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34
on which the rash was first noticed, and since the rash appears
usually on the fourth day of illness, the above fact shows that
the incubation period was in no case longer than thirteen days ;
which is in general accordance with the records of most observers.
From Wallington proper, the disease spread towards the
end of October to the Hackbridge and Beddington Corner divisions
of the parish, but as the cases were not so numerous, the
National School at the latter place was not closed.
It is a remarkable fact that but one death was registered as
due to measles throughout this epidemic—one death in 336
known cases, it being more than probable that there were several
other cases which were not notified.
The District is, I believe, the only district in the County of
Surrey, and one of the very few in England and Wales, where
measles is a notifiable disease. The utility of the notification of
this disease is a very debateable question, and the opinion 1
have formed from the experience of this epidemic is, that if
notifiable at all, it should be so on a basis somewhat different
from that of other diseases.
Measles is a disease which is highly infectious for several
days before it can be recognised and notified, owing to the late
appearance of its distinctive rash; consequently much of the
mischief is done before notification. Numerous cases are so mild
that no medical man is consulted, and no medical notification is
obtained; the only notification being then from householders,
which is frequently not forthcoming, and even when it is, it is
obvious that the diagnosis must frequently be faulty, and thus
notification from such a source is not of very great value. In
the epidemic in question, the first or most important cases thus
escaped notification. The disease, moreover, spreads so rapidly,
that it is absolutely impracticable, in a district such as this, to
carry out those measures of disinfection which we regard as
essential in other diseases; and finally, it is a disease that is not
seriously regarded by the public, which renders it extremely