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145
the welcome offered and given at the Infant Welfare Centres. Ingrained
custom and tradition are difficult to eradicate and supplant. Teething,
the use of the " dummy," flies, etc., are also responsible. The question,
however, will be a long way towards being solved when we get more
houses ; also education—in which clergymen, school teachers, doctois,
health visitors and voluntary workers all play their role— must have a
big effect. There is every reason for encouragement. The infant
death-rate for this area is much the same as that for the whole of
Glasgow or Liverpool; the people themselves are a pleasure to work
with, but they must be given more help and more and more attention
from all of us. Woodsellers, barrow men, dockers—you will get a
kind word from them all. I would like to see the effect of five years'
residence in this area of, say, 100 worthy people at present living under
pleasant surroundings and under happy auspices.
Measles.
In every case of Measles, visits were paid by the Health Visitors
and by the nurse who was engaged specially during the height of the
epidemic. A copy of the Measles card of advice was explained and
left at every house. It is not generally known that Measles has a
destructive effect on the tympanic membrane, thus leaving many with
defective hearing; further, Measles is often the starting point of
Pulmonary Tuberculosis. A sharp look-out was kept for aural complications
; these and doubtful lung cases were directed to Hospital and
to the Dispensary respectively. A prime point in such an epidemic is
to find out whether a doctor is in attendance or whether only one visit
has been paid; this is to be taken as meaning whether the people can
afford to pay for only one medical visit. I wish to take this opportunity
of expressing an opinion on the matter of medical attendance. As I
have said, poor people may only be able to pay for one medical visit.
It is not uncommon, in some cases, to call in a doctor from within or
around Deptford, whose scale of fees is low. One of the doctors told
me there was a sliding scale and it was sometimes allowed to " slide."
I have no doubt whatever that a doctor who charges a small fee may
be as capable and conscientious as one who charges a high fee, but in
view of the poverty of the patients I feel that there should be a medical
service for all such, directly answerable to the municipality. When a
Health Visitor calls, her function is to help the doctor carry out treatment,
to advise on general nursing, to promote warmth and good