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74
the available susceptible persons. Again, there is no evidence
that intercourse amongst school children is less frequent and
active than it was in the past, so that I fall
back provisionally, at any rate, upon the hypothesis
that the lessened incidence of infectious disease is due to
an increase in the natural insusceptibility or immunity present
in all children in varying degrees. In considering how this has
been brought about, it must be remembered that infectious
disease is usually most prevalent in the poorest and consequently
most crowded localities, amongst children who are not too well
nourished, housed or clothed. Such children more easily fall
victims to any prevalent infection than the children of better
circumstanced parents, because of their lessened resistance to
invasion. It is well known, and it has been proved experimentally,
that starvation, unsuitable diet, fatigue or exposure to excessive
heat, cold or moisture, will reduce the insusceptibility of
certain animals to certain infectious diseases, and it is not
unreasonable that these agencies will be followed by the same
results if acting upon the human organism. It is also known that
by improvement in the general health the natural immunity
against disease is increased, and there is no more certain method
of improving the general health of under-fed persons that by
proper and sufficient dieting. This has been carried out in this
Borough on a considerable scale during the last two years, and I
am inclined to believe that the effect of such feeding is showing
itself in a diminution of infectious disease, especially in that of
scarlet fever and diphtheria.
(2) The medical examination of school children with resulting
treatment is no doubt also exercising a beneficial effect
upon their general health, and will continue to act in this way so
long as it is continued; but I believe there is a special effect
being brought about by treatment directed to the removal of
adenoids and enlarged tonsils and the correction of unhealthy