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24
and it is the fact that its spread was commonly the result of
keeping patients at home under circumstances that rendered
nugatory any attempts at isolation.
The following cases may be cited as illustrations of the spread
of disease, that might have heen prevented by the removal of a
first case
A carpenter, aged 30, fell ill on December 5tli. Two of his children had been
attacked on the 3rd and 9th November respectively. The illness of the children
was concealed, and the father did not fall ill until a time at which he might
well have imagined that all danger of contagion had passed away.
A child, aged 4, fell ill, and the parents refused to let him go to hospital.
Three other children contracted the disease: the first child and the third
attacked, died. There was plenty of time to have prevented the occurrence of
the second and following cases by the removal of the first case, but the parents
refused to allow the child, and the other children, subsequently, to go to hospital,
much to their regret, afterwards frankly confessed.
A child was taken ill; the disease being mild was mistaken for measles, and
no doctor was called in. A young man took the disease, and was removed to
hospital. In the same room with him there lodged another man employed
at a confectioner's, and who continued at his work for some weeks in ignorance
of the nature of the child's indisposition.
In another house, a married woman, aged 34, contracted the disease from
her two children, whom she would not allow to go to hospital.
In two families there were four and five cases respectively, the second and
subsequent cases in each family resulting from concealment of the primary case.
In another family a child was found going to school while the skin was
actively "peeling"; two other children were found to be ill at home at the
same time, and two cases occurred subsequently; four of the patients were
removed to hospital.
Of the 202 cases, some 40 in all, were "concealed" cases,
that might have been removed to hospital with advantage,
irrespective of 50 (usually concealed) cases, the removal of which
appeared to be'unnecessary. In about 30 cases there was absolute
refusal to allow the children to be removed, with what results,
so far as known, has been indicated above. A few cases were,
as usual, imported.
Diphtheria, the mortality from which was in excess in
London as a whole in 1884, was the registered cause of 17
deaths only, in Kensington, or 5 below the corrected decennial
average; 9 in the Town registration sub-district; and 8 in