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City of London with its small resident population, no difficulty is experienced in
keeping this work up.to.date. The method suggested in the Circular accompanying
the Regulations, whereby returns of deaths can be obtained from the Registrar
of Births and Deaths by the Sanitary Authority on payment of a fee, has been in
operation in the City for many years and the necessary information with regard to
the deaths of tuberculous persons is obtained from this source.
Article 5 requires that every Medical Officer of Health on becoming aware that
a person suffering from tuberculosis, who has been resident in his district and has
permanently changed his address, shall notify the Medical Officer of Health of the
district to which the patient has removed and furnish him also with all relevant
details of the case such as are contained in the register of notifications. This also
has been the City's practice.
The suggestion which was made in the memorandum accompanying the
Regulations, to the effect that to ensure the close co.operation of the Medical
Officer of Health and the Tuberculosis Officer, the latter officer should be made an
officer of the Sanitary Authority, received very careful consideration. It did not,
however, seem necessary to adopt the suggestion, since the Tuberculosis Officer,
although an Officer approved by the Ministry of Health, is actually an Officer of
St. Bartholomew's Hospital, which Institution is responsible to the Corporation
for the clinical work in connection with the Tuberculosis Dispensary. The agreement
between the Corporation and the Hospital Authorities adequately provides
for the closest co.operation between the Medical Officer of Health and the Tuberculosis
Officer.
VENEREAL DISEASES.
I have already referred to the fact that the Centre for the treatment of venereal
diseases requires to be extended. The scheme which has been prepared cannot
be proceeded with at the present time, and for at least another twelve months the
view of the Ministry of Health is that the Centre should continue on existing lines.
When financial conditions are less urgent doubtless the necessary improvements
will be revised and reconsidered. The cost of the Centre during the year under
review exceeded £3,000.
At the beginning of the year 661 males and 212 females were registered on the
books as receiving treatment which compares with 933 males and 324 females in
the previous year. Of these patients 350 males and 137 females were under treatment
for syphilis and 301 males and 72 females for gonorrhœa. The decrease of
patients is most pronounced in connection with the latter disease, the patients under
treatment for syphilis number practically the same as in the previous year. New
patients admitted totalled 758 as compared with 1,053 in the previous year.
Again attention must be directed to the number of patients who cease treatment
before completion of the course. 51 males and 19 females suffering from
syphilis discharged themselves before completing the first course and 39 males and
14 females after the first course but before completing treatment; 24 males and
3 females completed treatment but no final tests were applied; 29 males and
4 females were transferred to other centres, whilst 19 males and 11 females were
discharged after completion of treatment and observation. In the case of gonorrhoea
179 males and 51 females out of the total of 320 and 77 of the respective
sexes coming under treatment discharged themselves before completion of the
first course of treatment.

A few beds are provided at the Centre for in.patient treatment, and the number
of days of such treatment totalled 126.
In the laboratories associated with the Centre 5,241 specimens were examined,
19 for the detection of spirochetes and 2,489 for gonococci. 2,620 examinations
for the Wassermann reaction were undertaken, also 113 other examinations.