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33
The provision for the sale of Anti-toxine at the Vestry Offices
at cost price continues to be much appreciated. The opinion
that the Anti-toxine is a valuable curative agent of Diphtheria is
gaining more and more ground each year, and the fact may now be
said to be generally accepted by the profession.
There can be no gainsaying that the continued prevalence of
this disease is determined to some extent by school attendance.
Apart from statistics, it is a conclusion warranted both by common
sense and experience that the daily aggregation of a large number
of subjects at the most susceptible ages in overcrowded class-rooms,
must, where a disease is concerned which often remains unrecognised,
be responsible for some degree of spread, if the well-known behaviour
of the disease within the household continues to hold good.
The Medical Officer of Health (Mr. Shirley Murphy) of the London
County Council has placed the matter upon a solid statistical
foundation. He has shown that the increase in Diphtheria has mainly
affected the ages 3—10, and that the relative increase of the mortality
at the ages 3—10 commenced with the operations of the Elementary
Education Act of 1870. The effect which the closing of the schools
during vacation periods has in reducing the incidence of the disease
is also susceptible of statistical demonstration.
In view of these facts, and seeing the part schools play in the
dissemination of other infections, the precautions taken in the
interest of the scholars are in my opinion unsatisfactory. The
Medical Officer of Health should be kept promptly posted up as to
those absentees who are away from illness; he should possess the
power of entering and examining any scholar or scholars at any
time when he has reason to think such action desirable in the public
interest; and he should also have the power of arranging for a
medical inspection of the scholars when he considers such a step
advisable. It is contended that the Medical Officer of Health, or
some medical man acting on his behalf, should make these examinations,
since the Health Officer is best acquainted with the
behaviour of infectious disease in the neighbourhood of the school,
and the knowledge of the condition of children in the school would