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But there were other influences at work, and one of these is:—
The non-notification of the disease by persons who have not called in
medical assistance. The epidemic, from its very commencement,
assumed a very mild character, and let me here state that during the
year it caused only 94 deaths in 2,879 cases, or a fatality of 3·0 per
cent. This is very small, and is very much below the usual mortality,
which is something like 10 per cent.
Many persons, consequently, did not call in a practitioner to their
aid, but treated their children themselves. I have come across cases
that were so mild that the children were never in bed, never, in fact,
felt sick, and never ailed anything beyond a slight throat affection.
These children showed scarcely any signs of desquamation, and, indeed,
some did not desquamate at all. But, nevertheless, they were all
sources of great danger to others, and I have no hesitation in stating
were in a great measure responsible for spreading the disease broadcast.
Again, many persons, especially among the poorer classes, owing
to the mildness of the disease, were indifferent, when it made its
appearance, as to the adoption of effective isolation, and allowed the
patients to live with their brothers and sisters, and also permitted their
friends to visit them indiscriminately.
People seem to have the impression that this disease must be
contracted some time or other by children. This is a most popular
error, resulting sometimes seriously, when little children are allowed—
deliberately allowed—to contract the disease. It is a fact as regards
Scarlet Fever that the older the child grows, the less likely it is that
he will contract the disease, or that it will be severe or fatal.
Then there is carelessness in the management of the disease:—
Although in my visits I have seen hundreds of cases, yet in no instance
did I find that patients were rubbed down with an unguent or oil to
prevent the desquamating skin conveying the disease to others. I
know this is not the fault of the profession, who, as a whole, usually
recommend this treatment, although I am bound to say some of its
members never order it, which is to be regretted, as personally I have
found it most efficacious.