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20
With regard to morbidity the rate of occurrence of new cases of pulmonary
tuberculosis rose by nearly 50 per cent. between 1938 and 1941 and remained at the
higher level until the end of the war, when it began to decline, at first quite rapidly
However, the rate has since 1946 risen very slightly and it appears that the decline
has ceased. The morbidity level for pulmonary cases is at present still more than
20 per cent. higher than it was immediately before the war. It must, however, be
remembered that morbidity rates are related to the zeal with which new cases are
sought and new methods such as mass miniature radiography now discover early
cases which formerly would have recovered without notification or would not have
been notified until the disease was more advanced. The war-time increase in
morbidity from non-pulmonary tuberculosis was less severe than for the pulmonary
form and the rates have fallen below the pre-war level; here also, however, the 1947
rate was not lower than that for 1946, and though the 1948 figure indicates a slight
fall there is a hesitancy about the decline.
Evidently the immediate benefit of the return to peace conditions has ceased to
operate and further improvement will not be easily attained. Dr. Stallybrass has
surveyed the problem (British Medical Journal, 1949, i. 207) and has stressed the
fact that the standard of living which is a major factor can only be expected to rise
slowly, that sanatoria waiting lists are far too high and segregation correspondingly
insufficient, and that the control of contacts needs to be improved.