AUTHORITIES 5 RESPONSIBILITIES : DISCUSSION 157 



regard to the death-rate from the disease. He thought thai 

 when they were face to face with a problem like that, they 

 had got to consider whether it was not wise to adopt the 

 means by which they had been able in the past to control all 

 other infectious diseases; and whether they should not adopt 

 compulsory notification. Conferences had been held in 

 London as to the best means by which measles could be 

 grappled with, and the question of compulsory notification 

 among others had been tried. Dr. Moore in his remarks 

 referred to the attempt that was made in his own district to 

 carry out compulsory notification, and he told them it had 

 failed. He (Dr. Lenane) would refer Dr. Moore to the 

 report of one of the medical officers of the Local Govern- 

 ment Board, Dr. Thompson, who brought out a very 

 elaborate report on that question some few years ago. Dr. 

 Theodore Thompson in that report referred to attempts 

 made by certain authorities in the country to carry out a 

 system of compulsory notification, and he pointed out that 

 in his opinion the reason such authorities did not succeed in 

 the object which they had in view was not the fault of the 

 compulsory notification itself, but the ' failure to carry 

 out a very important point, and that was the proper 

 isolation of such cases. It should be borne in mind 

 that when carrying out compulsory notification proper 

 treatment must always be provided, amongst the poorer 

 classes more especially, and he did not believe that 

 any attempt on their part to deal with the disease would 

 be successful, unless they were prepared to provide adequate 

 treatment for the children of the poorer classes who were 

 suffering from measles. The death-rate in measles was 

 essentially due to the fact that such children were not given 

 the advantage of proper treatment at an early date. If 

 proper treatment could be secured to them at an early date 

 he had no doubt that along with compulsory notification and 

 prompt removal of such cases to an isolation hospital a very 

 large amount of the death-rate which they now had in their 

 district from that disease would cease. There was another 

 point which should be borne in mind, which was that they 

 did not know to what extent the disease affected the death- 

 rate of tuberculosis. They knew very well that a very large 

 number of cases of tuberculosis followed upon measles, and 

 he himself had no doubt that as a factor in the production of 

 tuberculosis a great many cases indeed were the direct 

 results of the neglect of treatment of those persons who 

 survived an attack of measles. He therefore felt that -the 

 time had arrived when something should be done in 

 providing an efficient compulsory system of notification, 



