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The first of these, measles, pursues its way uncontrolled. It
is difficult to recognise in its earlier stages, there is no notification
of its occurrence, and the attempts at isolation are of the
feeblest possible character.
In scarlatina we have a disease which is earlier
recognised, and the notification of which is enforced, but for
which there is no specific treatment.
In diphtheria we have again a disease in which early
diagnosis is by no means difficult, in which isolation is usually
stringent, and in which remedial measures of the utmost value
are at our command. I have therefore chosen these three as
showing most typically the progress which has been made in
warding off the attacks and minimising the damage of the
three respectively. In order to be able to do this fairly I have
taken the number of notifications of the two latter, and the
mean mortality of all three from the tables published in the
Council's annual reports from its Medical Officer of Health.
The proportions of notifications and deaths have then
been, for each year, reduced to a rate per 100,000 of the
population, and then further represented in the charts which
are subjoined, as percentages of the average per 100,000, for a
period of twelve years, i.e., for six years before and six years
after the establishment of the Bacteriological Department and
the introduction of free anti-toxin.
Those members of the Council who are sufficiently
interested in the subject to follow the charts will find all the
most important factors with reference to these diseases therein
depicted, under a form which renders them easy of apprehension.
On Chart I. the blue line indicating the mortality from
Measles will be seen to pursue an extremely irregular course,
with epidemics of considerable magnitude in 1892 and 1896,
lesser ones in 1894 and 1901, and in the remaining years
being at or below the mean.
In the case of scarlatina, the heavy epidemic in 1893
was followed by a less severe one in 1896, and by a slighter
one still in 1901.
In the case of diphtheria, we find that whilst the
mortality was continuously above the average from 1893 to the
middle of 1896, it has since then only once, and then only to
a slight degree, risen above it, viz., in the epidemic of 1898.