.pulmonary tuberculosis, of whom 3 are untraced
and 3 are known to be still alive.
Of the remaining 306 cases, 90 removed and could not be traced, 17 refused medical supervision
at tuberculosis dispensaries or at hospital, 3 became insured and were dealt with by the London Insurance
Committee, and in 12 cases the diagnosis of tuberculosis was not confirmed. Thus a total of 122 cases
out of 306 (or 39 9 per cent.) treated have not been traced.
In this connection it should be borne in mind that owing to conditions arising out of the war,
there have been constant changes in the personnel of the tuberculosis officers in many boroughs, as well
as a considerable dislocation of the population, with the inevitable result that the following.up of patients
after institutional treatment has been rendered correspondingly difficult.
The same difficulties have occurred in connection with insured persons, but not to the same extent,
owing to the fact that such persons have for pecuniary and other reasons kept in touch with Insurance
Committees, and their subsequent medical history is thus more easily obtainable.
The Council, on the other hand, in the case of uninsured persons has to rely partly on the voluntary
submission of their patients to supervision and partly on the courtesy of the staffs of hospitals and
general practitioners for a good deal of their information.
Moreover, in the case of insured persons, panel doctors are under obligation to supply information
to the London Insurance Committee, while the Council has no means of obtaining information from
private practitioners other than that voluntarily given by them to the tuberculosis officers.
A further fact to be borne in mind is that persons sick and disabled from work by means of tuberculous
disease are more likely to resort to treatment again and again than those who have done well
under institutional treatment.