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18
decennial average. One hundred and sixteen of the deaths
occurred under five years of age, including 22 under one year.
The disease was more or less prevalent throughout the year,
seeing that it appeared as a cause of death in all but one of my
thirteen four-weekly reports. Sixty-eight, or more than half
of the deaths, however, occurred in the last quarter of the year
(vide Table, page 16). In the majority of the fatal cases, some
intercurrent disease—of the respiratory organs usually—complicating
the original malady, was the immediate cause of death.
Comparatively little care is taken by parents among the poorer
classes to prevent the spread of measles, Not regarding it as a
serious disease, considering it, moreover, to be just as inevitable
as teething, they naturally enough rather like to have all of the
children down with it at one time. We must allow, however,
that it is difficult to prevent measles from spreading, the
disease being highly infectious from an early stage, if not
from the commencement of the attack. The circumstances,
moreover, in which the poor live in London—two or more
families generally occupying one house and using a common
staircase—almost preclude the possibility of isolation. But
more care might be taken to protect the sufferers against
secondary affections, which, as already stated, are, as a rule, the
immediate causes of death.
There was a very serious outbreak of measles in London,
commencing about the first week in October, after which the
mortality rose very rapidly to a maximum in the middle of
December, when as many as 184 deaths were registered in a single
week. The Registrar-General remarked in his Annual Summary
for 1887 that " a very insignificant proportion of the deaths
from measles occur in hospitals, and the tendency on the part of
the public to estimate the prevalence of a disease merely by the
pressure to which it subjects hospital authorities is well illustrated
by the fact that while much alarm was felt as to scarlet
fever, which was in reality less than averagely prevalent, no
such general alarm was felt as to measles which was more than