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73
[1909
SCARLET FEVER.
Scarlet Fever caused 25 deaths, which, when the increase of population
is taken into consideration, is possibly the lowest return for the Borough since
1885. Indeed the returns, as far back as 1856, show no such record. When
the death registers are examined it is found that this disease, even without any
correction being made for the large increase of population, averaged in the
years 1856-1860,119; 1861-65, 214; 1866-70, 240; 1871-75,117; 1876-80,106;
1886-90, 51; 1891-95, 67; 1896-90,40; 1901-05, 33; and 1906-9,29. Thus from
1871, quinquennium after quinquennium, with the exception of 1891-95, has
exhibited a lessened mortality from it. Indeed, it is somewhat marvellous to
find that from the quinquennium 1866-70 to Ihe last four years, 1906 to 1909,
the deaths have fallen from an annual average of 240 to 29, in other words by
88 per cent. And what is happening in Islington is happening everywhere
throughout London and the country, so that one is driven to the conclusion,
and, indeed, it is generally acknowledged, that the severity of this infection is
not nearly so great as it was in former years. It is unfortunately not possible
to obtain a return of the cases of the disease that occurred in the earlier years
as was possible with the deaths. Nevertheless it is interesting to note that
while from the quinquennium 1891-95 to the 4 years 1906-1909, the annual
average number of deaths from Scarlet Fever fell by 56 per cent., the notified
cases of the diseases fell by only 2.1*8 per cent., thus showing that the
virulence of the disease as we know it during this short period has decreased.
The question naturally arises to one's mind, is not the disease now of the
same very mild a type that it was when Sydenham, one of the greatest medical
observers of past days, said of it "hoc morbi nomen (vix enim altius assurgit)"
thus speaking of it with a contempt vvhich he does not appear to have
felt for Measles or Small Pox ?
The history of Scarlet Fever, however, shows that from 1800-1804 it
ravaged Ireland and was very fatal, while from 1804-1831 the physicians who
had found it so terrible a disease from 1800 to 1804 saw scarcely any fatality,
so mild had it been. In 1831 however an epidemic of malignant Scarlet
Fever broke out in Dublin and its neighbourhood; in 1834 it had covered
Ireland with mourning even more extensively than some years later was
caused by Typhus Fever or even than that which had been produced two
years previously by the outbreak of Asiatic Cholera. Trousseau, the distinguished
Professor in the Faculty of Medicine of Paris says in one of his
lectures on Clinical Medicine that at the commencement of his studies his
illustrious master Bretonneau taught his class that Scarlet Fever, which he