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grossing struggle of life, pay scant attention to an ailment
which they deem inevitable and do not regard as 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 not seldom 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 (2876) were
29 below the corrected 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 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 1891, the deaths from measles
and whooping-cough respectively, were 1807 and 2876=4683 ;
the deaths from small-pox (8), scarlet fever (589), diphtheria
(1361), and " fever" (597), being 2555 only, or little more than
half the number from lightly-regarded measles and whoopingcough.
FEVER.
No death was registered from Typhus Fever, and only
one from Simple Continued Fever. The deaths from Enteric
Fever were 24, against 21, 19, and 15 respectively, in the
three preceding years ; they were five above the corrected
decennial average. Nineteen of the deaths were registered