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110
channel for the spread of infection. The danger is intensified by
the absence of some satisfactory system of notification. It is a
deplorable fact that while the death rate in all forms of notifiable
disease in London has greatly decreased in recent years, no such
satisfactory state of things can be shown as regards these two
diseases. It cannot be urged in extenuation that these deaths
are inevitable. It is only in the poorer quarters that such a high
percentage of fatality occurs, and it is perfectly evident therefore
that most of these deaths are preventable, and that one of the
preventive measures which should be insisted on is that children
under at least five years of age should not be permitted to attend
school. The report of the recent enquiry by the Consultative
Committee of the Board of Education, at which I had the honour
of giving evidence, while admitting that it was undesirable that
such children should attend school, were not prepared to advise
their exclusion on the ground that social and economical exigencies
rendered this course impossible.
It is regrettable that the Committee could not see their way
to recommend the exclusion of these very young children. On
other grounds as well (educational and social) their attendance
at school cannot be defended. When it is remembered that some
3,000 deaths of children from the two diseases annually occur in
London, the majority of which it may safely be said are preventable,
it is a serious reflection on the sanitary administration
of the Metropolis that some more effective steps cannot be taken
to prevent this great annual loss of life.