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48
the Register of Absentees will not even discriminate between the
different diseases. If this is so, we may never have the means in
our possession of comparing the incidence of Measles upon school
children in the years to come.
The school teachers consulted in Stoke Newington express the
opinion that, so far as they can judge, the new Regulation has had
no effect upon the prevalence of the disease.
Therefore there is no evidence at present available which will
enable one to conclude as to whether or not the new Regulation has
led to an increased prevalence of Measles among school children,
but I cannot but feel that it must have a tendency to make parents
regard the disease as comparatively trivial, as compared with the
other infectious diseases common in childhood; whereas it and Whooping
Cough are the two which occasion most mortality. It is therefore
bad from the standpoint of public health policy.
With reference to the mortality from the disease in London,
there has been a remarkable reduction in recent years. This may be
due to a greater appreciation bv the poorer parents of the danger of
the disease and a greater knowledge and concern in guarding against
this danger; or it may be due to a natural cyclical attenuation of
the virulence of the disease, such as is so strikingly in evidence in
the case of Scarlet Fever. The considerable variation in the deathrates
of different parts of London, although these death-rates are not
corrected for age-distribution, serve to indicate the extent to which
the Measles death-rate is a class mortality, affecting very largely
indeed the children of the poorer classes. Personally, I am at a
loss to explain the circumstance that the Measles mortality-rate in
London continues to be one of the highest among European capitals,
except it be due to admitting children to school under 5 years of age.
PUERPERAL FEVER.
Under Puerperal Fever are included the deaths from Pyaemia
and Septicaemia occurring in the lying-in women. The origin of each
of the 3 cases was very obscure, and it was quite impossible to suggest
the source of infection when I personally investigated them.