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nearest to the Hospital, has usually the lowest percentage of
Scarlet Fever, and, finally, where Fever Hospitals have existed
with crowded populations immediately outside their walls,
they have never been known to increase the Scarlet Fever
mortality of those populations (see Allbutt's system of
medicine).
35. Milk supply. I reported on the possibility of the milk
supply being the cause of infection at the beginning of the
year (see Appendix). Although the evidence implicating any
particular supply was quite inconclusive, owing to the insuperable
difficulties in tracing the origin of the milk, in the absence
of other satisfactory explanation, I am still inclined to suspect
that milk infection gave a fresh impetus to the prevalence
already existing at the commencement of 1899, as was also the
case eight years ago.
36. Unsuspected Cases.—The very mildness of the form of
Scarlet Fever lately existing, is a source of danger, for many
of the cases are so mild that either they are never suspected,
or parents easily persuade themselves that their children are
not ill enough to have 'the Fever': the result is, children
attending school in an infectious condition. I believe this is
one of the most important factors in keeping up the prevalence
of the disease, and it can only be prevented by the most careful
periodic examination of children attending school. Some
two or three school teachers render most valuable assistance
in detecting cases of infectious disease attending school, but,
from most schools, my attention has never been called to such
cases.
37. Arsenal Regulations.—The Arsenal Authorities have,
since notification began, most sedulously backed the efforts of
Sanitary Authorities, first by preventing employes from coming