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of the figures this year it seems to be an imperative duty on the part of
sanitarians to agitate for some reform in regard to the attitude adopted
by Local Authorities to this complaint. Personally I have no
hesitation in expressing the firm opinion that one of the first steps
should be notification. At present measles, though classed as a
zymotic disease, is not included amongst the diseases that are notifiable
under the Public Health (London) Act of 1891, so there is only
the mortality data to convey any information as to its prevalence
during any given period. Desirable as it is that the principle of
providing hospital accommodation for notifiable diseases should be
preserved, yet with the circumstances of 1896 before us I feel inclined
to modify my former opinion that notification and hospital accommodation
for measles must make their debut together. Doubtless
years will elapse before the hospital accommodation could be provided,
even supposing that the Legislature were to sanction the
necessary expenditure. That sanction, however, will take longer to
acquire than the buildings themselves, on account of the differences
of opinion which exist amongst experts on the subject. It seems to
me that with the figures before us of the prevalence of this disease,
which was the only one in 1896 in Bow which showed an excessively
epidemic tendency, the objections to notification and hospital accommodation
will be greatly weakened. In Shoreditch there were 143
deaths, in Bethnal Green 153, Whitechapel 51, St. George's 28,
Limehouse 62, Mile End 84, and in Poplar 147. The total deaths
in the Metropolis were 3,692, as against 2,628 for 1895. In May,
when the zymotic death rate in Bow rose phenomenally to 11.3 per
thousand, I presented the following report to the Sanitary Committee
:—
" I have again, as in last month's report, to draw your attention to
the prevalence and fatality of measles and whooping cough. Last
month the deaths had advanced to measles 10; whooping cough 3;
the totals for the current year having been measles 26, whooping
cough 20. But for this month only I have to report measles 26,
whooping cough 7. I trust that you will agree with me that it is but