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Guardians," inasmuch as it would appear probable that, as
measles may be classed as a " dangerous infectious disorder,"
the Managers could, with the approval of the Local Government
Board, contract, under section 15 of the Poor Law Act, 1879,
with any Nuisance Authority, for the reception and maintenance
in their hospitals of any person suffering from this disease. As
a matter of fact, however, and for reasons to which I need not
refer here, no such contract has ever been entered into, nor do I
think it probable that the Local Government Board would
approve of the use of the Managers' Hospitals for the treatment
of measles. Measles, like diphtheria, is not" fever," in the sense
in which the term is used in the Metropolitan Poor Act, 1867 ;
but the Boaid might authorise the Managers to admit persons
suffering from measles, as they have already approved the
admission of sufferers from diphtheria. The latter disease,
however, is undoubtedly a u dangerous infectious disorder," with
a high case - mortality, and early removal of a first case,
moreover, almost certainly prevents the spread of disease by
contagion. Measles stands in a somewhat different position.
The disease is almost infinitely more common; the casemortality
is low, and it is probably infectious from the first
commencement of illness three or four days prior to the
appearance of the rash. The isolation of sufferers in hospital,
therefore, would not have the same decisive effect as the early
removal of cases of diphtheria (and scarlet fever) in preventing
the spread of disease. And it must be borne in mind that
in order to deal effectively with epidemic measles, a large
extension of hospital accommodation would be necessary ; the
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probability being that, in an ordinary epidemic, more thousands
of children suffer from the disease than hundreds from scarlet
fever in such an epidemic as that of 1887, when the epidemic
was at its highest. It is the comparatively low case-mortality
of measles, and I may add of whooping-cough also, which
seems to remove these diseases somewhat out of the category of
" dangerous infectious disorders." But unfortunately it is the
fact that the actual deaths from both measles and whooping-