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children under five years of age, including 36 under one year.
Eighty deaths were registered in the first half of the year, and
only 13 in the second half. Reference has already been made
to the general 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 inevitable and do not think dangerous. Often enough,
when the disease ends fatally, the event comes as a surprise,
being due' commonly to some complication—of the respiratory
organs, or of the nervous system; few deaths being registered
from whooping-cough alone. These secondary diseases cannot
always be prevented; but the occurrence of bronchitis or pneumonia,
for instance, is often due 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 (3276) were
193 above the corrected decennial average, and nearly four
times as many as those from scarlet fever. The comparatively low
case-mortality of whooping-cough, and, I may add, cf measles also,
serves in the public estimation to remove these maladies somewhat
out of the category of "dangerous infectious diseases." It
is the fact, nevertheless, that the deaths from measles and
whooping-cough far exceed the deaths from small-pox, scarlet
fever, diphtheria, and "fever" combined. Thus, in 1890, the
deaths from measles and whooping-cough respectively were 3291
and 3276 = 6567; the deaths from small-pox (4), scarlet fever
(876), diphtheria (1117), and fever" (662), being 2959 only,
or less than half the number from ligbtly-regarded measles and
whooping-cough.
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