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The circumstances, moreover, in which the poor in London
live—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 secondary affections, which, as already stated,
are generally the immediate causes of death.
Whooping-Cough which was the cause of 119 deaths
in 1882, proved fatal to 44 persons only last year, all but 6
in the Town sub-district; the corrected decennial average
being 101. Reference was made, above, to the little care
taken by parents in the humbler walks of life, to prevent
the spread of measles: the observation is perhaps even more
generally true in regard to whooping-cough, the danger
of this always distressing malady being unappreciated by
the poor, who,.in the engrossing struggle for existence, find
little time to devote to the care of their children in respect
of an ailment which they have come to regard as at once
inevitable and not very serious. Often enough the fatal
event comes as a surprise, being due to some complication,
e.g., convulsions or bronchitis, the secondary causes of many
deaths : few deaths, indeed, are returned from whoopingcough
alone. In some instances, intercurrent diseases, of the
chest for example, are unavoidable, but they are often the
result of want of care in the treatment of the little sufferers—
though I would by no means imply that such want of care
proceeds from indifference, still less from unkindness. The
little ones are not, perhaps cannot be, confined to a single
room, kept at an even temperature: they catch cold ; the
"cold" and the "cough" are not differentiated ; medical
treatment is not sought until the child is obviously very ill,
and, when it is obtained, the patient is but too frequently
beyond the reach of help.
Scarlet Fever was the cause of 28 deaths, against 62
in 1882, the corrected decennial average being 60. Of the
28 deaths 22 belong to the Town sub-district, and 6 only to
Brompton. Six of the deaths took place in hospitals, to