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26
Besides educating the public as to the means to be adopted in the prevention
of the spread of Measles in the household, much remains to be done so as to secure
proper nursing of, and attendance on, the patient. Where the patients are cared for
in warm rooms well ventilated and protected from sudden changes of temperature,
the progress of the illness may be regarded with equanimity in ordinary circumstances.
To allow a child who is actually suffering from, or who is just getting over, the disease,
to play in a cold room is a most dangerous proceeding, and cannot be too strongly
deprecated. Unfortunately, in many instances, proper nursing facilities are impossible.
Poverty reacts on the case-fatality of Measles in many ways. One authority
asserts that a fire in the bedroom is one of the most necessary items in the treatment
of the disease ; where poverty so great exists as to render this fire impossible, the
children develop complications which make the percentage of deaths abnormally high.
The liability to complications is also enhanced by the fact that the employment
of the mother compels a large number of them to leave their homes during the day.
On the subsidence of the symptoms associated with the eruptive stages, the child
would often be left in the care of some person in the house other than the mother,
or taken to a neighbour's house to be looked after. In either case, the same care would
not be taken to avoid exposure as would be exercised by the mother.
Formerly we were in ignorance of the conditions which obtained in the houses,
and when a case was introduced into a family, usually all the susceptible children
were attacked.
So far we have dealt mostly with individual cases, and these have been considered
solely from an administrative point of view. The difference of incidence of
attack to that of death is of importance as bearing upon the epidemicity of the
disease. If the assumption be correct and our figures bear out the assumption, the
length of the inter-epidemic period is of importance. If the inter-epidemic period
could be lengthened, not only some children would have reached an age when they
would be less susceptible to an attack, but a larger number of children will, when
the epidemic arrives, have reached ages at which the disease is little fatal. A large
number of lives would thus be saved, which are now sacrificed to Measles.
It must be admitted though, that the measures which have been adopted to
meet epidemic prevalence of the disease, and the means by which it may be controlled
so as to arrest or delay a threatened epidemic, have not yielded satisfactory results.
It is generally agreed that Measles is spread on the largest scale by the attendance
at public elementary infant schools of children in the catarrhal stage of the disease
The occurrence of a similar spread in the boys and girls' departments of the same
schools is prevented by the fact that most of the scholars in these departments are
already protected by a previous attack.