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London County Council that we should look for assistance in
appointing a permanent referee.
We will assume that a doubtful case breaks out in a
large business establishment where means of isolation are
difficult. For the medical attendant to have the patient
removed on suspicion will do great harm to the proprietor, and
will certainly lead to unpleasant relations between the parties
concerned, to say the least, if it should not at the Wharf be
considered a case of small-pox. If, on the other hand, the
patient be kept at home, and other employes contract smallpox,
the public health necessarily suffers.
The total number of deaths from measles was 79; of
these 29 occurred in the two divisions of Camberwell and 26 in
Peckham.
Last year there were 100 fatal cases of this disease, of
which 41 came from Peckham. At first there was but little
improvement in the delay in notification of this disease that
we have experienced in previous years. On receiving information
from a school as to the existence of this disease in a given
house, the inspector learns at his visit that the child has recovered
or in other cases there is a denial on the part of the
parent that any illness whatever exists in the house. Towards
the end of the year there was an improvement in both
these conditions, i.e., earlier and more accurate information.
As I have previously pointed out, the punitive clauses
of the public health are practically inoperative owing to the
lack of provision for notification, and all parents have to do to
avoid any interference on the part of the authority is to assert
that the children have not suffered from the disease. In the
early part of the year I reported an instance to your Committee
where the people refused either to allow us to disinfect
and on the other hand equally to send us a certificate stating
that they had disinfected to our satisfaction. As we had no
evidence beyond that of the hearsay description that there had
been measles in the house, the Committee decided that no
action could be taken. At the same time the fact of our
insisting on disinfection and yet at the same time being unable
to enforce it is an anomalous state of things which can only
be properly dealt with by the term applied in altogether
different circumstances, namely, " ending or mending."
Up to the present year the Public Health Committee