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7
Table VIII. shows the average attendance of children in the London elementary schools for each
year since the Act has been in force; and Table IX. the average attendance at public elementary day
schools in England and Wales in each year during the period 1861-80. It is matter for regret that I
am unable to show the average attendance of London children at voluntary schools before 1871, for it
needs to be stated that while the Act was passed in 1870 visitors whose services were necessary for
enforcing school attendance were not appointed until 1872. Such information, however, as I have been
able to obtain leads to the belief that there was activity in provision of increased accommodation in
London voluntary schools in the beginning of the decennium 1871-80.

A further point consistent with school influence deserves passing comment. It has been pointed
out by Dr. Downes that the mortality of females from diphtheria is greater than that of males. Thus
in England and Wales in 1861-70 the male death rate at all ages was to the female death rate as 100
to 108. This difference is more marked at the school age period of life than at all ages. The statistics
of more recent years show that these differences are diminishing, and this might be due to any
circumstance such, for instance, as school life, tending to subject the two sexes to more equal conditions.

It is impossible to draw conclusions from these figures only as to how much of the prevailing
diphtheria may result from the condition which has thus relatively raised the rate of mortality at the
school age period of life, but it is obvious that disease contracted by children of school age has
opportunity for communicating itself to younger and older persons just as disease contracted by