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29
record, and were 66 above the corrected decennial average.
In 1891 the deaths from this cause fell to 29, viz., 20 in the
Town sub-district, and 9 in Brompton, and were 49 below the
corrected average : all but 4 occurred under five years of age,
and 6 under one year.
Measles is not one of the diseases required to be notified
to the Medical Officer of Health under the provisions of the
Public Health (London) Act, 1891; and, as I have shown in
another part of this report, it remains to be proved that any
great advantage would accrue from its addition to the list.
The disease is often spread through the agency of
schools. It is probable, therefore, that the duration of an
epidemic might be shortened by the closure of schools, which
are not seldom deprived of a large proportion of their pupils
by an outbreak. An epidemic is sometimes, as in 1890,
brought to an end by the occurrence of the long holidays.
With a view to prevent the spread of the disease through the
agency of public elementary schools, I addressed a letter, at
the commencement of the epidemic in that year, to the
Superintendent of Visitors of the Chelsea Division, pointing
out the desirability of an effort being made to exclude from
the schools all children from houses where measles existed.
The School Board do not allow children living in infected
houses to attend school, a fact probably unknown to
many parents. 1 suggested therefore, 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 measles in the only practicable way short of
closing schools : a similar step might be taken with advantage
when any infectious disease is epidemic amongst children.
It is to be regretted that comparatively little care is
taken by parents among the poorer classes to prevent the