Measles in pregnancy is also very rare, but when it does occur it is a serious disease. Gestation is interrupted in 55 per cent. of the cases, and the mortality is 15 per cent. for the women. The same moral and related conditions that obtain in scarlatina are found in measles. There is a marked tendency to hemorrhage and pneumonia. Of eleven cases reported by Klotz,[147] nine aborted. [147] _Archiv. f. Gyn._, vol. xxix, p. 448. In epidemics of Asiatic cholera the mortality among pregnant women is extremely high. In the Hamburg epidemic of 1897, fifty-seven per cent. of the pregnant women affected died. Abortion is very frequent because of the hemorrhagic endometritis. The mortality for all patients in Asiatic cholera is very great--almost 50 per cent. at the beginning of the epidemic. Typhus fever is the ship or famine fever of 1847. It is very rare now. When it does occur it is about three times as fatal as typhoid. It is a disease of poverty and war, and is spread largely by the body-louse, as happened in Serbia in 1915. Skilled hygiene, however, soon gains control of the epidemic. Erysipelas in pregnancy is rare, but not infrequent after delivery. In the puerperium it appears commonly as a septic infection in abrasions about the parturient canal. When it starts on the face, scalp, or breast the prognosis is relatively favorable, but even then it causes death; when it starts on the genitalia it has a mortality of 43 per cent. Erysipelas causes abortion. As it begins from pus bacteria, it is not seen so frequently now as formerly, owing to greater attention to asepsis. In the puerperium it is often an infection brought on by dirty midwives or physicians. Malaria, if severe, may interrupt gestation through fever or cachexia. During labor in such cases the uterine action is feeble, and hemorrhages are common after delivery. By proper treatment during pregnancy these evils can be averted. The infection is spread from one malaria patient to another by a mosquito (_Anopheles_), as yellow fever is spread by another mosquito (_Stegomyia fasciata_). Pulmonary tuberculosis in pregnancy is somewhat frequent; the estimate is that about 32,000 tubercular women become pregnant annually in the United States; and obstetricians incline to the opinion that pregnancy commonly, though not always, makes the tuberculosis worse. Nearly all agree that the combined effect of pregnancy, the puerperium, and lactation is a grave burden on the consumptive and lowers the power of resistance. Trembley of the Saranac Lake Sanitarium reported that 63 per cent. of 240 tubercular married women under his observation gave a history which showed that the disease was first recognized during pregnancy or the puerperium. Schauta's clinic found such origins in 29 per cent. Fisberg, Funk, Jacob, Panwitz, and other observers, in a series of 1100 cases, said 39 per cent. of these women thought the disease began during pregnancy or the puerperium.