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and myself at the International Congress on School Hygiene,
early school-closure must be allowed to have failed as a means of
preventing the spread of measles, and, except in special cases, has
been discontinued. Under present conditions it seems hopeless
to appreciably lesson the occurrence of measles, but measures
directed to diminish the fatality of cases that occur have been
much more successful. The simple distribution of printed
directions for the hygienic treatment of the disease has apparently
brought about the marked fall in its mortality in Woolwich.
More lives still might be saved if these directions could be
explained by an increased staff of health-visitors, and if all
cases which were seriously ill could have skilled nursing.
Early medical attendance is also necessary but often lacking
through inability to pay the doctor.
Whooping Cough.
35a. There were 37 deaths from whooping cough compared
with 21 in 1906, and, as mentioned above, no doubt many deaths
of young children attributed to bronchitis and pneumonia were
really due to this cause.
598 cases were notified by school-teachers. As with measles,
it is very difficult if not impossible to control the infection of
this disease, but general sanitary measures and improved conditions
of housing and more hygienic treatment of those affected
are steadily reducing its fatality. Education of mothers by
leaflets and health-visitors as to the hygienic treatment of
children affected would doubtless still furtherreduce the mortality.
The disease being chiefly fatal under two, and rarely over five,
one great object should be to postpone it as long as possible, or
at any rate until the child is over five years. School attendance
being the chief source of infection, it is advisable, as with measles,
that children under five should not attend school when these