their hands in their pockets waiting for physicans with rival pet theories to determine the preponderance of evidence as to whether a sore throat is produced by a Loeffler bacillus or by some other bacillus, or by a coccus. If the attending physician pronounces it diphtheria, or any quarantinable infectious disease, quarantine and isolation must be at once established, and such measures used as will best protect the public. If later it shall be found the disease is not infectious, the quarantine can be released, and no person will be injured thereby.

MEASLES.

There are two very erroneous and harmful opinions prevalent among parents, and also entertained to some extent by local boards of health, that measles are inevitable, and that the best time to have the disease is in childhood. It is a dangerous folly to so hold or teach. There is no necessity for any child to have measles, whooping cough or scarlet fever, and every case of them is evidence of negligence. They are preventable diseases, and the wanton exposure of children to them on the plea that they are children's diseases and they will have them some time is not only dangerous folly but it is criminal folly, as many have learned to their great regret.

It is probably true that over two hundred children die in Iowa annually from measles. Beside those who die many hundreds are physically disabled by having fastened on them. diseases of the lungs and air passages and of the eyes and ears. No good reason can be given for desiring a child to be sick with any disease, and what may be deemed right and safe in one case may be wrong and fatal in another. Because one child is rugged enough to throw off the disease easily is no reason why he should be turned loose and attend school or mingle with other children and be the means of communicating the disease to those less vigorous, and thus inflict pain, expense and possible death. An ounce of prevention is worth a pound It is a preventable disease. Statistics show a large percentage of deaths from it, and this is abundant reason for the efforts being made to prevent its spread and exterminate it wherever it makes its appearance.

of cure.

The report of vital statistics of Michigan for the year 1894 shows that from 1890 to 1894 there were twenty-two thousand and four cases of measles reported. There were two hundred and fifty-eight deaths. There was no quarantine nor isolation. There were also one hundred and ten cases in which quarantine and isolation were maintained, and there were no deaths. For the year 1894 forty-five per cent of deaths from measles were of children under six years old; sixty-five per cent under eleven; thirty per cent, ten to thirty, and over thirty, none. Of the cases reported over seventy-five per cent were of children under the age of eleven.

Early in the history of the State Board of Health measles was put in the list of quarantinable diseases, subject to all regulations applicable to other infectious and contagious diseases.

Scarlet fever is also one of the dreaded diseases of childhood, and a few years ago prevailed extensively over the State, because of the opposition to quarantine measures. By a sensible dread of that disease and a moderate compliance with quarantine regulations, it is rapidly disappearing. There is good reason to affirm that if quarantine and disinfection were promptly and faithfully observed, both scarlet fever and measles would be as rare as small-pox.

In England it is exceedingly rare to see or hear of a case of scarlet fever. The same method applied vigorously in cases of diphtheria, measles, whooping cough and mumps, would in time stamp out the diseases entirely.

Would not such a course be infinitely preferable to the policy of inviting these diseases and encouraging and assisting them in their demands for fresh subjects by sacrificing our beloved children to their seductive and fatal greed?

Pertinent to this article, and instructive also, is the report of Dr. R. Thorne Thorne to the Secretary of the Local Government Board of London for the year 1895. He says:

The question of measles as a cause of death in this country has engaged the attention of the medical department for several years. The death rates from most of the diseases of the zymotic class have continually decreased decade by decade, whereas measles has increased, and during the quinquennium, 1890-'94, the deaths from this disease now stand a figure higher than that for any other disease of the zymotic class except whooping cough and diarrhoea. The sum total of the deaths registered as due to measles in England and Wales during the ten years, 1885-'94, reached no less than one hundred and twenty-nine thousand four hundred and twenty-six, or a yearly mean of twelve thousand nine hundred and fifty. Now, measles is a disease the mortality from which falls almost exclusively on children; especially

This is more noteworthy
two to five years would

is it fatal to infants in the second year of life.
since, relatively to their number, children aged
appear much more prone to measles' attack than other persons, or than
infants under two years. The mortality from measles is much greater in
towns than in country places, where opportunities for intercommunication
between the healthy and the sick are more abundant than in rural areas.

In view of these and other considerations it appeared desirable to take account of those measures that are likely to avail urban or rural authorities in the prevention of measles, measures designed to meet epidemic prevalence of the disease, or directed toward such control over it on its appearance as to arrest or delay a threatened epidemic. The importance of control of the latter sort is apparent on consideration of the age at which measles is most fatal. If in any district, measles, which formerly was epidemic every other year, be so far discouraged by preventive measures as to acquire epidemicity only every fourth year, it is clear that a large number of susceptible children will, when the epidemic arrives, have reached ages at which the disease is little fatal, and in this way many lives will be saved which were formerly sacrificed to this disease.

Prominent among the difficulties in the way of preventive measures are, on the one hand, the extremely infective character of measles-especially in the early stages, before the nature of the disease is declared-and on the other, the slight estimation in which measles is held by the general public. The first step must be to obtain accurate knowledge of the persons attacked, many of whom never come under medical treatment. Every case reported or heard of must be made the subject of a personal visit. Repeated and detailed inquiries should be made by the sanitary officers in invaded households, if the spread of the disease from such houses is to be adequately controlled.

So, too, regarding schools. If preventive measures are to be of avail, they must be contrived to secure the exclusion from school of all children from any house which is invaded by measles, and if necessary of children living in the neighborhood of invaded houses, and even to all schools, Sunday and private, in the invaded neighborhood, and to other gatherings of children, before real advantage can be expected from the proceeding.

WHOOPING COUGH.

It is evident that very few people have any just conception of the magnitude of the fatality from whooping cough. To those who study vital statistics it is a disease demanding earnest consideration. By the masses it is considered a disease incident to children, of little importance, and not subject to sanitary regulation. Every mother becomes terrorized upon the appearance of scarlet fever in the vicinity of her home. Yet it is a fact that more children die from whooping cough

than scarlet fever, and nearly all the deaths are of those under five years, the majority being under one year. The census report states that for the year ending May 31, 1890, eight thousand and thirty-two children died in the United States from whooping cough; while there were only five thousand nine hundred and sixty-nine from scarlet fever.

The following statement is made from the official report of the States, for the years named:

The following table shows the deaths for the year 1895, in

These figures probably do not show more than two-thirds the actual number of deaths, but they are sufficient to indicate not only the wisdom, but the necessity for the intervention of sanitary measures to prevent the spread of whooping cough. Its ravages are greatest among the babies. It is an infectious disease, and is communicated by contact with an infected person or something which has been about an infected person. Isolation of the sick, is the only means of preventing its spread, and this often comes too late, as it is communicable before the "whoop" appears. There is a very general indifference among parents respecting this disease, as has been stated, hence, it is difficult to secure the proper and necessary isolation, during the protracted period through which it runs. Parents exercise little or no caution to prevent exposure. It is not uncommon

to hear the familiar " whoop" on the street, in railway cars, and public places.

Mothers should be especially vigilant to guard their nursing babes from exposure, for it is upon those under one year of age the fatality falls most severely. Should the disease appear in a family of children, in which there is a babe, the babe should be removed from the home at least it should be kept entirely free from all possible contact with the sick.

On the appearance of the disease in a community it is the duty of the mayor of a city or township clerk to take cognizance of it and see that measures are provided to prevent its spread. There is no necessity of shutting up adult members of the family. Children of the family should be excluded from the schools and public gatherings, and all children should be rigidly prohibited from entering the premises, which should be placarded with the danger card. Although the State Board of Health has made no official order for placarding whooping cough yet local boards should see that it is done.

HOW DISEASES ARE SPREAD.

November 30, 1895, the recorder of Rock Rapids, reporting a case of scarlet fever, said the source of contagion was supposed to be a letter received from friends in Illinois whose children at the time the letter was written were sick with scarlet fever.

Having often heard and read of contagious diseases being communicated by letter and by articles of wearing apparel, request was made for further investigation, and the following reply was received:

Pursuant to request I have investigated the matter and find this letter was received last December (1894), and after being read was laid away. Three days before the child was taken sick the mother was looking over some old letters and the children were around her. When this letter was reached the little girl exclaimed, "There is auntie's letter," and proceeded to open it out and held it some little time. The letter was written by the mother's sister, whom she intended to visit during the holidays, and told them not to come as their children were then all sick with scarlet fever.

There had been no previous cases of scarlet fever in Rock Rapids, and this child had, so far as known, had no other possible opportunity to be exposed.