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" Mumps, for such time as the medical attendant dealing with the case deems necessary, or in cases where
there is no medical attendant, for three weeks.
" Chicken-Pox, for two weeks.
" Whooping Cough, for two weeks."
It is just possible that some little friction may occur locally in the working of these rules till they
get known, but on enquiry it was found that they met with general approval from the Metropolitan
Medical Officers and were in force a year ago in Brighton, and subsequently in Bristol.
The general rule is to accept the suggestions made by the local sanitary authority or
the medical officer of health in all cases even if such suggestions differ from the Code. It is to be
hoped, however, that all these regulations will soon be modernised to agree with the Council's Code.
Disinfection of school rooms where closure has taken place is generally carried out by the local
authority, but a feeling is now gaining ground that in the case of measles the value of disinfection is
scarcely worth its cost.
In certain other diseases which, whilst extremely objectionable, are not fatal, especially in the
case of people who allow their children to be habitually verminous, or send them to school with contagions,
or refuse to adopt means to get rid of such disorders as scabies, ringworm or favus, some
power is necessary for compelling such people to cease the nuisance that they cause other persons.
The Paddington Borough Council have drawn attention to this, more particularly in the case of ringworm,
which now should be regarded as capable of cure in a month by the use of Rontgen rays.
It will be seen that in the working of these rules considerably increased discretion is given to the
teachers. This is as it should be, but it is almost asking too much to require teachers to act against
their own personal interests in decisions which are doubtful. When a question arises in matters of infection
it is always best to adopt the safest course and exclude the child, but such a course penalises
the teacher by reducing the attendance, and it is on attendance that grading and salary depend.
Whether the school is closed for epidemics, or whether the attendance is reduced by illness, not only
have the local Education Authorities to suffer indirectly through the illness, but they have rightly to
continue to pay teachers' salaries and school expenses. It is therefore unjust that the share of these
expenses in thelmperial Grant formerly paid under Article 101* of the old codes should have been withdrawn.
Apart from this failure to contribute the just share of the cost of the school, which came roughly
to some 2 per cent. of the grants, it is a premium on a teacher to act in doubtful cases against the public
interest, and indirectly the step forward in the bacteriological selection of carrier cases suspected of
diphtheria will cause increased cost through loss of attendance grant.
The time has now come with the progress of knowledge, especially in the last four years, to reopen
this question and to press on the Board of Education the necessity for allowing the epidemic grant as a
national insurance against the school diffusion of disease, and a means of allowing sufficient prolongation
of the convalescence period where children have been suffering from zymotic diseases.
In connection with infectious diseases, insufficient attention appears to have been given to
movement of the child population. On looking through the reports of suburban or rural
districts, and also of charitable societies, one is struck with the frequency with which outbreaks are
traced to visitors from London. It is not at all improbable that the majority of the whole
child population of London has some sort of a journey to the country in the summer.
During the summer holidays possibly a reduction of 20 per cent. takes place in the class forming
the elementary school population. This is a point on which some enquiry will be made during the summer
as it has very obvious bearings on the relations of infectious disease, the schools, and the public health.
SMALL-POX AND VACCINATION.
During the spring a few cases of small-pox occurred in several schools in the north-east district.
A girl, D.W., aged 10, was found to be suffering from small-pox on February 17th; she had been in
attendance at Teesdale-street school on February 9th. Another girl, 0.C., who had been last at school
on February 8th, was also found to have small-pox. As they resided in widely separated districts and
there was a possibility of an outbreak showing itself within a few days the school was visited by Dr.
Tyrrell, who examined the children, and at the same time, acting on my instructions, ascertained by
inspection what children were vaccinated. The numbers arc of considerable interest.

Unfortunately, the scientific question of protection from small-pox by vaccination is not clearly
distinguished from the other question of whether vaccination should be compulsory by law. The
question of the enormous protection afforded by vaccination against small-pox must be taken as a
fact as soundly established as any matter of scientific importance in our daily life, the other subject