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not be out of place to point out the absurdity of neglecting to
remove the known sources of infection, merely because a certain
number of the unknown are bound to be passed over. The very
uncertainty of the mode of infection in two-thirds of the total cases
may be taken as evidence that the grosser and more obvious sources
of infection can in most instances be robbed of their power for harm
by prompt removal and disinfection. The failure of Scarlet Fever
to spread in the class-rooms of schools is in the first place due to
the fact that the greater number of patients are too ill to attend
school on the day of onset, and in the second place to early notification,
which enables the contacts to lie removed from school and
quarantined immediately they have become a source of danger.
The absence of school infection is a valuable criterion of the success
of preventative measures, and a proof that, at least as far as Scarlet
Fever is concerned, school attendance cannot be represented as an
added source of danger to child life under an effective system of
isolation.
Diphtheria and School Influence.—Sixty cases of Diphtheria,
occurring during the first half of the year, were investigated with
reference to school infection, and more particularly to class-room
infection, a school and class record being kept as for Scarlet Fever,
Four cases were traced to schools, but only one of these had actually
sat in the same class with a diphtheria contact. The infection
was in every instance indirect. The spread of the disease seems
to have been less influenced by school attendance than the spread
of Scarlet Fever, and the same deductions hold good for both. It
should perhaps be added that the inferences drawn have been based
on the experience of the Borough of Finsbury, and that their
value is consequently comparative rather than absolute.
ENTERIC FEVER.
In Finsbury during 1904 there were only 40 cases of Typhoid
or Enteric Fever. There were 65 cases in 1901, 77 in 1902, and
47 in 1903. There were in 1904 eight deaths among the 40 cases
removed to hospital for treatment. This number of deaths gives