Abstract
The British tuberculosis publication<i>Tubercle</i>calls attention to a condition that has confused medical interpretation for centuries.<sup>1</sup>For a long time<i>Tubercle</i>has been interested in the paradox of the decreasing tuberculosis death rate in England and Wales and the apparent increase in morbidity, and three years ago it produced graphs showing that the United States and Canada were having a similar experience. At that time the opinion was expressed that the increase in notifications represented an improvement in ascertainment rather than a true increase in morbidity, and this view is still held today. The threshold of notification seems to be at a different level for each doctor. Some report symptomless primary lesions in children; others do not; some even notify at the time of conversion of the tuberculin test; some report symptomless quiescent lesions discovered at mass radiography, which is most likely when the examinee is in the
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