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134
compared with the 241 pulmonary cases and 32 non-pulmonary cases
which were notified in the district in 1953 and in which case the onset
of illness was not definitely known to have preceded their coming to live
in this district. The notification of new cases during 1954 was a rate
per thousand population of 1.28, a figure to be compared with that of
1.0 for the country as a whole.
Each year the death returns disclose that some persons had suffered
from tuberculosis who had not been notified during life. There were
five such cases this year. One, however, related to a person who had
not lived in the district for many years. One certificate related to an
elderly lady who died of broncho-pneumonia in a hospital not in this
area and who was found to have old standing tuberculosis. The death
certificate of an elderly male who died of some other cause referred to an
old standing tuberculous lesion of a bone; another of the cases was an
old lady who died of peritonitis which post mortem examination showed
to be of tuberculous origin. In only one of these cases was there the
disadvantage that because the case had not been brought to the notice
of the authority, precautionary measures which would have been advised
had not been taken. The remaining case, though, which was not notified
was known to those at the Chest Clinic so that there was not this risk
in this instance.
Register
Under the 1952 regulations the official register is now that kept by
the Chest Physicians. But whereas the register kept by the Medical
Officer of Health included all cases notified and the names of those learned
of by means other than by official notification, those kept by the Chest
Physicians were the working registers of the clinics and would, therefore,
not include the names of those who had not at any time attended the
clinic and possibly not of those who having attended at one time had
discontinued attending. For these reasons the numbers on the registers
at the Chest Clinics must be smaller than those on the registers kept
in the Public Health Department. The Minister, although making
these changes about the official registers, urged that Medical Officers
of Health would keep records for their own purposes. This is done
in this district. It is not possible to compare the numbers of those on
the two registers because both the Chest Clinics which serve the population
of this district accept patients from other districts.