1910-11.] Incidence of Mortality from Pulmonary Tuberculosis. 355 
The Decrease in Mortality from Tuberculosis of the Lungs. — From a 
study of this table it is seen that in Scotland a decrease in mortality from 
tuberculosis of the lungs began in quinquennium 1871-75 and has continued 
since. The rate of the decrease has varied from quinquennium to quin- 
quennium, and has been more marked since 1901. During the thirty-seven 
years 1871-1907 the reduction has been 50 per cent, in both sexes taken 
together. Two-thirds of this reduction took place in the twenty-five years 
1871-95, and one-third in the twelve years 1896-1907. In England 
and Wales the decrease began earlier than in Scotland, and has been more 
marked. This will be more fully discussed later. In Ireland there has 
been a very small decrease. 
Change in Sex Incidence. — In 1855 the first Detailed Annual Report 
of the Registrar - General for Scotland appeared. From 1861-65 to 
1886-90 the rate of mortality was higher among females than among 
males, not only as an average, but in every individual year of that period. 
In 1891-95 the mortality among males was higher, but in three of the 
years the female rate was in excess. From 1896 to 1907 the female rate was 
lower in each quinquennium, but was slightly higher than the male rate in 
two of the years. In England and Wales the mortality among females was 
higher than among males till 1865, but from 1866 onwards the excess has 
been invariably and increasingly among males. 
In Scotland this change in sex incidence began twenty-six years later 
than in England, and has been much more gradual. While in England and 
Wales in 1907 the difference of mortality between the two sexes was 
nearly 4 per 10,000 in favour of females, in Scotland it was practically 
only *5 per 10,000. 
A similar change in sex incidence of mortality has occurred in other 
countries. The following table is condensed from one given by Frederick 
JL Hoffman * j — 
Mortality from Tuberculosis of the Lungs among White Population in 
the United States (five Eastern States and three other Cities). 
Per 10,000 living at all ages. 
Males. 
Females. 
1871-75 . 
34-50 
35-30 
1876-80 . 
31-40 
33-33 
1881-85 . 
30-17 
32-03 
1886-90 . 
28-66 
27*23 
1891-95 . 
25-10 
22-63 
1896-1900 
23-70 
19-24 
'* Transactions British Congress on Tuberculosis , 1901, vol. ii. p. 350. 
