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15
confinements where it is impossible to record such frequent
and reliable temperature readings.
SCARLET FEVER,
1955 was a quiet year for scarlet fever, only 118
cases were notified compared with 287 in 1954. The disease
was again of a very mild type.
SMALLPOX,
Five persons who may have been contacts of a case
which occurred in a liner returning from the East were
kept under uneventful surveillance for the necessary
period.
TUBERCULOSIS,
In recent years I have drawn attention in my Annual
Report to the sharp decline in Tuberculosis.
During the last five years, as will be seen from the
attached table, the pulmonary cases have fallen from 209
to 119, whilst the non pulmonary cases have fallen from
41 to 24. If one looks at the deaths from Tuberculosis the
comparison is even more striking. In 1950 there were 48
deaths from pulmonary Tuberculosis and in 1955 there were
17, the figures for non pulmonary Tuberculosis being 5 in
1950 and 3 in 1955. Looking at these figures as part of
an epidemiological curve there seems no doubt that we are
at the end of a wave of infection which, although the
figures may not be reliable before 1837, seems to show
that since the London Bills of Mortality were commenced
in 1629 there is undoubted evidence of the prevalence of
Tuberculosis over a period of about 200 years,
The death rate rose steadily to the middle of the
18th century until about 1810 with a death rate of 6,000
per million living. Since then there has been an almost
continuous steady decline in Tuberculosis mortality.
In 1855 the death rate was 3,600 per million, in 1905
1,600 per million and in 1955 148 per million, It is of
particular note that the most conspicuous fall is in the
age group 20 24 years, - 100 years ago the death rate in
this group was ten times the death rate of today. Among
the older groups the death rates were only two to three
times what they are at the present phase of the epidemiological
curve. Another interesting sidelight on this curve
of mortality is the sharp fall in the deaths among children.