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The term itself is an exceedingly vague one and means that
the child's violent convulsive movements were prominent features
of the illness which preceded death. This, however, gives no
information about the disease itself. Convulsions may occur
in a child at the onset of any infectious disease such as measles,
at the onset of pneumonia, during the progress of tuberculous
meningitis, as the result of asphyxiation or an injury, or they
may be associated with dentition or rickets and many other
affections.
Convulsions are not a disease; they constitute a symptom and
are the equivalent in the child of what passes as a "shivering
fit," or as a "chill" in the adult.
Some of the deaths ascribed to convulsions are most likely
due to overlying.
When convulsions occur in the course of a definite recognised
disease then the special sanitary measures applicable to that
disease apply. Otherwise the vague group of symptoms, known
as "convulsions," which passes for a disease lies outside the
scope of public health intervention.
Measles and Hooping Cough.—In 6 years, measles and
Hooping Cough caused 190 deaths, or an average of 32 per
year.
Neither of these diseases is notifiable—the knowledge of their
presence is derived from casual information.
Provision has been made for the reception into the hospitals
of the Metropolitan Asylums Board of cases occurring in poor
law families, and, subject to certain restrictions, of cases
occurring in non-poor law patients.
This accommodation is, however, quite insufficient for the
whole of London, so that many cases have perforce to be treated
at home. And, unfortunately, in such homes it is nearly always
impossible to secure isolation.