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7
to direct infection in the playground, especially as a considerable
proportion of the cases occurred amongst children
attending the school, who lived in streets at some distance
away. From the date of the closing of the schools for the
holidays, and subsequent shutting up of the playground, the
outbreak diminished, and soon ceased. I am by on means
satisfied as regards diphtheria, that the shutting up of schools
is advisable for protection of the scholars; but I am fully
persuaded that the closing of the playground is important, and
should always be adopted under similar circumstances. In
several instances four cases of the disease occurred in one house,
almost simultaneously, that is to say within a few days of the first
case. In not one of these could the original source of infection
be traced, and in all instances the disease was confined to one
family, although other families were in the house. In one
instance the wall of the room was damp in consequence of the
rainwater pipe being stopped up; in one or two the drains were
defective, but in most no defect in the drainage or other sanitary
arrangements were found. The total number of cases reported
to me during the year was 125, of deaths 72, the majority
having occurred in the months of May and November.
The removal of persons affected with the disease to the
Metropolitan Hospitals, which was not then earned out, is
likely to be very beneficial, and if it had been possible during
the epidemic amongst the Detmold Road scholars, would
probably have prevented many cases and some deaths.
The question of closing schools when infectious diseases
are prevalent amongst the scholars is one concerning which
much may be said both for and against. One reason against
the closing is that children will play together in the streets if
not attending school, so that those from infected houses may
mix with others not infected. Speedy removal of the sick will,
however, to a great extent remove this risk. In practice I find
that closing the playgrounds and shutting out all children
from infected houses, although there may not be disease in