2. Under present conditions of medical practice, early diagnosis of tuberculosis often fails to be secured, even when the patient places himself under medical care. It is to the private practitioner that most patients resort, and the early recognition and treatment of disease depends primarily (_a_) on his skill, (_b_) on his not being so overworked as to be unable to devote adequate time to the examination of each patient coming under his care, and (_c_) on his willingness to refer doubtful cases for consultation with the official tuberculosis officer of each area. These officials have only existed during the last few years; their work was partially in abeyance during the four and a half years of war; and apart from this, they have not always succeeded in persuading the private practitioner that their coöperation is to be welcomed and that they are not agents for depriving him of his private patients. This assumed antagonism between private and public medical practice is one of the most serious difficulties in securing more rapid progress in anti-tuberculosis work. 3. For nearly every sanitary area gratuitous facilities are now provided for the examination of sputum for tubercle bacilli, and yet in many areas there is grave neglect to utilize this provision, and patients with chronic phthisis may be treated during long months or even years for “winter cough,” “bronchitis,” etc., without adequate physical examination of sputum. The diagnosis of pulmonary tuberculosis ought, it is true, to be made before tubercle bacilli are found in the sputum, and failure to recognize the disease prior to this implies that the disease has already become serious; but in fact a very large proportion of consumptive patients for many months have tubercle bacilli in their sputum, before the diagnosis of tuberculosis is made. 4. When, as in some areas, the medical officer of health or the tuberculosis officer takes little, if any, useful action after notifications have been received, the practitioner has an excuse for not notifying subsequent cases. He can argue with some cogency that notification has no value _per se_; its utility depends on the action which follows on notification. Unless useful action follows on notification, default in notification has little practical importance. _Public Health Action Following Notification_ Under the English Tuberculosis Regulations the medical officer of health or an officer of the local authority acting under his instructions is required to make such inquiries and take such steps as may be necessary or desirable for investigating the source of infection, for preventing the spread of infection, and for removing conditions favourable to infection. The action required includes _inter alia_ 1. Attention to the personal hygiene of the patient, including instruction in the necessary precautions as to coughing and expectoration. 2. Any assistance needed to ensure for the patient