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11
pointed out that during the war out of every 9 men of military
age in the country only 3 were perfectly fit and healthy, and also,
that year by year in England over 270,000 years of work are
lost on account of sickness. It may or may not prove economical
to perpetuate the present state of affairs.
Tuberculosis.
The Tuberculosis Death-rate shows a slight increase, the
mortality being 1.17 per 1,000 of the population, as compared with
1.1 for 1920, the number of deaths being greater by 15 in 1921,
although there were 83 fewer primary notifications as compared
with 1920.
One of the outstanding features of the tuberculosis service
is the extremely unsatisfactory conditions under which the treatment
of advanced cases is carried out. There is no adequate
provision for the institutional treatment of advanced pulmonary
tuberculosis.
It should also be borne in mind that a large proportion of the
cases who are tabulated among the deaths in institutions have in
reality, during the greater part of the time that the disease was
advanced, been under treatment at home, such cases frequently
entering and leaving hospitals and infirmaries (see pages 51 and
57), while in an extremely infective condition.
Thus the fact that only 97 deaths, or 45.5 per cent. occurred
at home out of a total of 213, is entirely misleading in that the
remaining number of cases under treatment in institutions at the
time of death by no means represents cases rendered harmless by
removal to an institution.
A fact that conveys a more accurate idea of the conditions
existing that help to spread infection is that out of the total
number of deaths from pulmonary tuberculosis 180 or 84.5 per
cent. were unable to secure a separate bedroom during the course