TUBERCULOSIS IX AUSTRALIA. 



553 



since 1901, for the whole of the Commonwealth. The figures for 

 each year are given from 1898 onwards, and for every fifth year from 

 1873-1898. These fig-ures are set out graphically in Figure 1. 

 Tal)le II. and Fig-ure 1 show that there has been a progressive 

 decline in the death-rate from phthisis in every State, except West 

 Austraha. Somewhere between 1883 and 1888 each State, except 

 "West Australia, seems to have attained its maximum, and from 

 that time onwards the decline has been progressive and uniform (with 

 the slight exceptions of New South Wales, which in 1903, and Tas- 

 mania, which in 1905 showed slight subsidiary rises). The single 

 exception to this satisfactory'' progress is West Australia, in which 

 the phthisis death-rate declined until 1899, rose again until 1901, and 

 since has remained practically stationary. It will be demonstrated 

 later in this paper that West Australia is. so to speak, bearing the 

 burdens of others in this respect, and some at least of her disability 

 should be debited to the other States. 



The order in which the States are arj-anged according to their 

 phthisis death-rate for 1907 is Tasmania, iSew South 'Wales, Queens- 

 land, South Australia, West Australia, Victoria^ — the order being 

 from the lowest to the highest. Table III. shows how these rates com- 

 pare with those of other countries; from these it will readily be seen 

 that all of the States and the Commonwealth as a whole occupy very 

 favourable positions in the phthisis rates of the world. 



While the phthisis death-rate in Australia is low compared with 

 that of other countries, it is not to be considered that the decline in 

 the phthisis rate is an exceptional feature in which Australian mor- 

 tality returns particularly excel. 



Dr. Bulstrode says : — " It will )je seen by the accompanying chart 

 that in practically every county in England there has been a sub- 

 stantial fall in the death-rate from pulmonary tuberculosis '' between 

 1871-1900 (35th Annual Report, Local Government Board (1905-6). 

 Chart facing p. 38). 



Dr. New'sholme: — "In recent years, in many but not in all 

 countries, the death-rate from phthisis has declined." (" Tlie Relative 

 Importance of the Constituent Factors Involved in the Control of Pul- 

 monary Tuberculosis," read before Epidemiological Society, 15-12-05.) 



Although the actual number of deaths from phthisis in Western 

 Australia has increased, the total population also of the State has 

 increased in an extraordinary degree (Figure 2), and the net result, 

 as has been pointed out, is that the increase in the number of phthisis 

 deaths means simply that the amount of phthisis in the State has 

 only increased with the population, and it cannoi, therefore he said 

 that jjhthisis is on the increase in this State. This aspect is further 

 supported by a reference to Figure 3, wdiich shows the percentage of 

 deaths from phthisis to total deaths from all causes during tlie 20 

 years ending 1906. As the figure shows, the percentage fell steadily 

 until 1896-7, and then rose slowly till it arrived at its original 1887 

 level . 



Reverting to Figure 1, it will be seen that between 1893-1900 a 

 distinct depression in the curve is present. The significance of these 

 two depressions will be discussed later on in this paper. 



