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must, however, be admitted that it is difficult to prevent measles
from spreading, the disease being highly infectious from an early
stage, if not from the beginning. The circumstances, moreover, in
which the poor live in London—two or more families commonly
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, as a rule, the immediate causes of
death.
Whooping-Cough, which was the cause of 119 deaths in 1882,
and of 44 only in 1883, proved fatal to 81 persons in 1884, (all
but 13 in the Town sub-district), the corrected decennial average
being 102. Reference has been made to the insufficient 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, not unnaturally disregard an ailment which
they have come to regard as at once inevitable and not very serious.
Often enough the fatal event comes upon them as a surprise, being
due to some complicating disease of the respiratory organs, or of the
nervous system ; few deaths are registered from whooping-cough
alone. Intercurrent diseases of the chest, it is true, are not seldom
unavoidable, but the occurrence of such diseases is often due to
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 intentional unkindness. The little
ones are not, perhaps cannot be, confined to the house, even in
winter: 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, fatal to 62 persons in 1882, and to 28 only in
1883, the corrected decennial average being 62, was the cause of
the remarkably small number of 18 deaths in 1884. The disease
was not epidemic in London, the deaths being 1,200 fewer than