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73. To judge of the decrease of tuberculosis it is necessary
to consider carefully the figures given above for the various
forms of the disease. It is seen that the number of cases of
simple meningitis has considerably diminished, while that of
tuberculous meningitis has increased. The number of the two
together has remained nearly uniform. There can be little
doubt that cases which were formerly called simple meningitis
are now certified as tuberculous meningitis, and that the increase
of the latter is only apparent.
Again it has become increasingly the practice to certify
deaths from such diseases as hip and spinal disease as tuberculous
; hence the increase from tuberculosis, in other forms,
is also probably apparent only. It appears, therefore, that the
real diminution of tuberculosis other than phthisis is greater
than appears on the surface. The reduction of phthisis in
the past three years, especially in Woolwich parish, is very
marked.
There has been but very slight reduction in tuberculosis of
intestines and peritoneum; if this disease, as Dr. Koch and
others think, is mainly contracted from other persons in the
home suffering from phthisis, the reduction should have been
greater. If, on the other hand, it is mainly due to the consumption
of tuberculous milk, little diminution could be
expected, for until this year there has been no radical step
taken for preventing the importation into the Borough of such