EVOLUTION AGAINST DISEASE 153 



cervical and submaxillary regions, and in the groin, etc., not 

 a few had parotid abscess with suppuration. Numerous 

 abortions and cases of premature labour occurred, but none 

 died with ordinary treatment. Single and multiple abscesses 

 are an every-day occurrence here, but these have multiplied 

 almost tenfold since the advent of measles. Before the rash 

 had disappeared a large number of adults passed intestinal 

 worms by the mouth. 



" Now that nearly two months have elapsed since the last 

 case of fever and rash, a mild persistent form of intermittent 

 fever is prevailing. This with glandular and respiratory 

 affections are the most common ailments at this season. 



" In the missionary dispensary I am daily seeing cases of 

 sickness the starting point of which was measles. The two 

 epidemics of influenza at the end of 1891 and January 1893 

 increased the tendency of Sarnoans to chest affections. 

 Measles will be found to have still further intensified their 

 tendency to respiratory diseases ; and the frequent deaths as 

 well as the many debilitated natives one daily meets with, 

 give evidence that we have not as yet reached the end of the 

 measles epidemic an epidemic which will long be remem- 

 bered, as not one of the entire population seems to have 

 escaped/' l 



255. Dr. Davis is doubtless right in attributing a great 

 proportion of the deaths in the Samoan epidemic to improper 

 treatment, but the conditions in that benign climate can 

 hardly be worse than those to which little children are ex- 

 posed by the ignorant inhabitants of our slums. Neverthe- 

 less the latter do not suffer from sequelae to anything like the 

 same extent. 



256. Many epidemics of whooping-cough have occurred 

 in the New World. 2 Last year (1903) it was said to be de- 

 populating New Guinea. The disease is not very amenable 

 to treatment, but as seen in adult Europeans it is not one 

 which, especially in a warm climate, entirely incapacitates 

 the sufferer from the ordinary duties of life. A widespread 

 epidemic in an English colony, for example, would hardly 

 result in decimation. 



257. Small-pox also makes frightful ravages in communities 

 that have had no previous experience of it, but, here again, the 

 high mortality is undoubtedly due in part to the universal 

 nature of the epidemic. The sick are left unattended. But, 

 as in the case of measles, though many widespread epi- 



1 Davis, British Medical Journal, May 18, 1894. 

 2 Hirsch, vol. iii., pp. 28-44. 



