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70
(33 pulmonary) were of persons who had recovered, 2 (1 pulmonary)
were of persons in respect of whom the diagnosis had been withdrawn
and 12 (10 pulmonary) were of persons who had been lost sight of.
The net increase in the number of cases on the register is 154, of
which 136 were of pulmonary cases and 18 of non-pulmonary cases.
This figure compares with those of 160 in 1950 and 153 in 1951.
Deaths
26 persons (16 male and 10 female) died from pulmonary tuberculosis
during the year and four (3 male and 1 female) from non-pulmonary
tuberculosis. The number of deaths from tuberculosis in 1952 was 38.
This infection, then, accounted for a death rate per thousand population
of 0.14, and for 1.5 per cent. of the total deaths. These figures are
a marked contrast to those of 0.57 and 71 for 1934, and even of those of
0.42 and 4.9 for 1948.
Preventive Measures
In the years 1851-60 tuberculosis killed each year 70,000 people in
this country out of a population of nineteen million. Although there
was such an improvement that by the turn of the century in spite of the
population having grown to thirty-three million, the number of deaths was
less than 30,000 each year ; nevertheless, that did mean that the disease
was killing something over 1,100 people each week and was responsible for
more than 10% of the deaths from all causes. This century has seen a
further marked improvement. For the years 1926-28 the average annual
number of deaths was 30,000, for 1936-38 23,000, and for 1946-48 19,500.
Even since 1948 the number has been halved, there being only 9,335
deaths in 1952 compared with 17,779 in 1949.
On the other hand, the number of new cases diagnosed each year
remains steady at something over 40,000. That there should be this
constant addition of new cases with the fall in the mortality from the
disease brought about probably by improved treatment means that there
are many more patients in the population and so, though not to the same
extent, many more infective foci. Great as the improvements have been
in the way of early recognition of the disease, operative treatment and
chemotherapy, the disease is still killing 200 persons every week and those
persons in the best years of their lives.
Early Detection. The incubation period for tuberculosis from
the primary infection to the development of the declared disease of pulmonary
tuberculosis with cavities may be anything from months to many
years. During that period, in many the infection is symptomless. Various
methods have been tried of discovering these persons in this symptomless
stage.
(a) Examination of the contacts of those already diagnosed could be
expected to bring to light either those infected by the patient or one who
had infected him. In the country as a whole 6,841 cases were discovered
by this means, or 4.6%. At the Edgware Chest Clinic in 1949-52, 16,589
contact attendances were recorded; these persons had an incidence of
tuberculosis of six per thousand.