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77
Paddington were the highest recorded in the eleven years
1886-96. Both in London, and in Paddington, the rates
recorded in 1892, viz.: 0.80 and 0.68, respectively,
approximated most nearly to the rates for 1896.
This disease is epidemic practically every second
year, and the question of the best means of checking its
ravages is at the present time engaging much attention.
Proposals to include it in the schedule of notification
have been objected to on the score of expense, and the
slight effect which such course is expected to have.
There is little doubt that the mortality would greatly
diminish if parents would give up regarding the disease
as trivial and inevitable, would take precautions to prevent
their children from acquiring the infection, instead
of, as at present, wilfully exposing them to it, and
would do their best to guard against chills during convalescence.
What the sanitary authority requires to be
in a position to cope with the disease, is a knowledge of
the first case in each house or family, so that the children
may be excluded from the schools, the families kept
under observation, and the necessary disinfection
carried out. Notifications of the first case in the family
by the medical practitioner, when called in, and
systematic reports of absentees by school teachers, are
the most promising methods of keeping the sanitary
authority in touch with the disease. Hospital isolation
would, except under special circumstances, appear to
be unnecessary. Having regard to the highly infectious
condition of the patient from the first onset of