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wished to ascertain whether there would be any advantage in
freeze-dried vaccine over liquid vaccine, and whether the freezedried
product now being manufactured in this country could be used
extensively. We were only too happy to co-operate with the
Medical Research Council in this investigation, which has proceeded
without incident in our secondary modern schools.
Somewhat later in date, but still during 1956, we began what
might be described as our normal B.C.G. programme in secondary
grammar schools. Here again, vaccination has proceeded smoothly.
The total number of cases of tuberculosis notified in Southgate
over the past five years would seem to show that the incidence of
this disease is decreasing in the Borough. That, however, is a conclusion
which one would not be prepared to justify from the totals
involved. It has often been pointed out that the figures relating to
tuberculosis have never been strikingly out of the ordinary so far
as Southgate is concerned. This may seem surprising when the
nature of the Borough is taken into account. Quite obviously, however,
many ancillary factors must be considered. One must
remember, for instance, the position of Southgate, on the very edge
of one of the largest cities in the world. One must also remember
the migratory character of at least a proportion of the population,
especially those moving into the Borough from areas and even from
countries where the incidence of tuberculosis is probably very much
higher than it is here. All this means that Southgate cannot
possibly hope to avoid the appearance within its boundaries of fresh
imported cases of tuberculosis ,each of which may act as a focus of
infection. It is here, of course, that the admirable work carried out
by the Finchley Chest Clinic in tracing and investigating cases and
contacts is of such incalculable value. Even when this is given its
full value, however, and when the work of the Mass Radiography
Unit which visits Southgate is also remembered, it is abundantly
clear that tuberculosis will still remain a problem with which the
Borough must contend.
In order to view the picture in its proper prospective, we must
also bear in mind that, in company with many other infectious
diseases, the character, especially the prognosis of tuberculosis,
notably pulmonary tuberculosis, has altered considerably within
recent years. One still remembers the shock which the word
"tuberculosis" brought to so many families. Although the bacillus
tuberculosis has not altered appreciably in virulence, and although
there is little concrete evidence that it is less evident among the
community as a whole, we do know that the methods of treatment
available to those suffering from tuberculosis have improved beyond
all recognition. It is this fact, together with the excellent early
diagnostic work carried out by Chest Clinics and Mass Radiography
Units in particular, which has reduced the terrors of tuberculosis so
materially. Indeed, one tends to find that the pendulum occasionally
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