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and premises where these measures are necessary. In appropriate
circumstances the head teachers of schools are notified and the
London County Council regulations with regard to exclusion of
both patients and contacts are enforced. There are two exceptions
to this general arrangement. All cases of tuberculosis are
dealt with directly by means of the Tuberculosis Dispensary
organisation, visits being paid at regular intervals to the homes of
all notified patients, and in the case of measles and whooping
cough, since so many of the patients are children, the visiting is
done by the Health Visitors and not by the Sanitary Inspectors.
Special enquiries of any kind in connection with infectious diseases
are made by the Sanitary Inspector, and the body of a person who
has died from any infectious disease is not allowed to remain at
home or to return home from hospital, unless the Sanitary Inspector
is able to satisfy me that this procedure would be absolutely
safe and reasonable.
DIPHTHERIA.
The number of cases of diphtheria notified during the year
was 167 ; this is the lowest figure recorded in the borough for
32 years. Of these patients, in 30 cases the diagnosis of diphtheria
was not confirmed, so that the actual number of cases of diphtheria
which occurred in the borough last year was 137. When it is
remembered that last year's net figure of 180 was the lowest
recorded since 1910, I feel sure that the Council will receive
the present low record with pleasure. I do not think that
it would be either wise or fair to attribute this reduction to
any particular cause, but at the same time the vigilance of the
general practitioners and the work of the Schick Clinics must have
played a part in securing this reduction. As an illustration both
of the value of Schick immunisation, and of the excellent work
of the general practitioners and of the co-operation between this
Department, the private doctor and the London County Council as
the infectious hospitals authority, I wish to record the following
notes. A child was notified to me as suffering from diphtheria
on 28th August and removed to hospital at once. She had been