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Pulmonary Tuberculosis. 
Pulmonary tuberculosis' which is a disease more 
of urban than of rural areas has a general death rate 
of about 2 per 1,000 per year which is higher than that 
for the United Kingdom. The death rate for the large 
towns is about double that for rural areas but this 
must not be taken as the true rate of the towns for 
included in the deaths recorded are many who 
contracted the disease elsewhere and who drifted to 
the towns for the medical treatment or to enter one 
of the many benevolent institutions provided for the 
care of the distressed. 
Because of the enervating influence of the climate 
and the consequent lowering of the bodily tone cases 
of active tuberculosis have not the chances of re- 
covering they would have in more bracing atmospheres. 
Asiatics seldom seek advice from a qualified practitioner 
until they are in an advanced stages of disease when 
recovery is almost hopeless. Those early cases which 
do come under notice usually tire of the discipline 
necessary for their recovery and leave the hospital 
against the advice of the Medical Officer to return 
after an interval with symptoms of advanced disease. 
Though there are many cases of Europeans with 
arrested disease enjoying normal lives in the country, 
Malaya cannot be recommended as a suitable climate 
for those who have tuberculous histories. 
Compulsory notification of tuberculosis was given 
a trial but was not a success owing to the reluctance 
of the people to report cases. 
The measures directed against the disease are 
improvement of housing, propaganda and education. 
