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39
infectious diseases. Some years ago the Asylums Board provided
facilities for the attendance of students at the Fever
Hospitals, and early in the present year the Managers provided
facilities for the acquisition of knowledge of small-pox, by
adding the Hospital Ships to the list of Hospitals available
for purposes of medical instruction. It will follow that, henceforth,
a large proportion of the young medical practitioners
will enter upon the practice of their profession with adequate
clinical acquaintance with the symptoms, and the appearance
of the rash of small-pox. It may be hoped, therefore, that
errors in diagnosis, such as in the calamitous story set
out above, will become rarer in the future.
MEASLES.
The deaths from measles in 1889, were 14 only, the
smallest total on record: it was not surprising, therefore,
that there should have been a greatly increased mortality
from this cause in 1890; and, in fact, the deaths registered,
140, were more numerous than in any previous year on
record, and 66 above the corrected decennial average. In
4891 the deaths from this cause fell to 29. In 1892 the disease
again became epidemic, the deaths being 109, viz., 91 in
the Town sub-district, and 18 in Brompton, and were 35
above the corrected decennial average: all but 6 occurred
under five years of age, 17 under one year, and 86 between
one and five years.
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 endeavoured to
show in my report for 1891 (pp. 97—106), 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