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tion of their pupils by an outbreak. An epidemic is sometimes,
as in 1890, brought to an end on the occurrence of the
long holidays. With a view to prevent the spread of the
disease through the agency ot 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. I suggested, therefore, that a
circular letter should be sent to the parents of pupils for
their instruction; but this course was not adopted. Such a
communication, if systematically made at the beginning of
an epidemic, would probably be the means of saving many
lives, and it would certainly have the effect of checking the
spread of measles in the only practicable way short of closing
schools.
It is to be regretted that comparatively little care is
taken by parents among the poorer classes to prevent the
spread of measles. Not regarding it as a serious disease;
considering it, moreover, to be as inevitable as teething, they
naturally enough rather like to have all of the children ill
at one time, and get the trouble over. It must be allowed,
however, that it is difficult to prevent measles from spreading,
the disease being highly infectious from an early stage, if not
from the commencement of the attack. The circumstances,
moreover, in which the poor live in London—two or more
families usually occupying one house, and using a common
staircase—almost preclude the possibility of isolation. But
more care might be taken to protect the sufferers against
secondary affections, of the lungs, &c. which are, as a rule,
the immediate causes of death. I entertain no doubt that
many lives might be saved were it practicable to isolate the
little sufferers in hospital, especially such as live in