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10
Parish of St. George the Martyr, Southwark.
The mortality from measles, diarrhoea, whooping cough, and diphtheria, is thus
seen from the foregoing table to be excessive in St. George's as compared with all
London.
Measles.
The death-rate from measles is high, and, indeed, heads the table of mortality
from zymotic diseases, both in St. George's, Southwark, and in the whole of London.
In St. George's it has been more fatal than throughout London generally, in the
proportion of 100 to 44.
This waste of life, in my opinion, may be traced to the following causes :—
(1) Measles, although highly infectious, is non-notifiable, and therefore outside the
control of your Sanitary Authority.
(2) It is generally looked upon as a mild disorder that wants little or no treatment,
whereas it requires careful isolation and nursing, as it is liable to many grave
accidents.
(3) Bad environment: measles does little harm among the well-to-do, but among
the poor it is estimated that twenty to thirty die out of every 100 attacked by the
disease.
The Notification of Measles.
With regard to this important question, I think that the compulsory notification
of cases of measles, with subsequent hospital treatment and disinfection, could not
fail to result in a great saving of life. If compulsory notification be a fit and proper
step in other zymotic disorders, such as scarlet fever or diphtheria, there is no reason,
so far as one can see, why measles, which actually claims a greater number of victims,
should not also be notifiable.
During the year 1894 measles caused 100 deaths in vonr parish, whereas scarlet
fever killed 15, diphtheria 49, typhoid 5, and small-pox 0.
In London during the same period 3,291 deaths resulted from measles, as against
89 from small-pox.
If measles were included under the list of notifiable diseases no doubt a large
increase of hospital accommodation would be required, at any rate, for several years
to come. Into that aspect of the case, however, it is not my duty to enter. As your
medical officer I have only to point out that in measles we find an ever-increasing
cause of avoidable death in this parish, and one which, in my opinion, would be
materially reduced if dealt with in the same manner as most other infectious
diseases.
To some extent a precisely similar line of reasoning applies to whooping cough,
which during the year 1894 was answerable for 64 deaths in St. George's, as against
2,094 in London.
The affection is highly infectious, liable to lung complications, and is regarded
by parents as a trifling disorder, requiring little or no treatment.
The Salvation Army Shelter.
This institution, as you are aware, was founded by Mr. Booth for the night shelter
of poor persons. Although no doubt founded on philanthropic lines, a charge is
made for accommodation, and there is no attempt to disguise the fact that enterprises
of a similar kind are not only self-supporting, but are even carried on at a profit.
Notwithstanding this commercial aspect of the case, in the Court of Appeal