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of the danger of this disease, and to thus make people more
careful as to its treatment. This, of course, is a good argument,
but it cuts both ways, because it will not have the effect on the
mild cases, which in measles, as in all cases of infectious
disease, are the chief agencies of the spread of infection. I
have, for instance, frequently been told by friends of patients
who have undoubtedly had scarlet fever, that they do not think
it could have been really scarlet fever, because the child was
not ill.
So long as people insist on judging the amount of infectivity
possessed by a disease according to the severity of the
symptoms the same opinion will inevitably apply to measles,
should it be attempted to bring it under the same conditions.
If the mortality from measles be used in favour of its
notification, the more it must follow that a disease like syphilis,
so eminently contagious, and so fatal in its consequences to
life and health, ought to be included in the same way.
This Vestry on June 15th joined with St. Marylebone
Vestry in an application to the London County Council to add
to Section 55 of the Public Health (London) Act the names of
all diseases included under the heading of "puerperal fever"
in the Registrar-General's report. In December we heard
from the County Council that all acute septic inflammations in
the pelvis occurring as a direct result of child-birth are covered
by the term "puerperal fever." This does not make any
difference to our statistics, for ever since 1895 I have considered
the notification of one of these diseases to come under the
heading of " puerperal fever," and in the same way a death
arising from similar causes has always been attributed in the
returns to that disease.
The subject of tuberculosis, especially that form of it
which is known as consumption of the lungs, has been prominently
before the public of late, and an association has recently
been formed under the presidency of the Prince of Wales, to
enter on an active crusade against this disease, which has come
under the head of infectious disorders ever since the discovery
of the tubercle bacillus some 15 or 16 years ago. In considering
the subject of tuberculosis there are two factors to be dealt
with, namely, the bacillus, which may be considered as analogous
xii.