. 
On the Epidemics of 1852-8. 467 
“The greatest number of deaths from scarlet fever occur 
among the poor, owing to the circumstances which both 
predispose to infection and render the disease more malig- 
nant; and even those causes which develop the sequels of 
the disease and render them fatal are also most prevalent in 
the lower classes. If the above amount does not comprise 
the deaths from dropsy, or other diseases consequent upon 
scarlatina, the mortality from this malady must have been 
greater than here stated. ‘The above results will show that 
there are few diseases, perhaps none, from which the general — 
amount of mortulity and of danger is greater than in scarlet 
fever ; and yet there is not one of which the pathology and 
treatment has received less attention and elucidation in 
modern times than it.” 
There are probably two causes which concur to produce 
here so many deaths from these visitations. In England 
the disease is always present, a number each year being the 
subjects of its attack while in a mild form, and therefore 
not victims to the severer epidemic visitations. In new 
countries the poison, not so large in quantity, does not act 
so constantly ; this, with the less dense population, causes 
fewer to be affected with fever in the intervals between the 
epidemic visitations. ‘The other cause I believe to be, 
that a larger number of children attain in this country to 
fourteen years of age than in Europe; but many of them 
are not robust, or fitted to bear a severe disease. 
Still it is desirable to,watch the progress of epidemics 
with care and attention, so that all local circumstances 
operating or likely to operate on them should be inyesti- 
‘gated. 
When I compare my own experience of the epidemic 
of 1842 and 8 with that of the present year, I am struck 
