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of age, including 10 under one year. Reference has already been made
to the indifference of parents in regard to the spread of measles in
their families. The observation is even more generally applicable
in regard to whooping-cough, the danger of this always distressing
malady being unappreciated by the poor, who, in the
engrossing struggle of life, pay scant attention to an ailment
which they deem at once inevitable and seldom dangerous. Often
enough, when the disease ends fatally, the event comes as a
surprise, being due commonly to some secondary disease—of the
respiratory organs, or of the nervous system: few deaths are
registered from whooping-cough alone. These secondary diseases
cannot always be prevented; but the occurrence of bronchitis or
pneumonia, for instance, is often owing to want of care in the
management of the sufferers. The little ones, it may be, are not
confined to the house; 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.
The deaths in London from whooping-cough (1749) were
1406 fewer than the decennial average. The comparatively low
case-mortality of whooping-cough, and, I may add, of measles also,
serves in the public estimation to remove these diseases somewhat
out of the category of "dangerous infectious disorders."
It is the fact, nevertheless, that the actual deaths from measles
and whooping-cough exceed the total deaths from small-pox,
scarlet fever, diphtheria, and "fever" combined. Thus, in 1889,
the deaths from measles and whooping-cough respectively were
2314 and 1749=4063; the deaths from small-pox (1), scarlet
fever (784), diphtheria (1588), and "fever" (593), being 2966
only.
SCARLET FEVER.
This disease, which was the cause of 11, 40 and 26 deaths in
1886, 1887 and 1888 respectively, proved fatal to 28 persons only
in 1889, the corrected decennial average being 41. Only three