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examination made of every case which has been notified as
diphtheria. In the case of the Metropolitan Asylums Board's
hospitals I understand that these examinations are made as a
matter of routine before the child is returned to its home as
cured, but in the case of those children who have been kept at
home the whole time, this precautionary measure is not so
systematically carried out by the medical men in attendance.
We invariably send a letter to the head of the house where a
child is attacked by this disease, pointing out that it will not be
possible for the children to attend school until notice has been
sent by the Council to the head teacher. Some of the
authorities of the Board Schools have been most careful in
refusing to allow such children to attend school until they
have communicated with me, but I cannot by any means pay
the same compliment to all, for I have found in many cases
that children have been taken back without any certificate of
disinfection from us, and without a bacteriological examination
having been made of the throat. Now that there are facilities
for the absolutely gratuitous examination of such cases, there
can be no reason why the opportunities so provided should not
be used by all the medical men in the Parish, and it
would save many fresh cases if all the teachers were to
satisfy themselves that this had been done before re-admitting
the children who have either been notified as suffering from
this disease, or have come from an infected house.
I give below the percentage of fatal cases in relation to
the number of persons attacked by diphtheria and scarlet fever
since 1895.

xii.