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135
On the 225 deductions, 120 (113 pulmonary) were of persons who
had left the district, 44 (40 pulmonary) were of persons who had died,
51 (43 pulmonary) were of persons who had recovered, 6 (5 pulmonary)
were of persons in respect of whom the diagnosis had been withdrawn,
and 14 (12 pulmonary) were of persons who had been lost sight of.
The net increase in the number of cases on the register is 68, of
which 56 were of pulmonary cases and 12 of non-pulmonary cases.
This figure compares with those of 154, 160 and 183 for the three
preceding years.
Deaths
28 persons (22 male and 6 female) died from pulmonary tuberculosis
during the year and 4 (2 male and 2 female) from non-pulmonary tuberculosis.
The number of deaths from tuberculosis in 1953 was 26.
This infection, then, accounted for a death rate per thousand
population of 0.15, and for 1.7 per cent. of the total deaths. These
figures are a marked contrast to those of 0.57 and 7.1 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 57,000 each year, nevertheless, that did mean that the
disease was killing something over 1,100 people each week and was
responsible for more than ten per cent. 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 8,902 deaths in 1953 compared with 19,797 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 nearly 200 persons every
week and those persons in the best years of their lives.
Early Detection. The incubation period 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