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9
The death-rate from respiratory phthisis was 0.95. and from
other forms 0.22 per 1,000.
Although still one of the diseases responsible for the
greatest number of deaths, some satisfaction may be drawn
from its steady, if slow, decline. 370 deaths and a tubercular
death-rate of 1.17 per 1,000 during 1923 compares favourably
with the mortality during the ten years 1903 to 1912, during
which period the average yearly number of deaths from the
disease was 496 and the average annual tubercular death-rate
was 1.75 per 1,000. There is no doubt that advent of notification
and the formulation of Tuberculosis schemes on the passing
of the National Health Insurance Act has led to more accurate
diagnosis and certification of deaths in the case of tubercle,
but when every allowance for error in the earlier years is made,
the fact that Tuberculosis is being slowly vanquished remains.
The detailed work carried out at the Tuberculosis Dispensary
and Dagenham Sanatorium will be found in the
appended reports of Dr. Garland Collins and Dr. Mayberry
respectively.
Cancer.
This disease, which has caused much concern for many
years past by reason of its increasing prevalence (both apparent
and real), was responsible for 349 deaths (184 males and 165
females) in West Ham during the year, making a death rate of
1.11 per 1,000. This discovers a slight improvement on the
previous year, when 350 deaths (175 male and 175 female)
occurred, the death rate being 1.14 per 1,000. In England and
Wales during that year (1922), 46,903 deaths from Cancer
occurred, equivalent to the higher death rate of 1.23 per 1,000
of the population, but although West Ham's figures appear to
be favourable as compared with the whole country they support,
the belief generally held as to a real increase in the incidence
of the disease. Twenty years ago (1903) the death-rate from
malignant disease was 0.73 per 1,000, and the average death-rate
from the disease during the ten years 1903 to 1912 was 0.79
per 1,000.
Among the numerous proposals made with a view to
checking the incidence and mortality from Cancer, notification
of the disease was suggested several years ago, but its varied
forms, insidious development and multiple modes of attack are
such that the Local Government Board decided notification was
impracticable in view of the many administrative difficulties
connected with its adoption—a view which, in my opinion,