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tration of a death is oftentimes the first clue to the existence of the
disease, and the information then comes too late for practical, i.e.,
preventive purposes. It is obvious, also, after repeated experience
that some of the poor who can ill afford to pay a doctor, employ
the services of private medical men for fear that if they applied for
Parish relief the sick child, or children, will be sent to the hospital.
Private practice, is, under such circumstances, conducted under
great disadvantages, for the payment of the small fees with which
the medical man is content in such cases, deprives the poor of the
means of purchasing those comforts, not to say necessaries, of the
sick chamber, on which, inter alia, recovery so largely depends. It
is heart.breaking to see the wan faces of little sick children in their
miserable rooms, especially when the contrast is mentally made
between the condition prevailing " at home," and the well.ordered
hospital, with its staff of doctors and nurses, and all requisites
for every stage of illness and convalescence. Another case that
came under my notice in the course of the enquiry may be mentioned.
The child was attended by a non.qualified practitioner;
the parents, however, believing him to be a duly qualified medical
man, for how should a poor ignorant Irish labourer know the
difference between " Doctors " ? The child died at the end of the
second week, and the existence of scarlet fever in the house became
known to us only on the registration of the death : too late, in fact,
for the mischief was done. The two rooms occupied by this family
contained seven persons, viz., the parents and five children. Successively
the father and two more children fell sick, and were
removed to the hospital, where they are all doing well. The rooms
and clothing were disinfected, and the mother and two remaining
children were reluctantly compelled to leave the house; but no
sooner had they done so than the elder child fell sick, and was sent
to the hospital. The mother and her infant are at present well.
The day following the burial of the deceased child another family of
nine persons left the house. They have been traced, and two children
found to be ill. They are tolerably well isolated, however, and seem
likely to do well. I am trying, nevertheless, for the sake of the rest of
the family, to have them removed. The lessons taught by this story
are too obvious to need recapitulation; I will only observe, therefore,
what the facts have strongly suggested to my own mind, viz.,
that among the many requirements in sanitary legislation, none is
more needed than power to provide quarantine for the apparently
healthy members of poor families in which infectious disease has
broken out." The other cases that have occurred up to the present
time are too few, and otherwise offer nothing to call for special
notice. All the fatal cases occurred in streets wholly occupied by
the poorer classes. But, as I observed in my report,—" A principal
source of danger in the future lies in the carelessness or ignorance
which leads to the premature exposure of convalescents, to which
cause several cases have been referred by my correspondents. A
case of this kind occurred a short time ago. I ascertained that a
boy, who had been ill only a few days and whose skin was actively
peeling, bad not only, by inadvertence, attended at the waiting.