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of the fatal cases, intercurrent diseases, e.g., pneumonia, bronchitis,
etc., complicating the original malady, were the immediate
causes of death. Little care is taken by the poor to prevent
the spread of measles in their families; they consider it as inevitable
as teething, and reason that it is less trouble in the
end if all the children have the disease at one time. It must,
however, be admitted that there is much difficulty in preventing
measles from spreading, for it is highly infectious from an
early stage, if not from the very beginning of the attack.
' The circumstances, moreover, in which the poor live in London
—several families occupying one house and using a common
staircase, almost preclude the possibility of isolation. More care
perhaps, might be taken to protect the sufferers against the
complicating affections which, as already stated, are generally
the immediate causes of death.
Whooping Cough (the most fatal disease in the zymotic class
in 1882) was the cause of 119 deaths—97 in the town subdistrict
and 22 in Brompton—or 20 above the corrected
decennial average. One hundred of the deaths were registered
in the 24 weeks ended June 17, and 68 of these in the first 12
weeks of the year. The London death-rate from whoopingcough
in 1881 was the lowest on record, only 1,961 deaths
having been assigned to this cause, whereas there would have
been 3,144 had the mortality been at the average rate of the
preceding ten years: but towards the end of the year an
epidemic commenced, and the deaths in 1882 were 4,647, or
1,526 above the average of the previous ten years, and equal to
1.20 per 1,000 inhabitants. If so great a mortality had
occurred from small-pox, what an outcry there would have been !
The destruction of infantile life is, but too commonly, somewhat
lightly regarded. But as I have had occasion to remark in
former reports, the danger of this always distressing malady is
scarcely appreciated by the general public, and least of all by
parents in the poorer classes, who, in the engrossing struggle
for existence, have little time to devote to the care of their