Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London County Council]
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The ascertained mortality within four years of completion of institutional treatment of the
patients who were traced was therefore 63.6 per cent. The 306 cases treated have been classified as to
the stage of disease at the time they were referred to the Council for treatment with the following
result:—
Table II.
| For diagnosis | 17 ( 5.55 per cent.) |
| Early cases | 99 (32.35 per cent.) |
| Moderately advanced cases | 157 (51.30 per cent.) |
| Far advanced | 33 (10.8 per cent.) |
| 306 |
The ascertained mortality in each group was as follows (untraced cases excluded):—
Known to be alive Known to be dead
No. of cases. 31.12.19. 31.12.19.
For diagnosis 5 3 (60 per cent.) 2 (40 per cent.)
Early cases 59 27 (45 8 per cent.) 32 (54 2 per cent.)
Moderately advanced cases 97 33 (34.0 per cent.) 64 (66 0 per cent.)
Far advanced 23 4 (17.4 per cent.) 19 (82.6 per cent.)
In the following table the first three groups have been divided under the heading (1) Tubercle
bacilli found in the sputum ; (2) Tubercle bacilli not found in the sputum, and (3) no examination of
sputum or no record of such.
No. of cases. Alive. Dead.
Tubercle bacilli found in sputum 91 28 (30.76 per cent.) 63 (69 24 per cent.)
Tubercle bacilli not found in sputum 26 20 (76.9 per cent.) 6 (23.1 per cent.)
No examination of sputum or no
information 44 15 (34.0 per cent.) 29 (66.0 per cent.)
It will be seen that the mortality in cases where tubercle bacilli have been found is much greater
than in those where they have not been found.
From this report it will be seen that there is practically no difference between the results obtained
from the institutional treatment of uninsured adults as compared with insured, the facts brought out
being very much the same in both cases.
Children.—The Council's scheme for children was put into force in June, 1914, but as only 110
received treatment and 18 completed treatment in that year the subjoined report has been made to
include children who were discharged from institutions up to 31st December, 1915.
During this period 896 applications for institutional treatment were received ; 53] cases were
treated, and 288 children completed at least one period of treatment before the end of 1915, the remainder
being under treatment on that date.
Of these cases (81.5 per cent.) were pulmonary and 53 (18.5 per cent.) were non.pulmonary cases.
Pulmonary.—The pulmonary have been classified in the following table as to stage of the disease
at the time application for treatment was made to the Council:—
Table I.
| No. of cases treated. | |
|---|---|
| For diagnosis | 59 (25.11 per cent.) |
| Early cases | 99 (42.12 per cent.) |
| Moderately advanced cases | 64 (27.24 per cent.) |
| Far advanced cases | 13 ( 5.53 per cent.) |
| The results of observation of the 59 cases sent for diagnosis were as follows:— | |
| Diagnosis confirmed | 11 |
| Diagnosis not confirmed | 29 |
| Diagnosis still in doubt | 19 |
Table II.
| No. of cases treated and traced to 31.12.19. | No. known to be alive on 31.12.19. | No. known to be dead on 31.12.19. | |
|---|---|---|---|
| Diagnosis doubtful | 24 | 20 (83.3 per cent.) | 4 (16.7 per cent.) |
| Early cases | 81 | 78 (96.2 per cent.) | 3 ( 3.8 per cent.) |
| Moderately advanced cases | 48 | 36 (75.0 per cent.) | 12 (25.0 per cent.) |
| Far advanced | 10 | 4 (40.0 per cent.) | 6 (60.0 per cent.) |
| Totals | 163 | 138 | 25 |
Thus of a total of 163 cases, 25 (or 15.4 per cent.) have died within four years of completion of
treatment, but it has been ascertained that in four cases tuberculosis was not the primary cause of death.
The mortality from tuberculosis was therefore 21 in 163, or 12.9 per cent.