It was not anticipated that complete notification of cases would be obtained for some years, but a review of English national experience of notification of tuberculosis up to the present time necessitates the confession that there has been failure to secure the coöperation of an unexpectedly large proportion of the medical profession in this public-health duty. Many cases have never been notified and in a large number of other cases notification has been belated; Dr. Barwise, County Medical Officer of Health of Derbyshire, obtained information as to 417 deaths certified during 1917 to be due to tuberculosis, and found that of this number 39 per cent. had never been notified, and that over 70 per cent. had either not been notified or died within twelve weeks of notification. This may be an exceptionally bad experience; but the duty of notification in many areas is only imperfectly performed, and no adequate steps are being taken to diminish this default. As notification is the first step towards coördinated measures for the patient and in the interest of the public health, the causes of delay in notification and of failure to notify deserve further examination. _Causes of Failure in Notification_ 1. The patient himself commonly is responsible for much delay in the recognition of his disease. A large proportion of consumptive patients refrain from applying for treatment until disease is fully established, and until they are incapacitated for work. Not infrequently this means that the patient does not consult a doctor until a few months or even weeks before his death. Until the conditions of general medical practice are altered, and every person has the right to state-paid medical consultations, belated recourse to medical advice will continue. With this there is badly needed further education of the public as to seeking advice for protracted colds and coughs, or for other symptoms suggestive of tuberculosis; and a wider hygienic propaganda as to housing, overcrowding, dusty indoor occupations, expectoration, etc., is also called for.