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the civilian, and this is actually the case. Taking the most instructive class—the
moderately advanced cases (B.2)—the records are as follows:—
Number of Number Number
cases. alive. Percentage. dead. Percentage.
Ex-service men 435 221 61% 214 49%
Civilian males 191 46 24% 145 76%
Civilian females 144 40 28% 104 72%
From these records it will be seen that in this group the results of the treatment
of the ex-service men are materially better than those for comparable cases among
the rest of the population.
Age at death of the 1918 cases.—The next table which records the age at death
of the 1918 cases, is of some interest. It shows that among the civil population the
heaviest mortality occurred at the younger ages among women, namely, from 16 to
30, and at a somewhat later age among men, namely, from 36 to 50. Among the
ex-service men, the age of death was relatively low, the greatest number of deaths
having occurred at ages 21 to 30:—
Age at death. Males. Females. Ex-service men. Totals.
16—20 4l 55 22 l8
21—25 36 82 122 240
26—30 38 69 120 227
31—35 37 30 98 165
36—40 54 14 92 160
41—45 58 13 78 149
46—50 61 8 29 98
51—55 27 3 17 47
56—60 17 2 3 22
61—65 4 2 — 6
66—70 4 — — 4
377 278 581 1,236
The County Medical Officer of Health dealt fully with the subject of mortality
from tuberculosis in his annual report for 1922. He has suggested in that report
that one of the indirect influences of the war may have been to emphasise the
tendency, already manifested several years before the war, towards an increase
in the mortality among young adults. This view is confirmed by records given
above. The explanation is doubtless to be found in the fact that soon after the
war broke out the outward migration of young adults suffering from phthisis practically
ceased. With respect to the maintained and indeed increased mortality
among women at younger ages in 1921 and 1922, it is suggested in the same report
that the " tendency for young girls to exchange ' living-in' as domestic servants
for ' living-out' may have operated prejudicially upon their health. The domestic
servant, who formerly was well-housed and well-fed and cared for, has now, in many
thousands of instances, repaired to the tenement, the picture palace and the factory."
One's every-day experience favours this view. Certainly cases of acute pulmonary
tuberculosis—the so-called galloping consumption, which runs a rapid and fatal
course—are more commonly seen among young adult women than among young
adult men. and thpse vouner women are drawn largrly from factorv and allied workers.
Dr. Knobel's
report on
mortality in
relation to
age and
occupation.
From figures supplied him by the Registrar-General, Dr. Knobel has studied
the question of the mortality from pulmonary tuberculosis of men, in London, for
the years 1921 and 1922 in relation to age and occupation. His results are published
in " Tubercle " for June, 1924.
He points out the wide variation that exists in the mortality rates in different
industries and he suggests that there are three main factors at work :—
(i.) The number of " weaklings " and " susceptibles " in the industry,
(ii.) The character of the work and the conditions under which it is done,
(iii.) The general habits of the employees, particularly their tendency
to alcoholism.