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98
forms of continued fever combined, were under 100, "there
would seem to be a prima facie case for adding that
disease to the list—if only for a time and experimentally,
although it would involve a large additional amount of sanitary
work in visiting infected houses, and in disinfection.
It is but too probable, however, that notification would be
at best incomplete, for in a large proportion of cases measles is
allowed to run its course without medical attendance. The
beneficial results, therefore, w ould not be so great as those
attending the notification of scarlet fever and enteric fever,
especially having regard to the fact that measles is infectious
at a very early period of the illness, and spreads rapidly
among susceptible children—that is, in effect, all children who
have not already had it. Measles, moreover, is on a different
footing from scarlet fever in this respect, that provision is made
in London for isolation in hospitals of cases of the latter
disease, whilst measles is excluded from the hospitals of the
Asylums Board. In my first monthly report for 1889 I dealt
with the question of hospital accommodation for measles, in
connection with a communication which had been addressed to
the Asylums Board by the Battersea Vestry, requesting that,
as "measles is a dangerous infectious disease of a febrile
character," the Managers would "take such steps as they might
consider advisable with a view to arrangements being made for
the reception of sufferers therefrom into their hospitals."The
Managers replied that they had no legal power to treat cases
of measles in their hospitals. I pointed out that, owing
to the early stage at which measles becomes infectious,"isolation
in hospital," if it could be obtained, "would not have the
same decisive effect as the early removal of cases of diphtheria
and scarlet fever, in preventing the spread of disease."At the
same time I observed that " admission to hospital would be of
the highest value to individual sufferers, by removing them from
homes too often wholly unfit for the treatment of a disease
which is apt, under insanitary conditions, to assume an