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34
On the positive side, we have evidence that one of the most
hopeful modes of the treatment of measles is with a fish-liver oil
concentrate rich in vitamins A and D. In the London County Council
Report on the measles epidemic of 1931-32, Dr. Ellison reports
favourably on this treatment which was tried in the case of 300
patients. The mortality of the treated group was rather less than
half that of the controls, suggesting that the vitamins exert a specific
beneficial action on acutely inflamed lung tissues. Whether this
apparent action is real or merely accidental can only be determined
by a further and larger series.
We treated the majority of the cases admitted into our hospital
in the epidemic last year with Cod-liver oil, and, though our
figures are too small on which to base any conclusions, we were
satisfied that the treatment was well worth further trial. Of the
78 cases admitted into hospital there were 5 deaths. Most of our
cases were admitted on account of complications, severity of attack,
or unfavourable home conditions. In the circumstances, therefore,
they are very favourable figures.
If we turn again to the mortality figures on a former page,
it will be seen that the worst period was in the later years of the
last century, and the earlier years of this century, and the best
period toward the end of the war and in the boom period following
the war. It is known that in the former period sophistication of
food was rampant. Milk and dairy products were treated unscientifically
and substituted, and cod-liver oil was used chiefly as a
medicine in tubercular diseases, and these are the chief sources
of vitamins A and D.
Margarine was very largely used instead of butter, and in
those days margarine contained no vitamins. So little care was
taken in the production and distribution of milk, that prolonged
boiling had to be resorted to in order to prevent its souring. In the
summer, milk would not keep unless it was boiled, and even in the
winter it was not considered too safe to drink raw milk. Pasteurization,
in the sense that it is now done, was hardly ever carried out.
The prolonged boiling of the milk destroyed the vitamins, and the
margarine contained none. It is only since the war that the use of
cod-liver oil in the feeding of infants and young children has become
so common. So that in the years during which measles was so
fatal the infants and young children were suffering from vitamin deficiency
and more especially vitamins A and D. It is also possible that in
the boom years which followed the war, the food contained the
(Note—Of the 78 cases admitted to hospital, 6 came from outside
the Borough and 1 death was of an out-patient).