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the age of twelve months, and these fell ready victims of ailments
which attacked them between the ages of 2 and 5 years, of which
measles was one of the most important. In this manner, probably
our infant welfare efforts did affect the mortality from measles.
Moreover our propaganda work has resulted in a realization of the
seriousness of measles.
But this is not the only factor which has operated. The reduction
in the mortality from measles did not take effect for a decade
after the appointment of Health Visitors in London and the Home
Counties. A joint appointment of School Nurse and Health Visitor
was made in Acton in 1904, but not only was there no reduction in
measles mortality until 1914, but a most marked rise commenced
in 1906 and continued for about 8 years. Other factors which may
have been mentioned as likely to be operative are improved housing
conditions, and increased institutional treatment. These would
not result in the abrupt improvement which was noticed about
1914, and the improvement took place before these were in operation.
During the war, dwelling-house erection was practically at
a standstill, and naturally the conditions at the end of the war were
worse than they were in the pre-war period. In Acton, removal
of cases to the fever hospital did not start until 1924, and extensive
hospital treatment of measles did not commence in London before
that date.
There is something more than a coincidence in the fact that
a fall in measles morbidity followed closely on the discovery of vitamins.
In saying this I know that one lays oneself open to the old gibe
of " post hoc, propter hoc" Neither do I forget the well-known
gibe about the increase in Cancer and the increased consumption of
hananas. But there are good reasons for assuming that measles
morbidity may be associated with deficiency of vitamins.
As often happens in the development of science, a fundamental
idea is foreshadowed in many quarters, but has long to wait
before it emerges as a basis of accepted knowledge. The existence
if vitamins was suggested long ago, but it was the publication of
Professor Gowland Hopkins' researches in 1912 which served the
purpose of gaining for vitamins a universal recognition. The 22
years since the appearance of Professor Hopkins' paper have been
a truly remarkable progress in the study of vitamins. I may mention
only two of the vitamins. When severe deficiency of vitamin
A is present records nearly always mention a high morbidity rate
from various infections, and undoubtedly A—deficiency itself is in
part responsible. A deficiency of vitamin D is probably particularly
associated with infections of the respiratory tract.