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21
to attend school, but the fact being probably unknown to many
parents, I suggested that a circular letter should be sent to the
parents of pupils for their instruction. Such a communication, if
systematically made at the beginning of an epidemic, would probably
be the means of saving many lives, and would certainly
have the effect of checking the spread of the disease in the only
practicable way short of closing schools : a similar step might be
taken with advantage when any infectious disease is epidemic.
It is to be regretted that 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 as inevitable as teething, they naturally enough
rather like to have all of the children ill at one time, and get
the trouble over. 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 usually 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.
The deaths in London from measles in 1890 were 3291,
being 664 above the corrected decennial average, and not
far short of quadruple the number of deaths from scarlet fever.
SCARLET FEVEE,
This disease, which was the cause of 44, 26, and 28 deaths
in 1887-88-89 respectively, proved fatal to 26 persons in 1890,
the corrected decennial average being 38. Only five of the deaths
belong to the Brompton sub-district : twenty occurred in
hospitals, to which 214 out of 375 recorded cases were removed.
Of the 375 cases, 260 belong to North Kensington, viz., that