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of a small degree of severity are difficult to recognise, and at the
same time, if unrecognised, are liable to spread the disease; then, if
samples of the secretions are taken from the throat, even though the
bacteriological examination shows absence of diphtheritic germs, a
fee would possibly be payable.
"If the Board School Authorities would not re-admit a patient
until such an examination had been properly made, the spread of
diphtheria would, doubtlessly, be mitigated (this examination has
been done in the case of a private school outside the district); but
among the poor, who is to pay Practitioners for this examination,
which may have to be repeated: the Sanitary Authority or the
School Board ?
"It is very largely agreed that since the coming into force of the
Education Act of 1870, diphtheria has prevailed in towns, and this
fact is no doubt due to the crowding together of children in Schools.
"One Practitioner, in his reply, suggested that all Board Schools
should be closed six months in order to stamp out the epidemic,
which he stated had been" going on for ten years.
"There are cases notified as diphtheria which rapidly improve
in a few days, and are certified by the Medical Practitioners as
recovered. Before advising the Committee further in the matter,
I decided in the early part of the year 1898, to prevent—as far as
I was able—children returning to School within four weeks after
notification, and not to have premises disinfected within that period.
A space for inserting the date of the notification has been printed on
the post cards left at infected houses, so that the Medical Practitioner
can see the time which has elapsed before signing the cards, and
Practitioners have been constantly communicated with respecting their
certificates of recovery, and their attention called to the desirability
that not less than a month should elapse before disinfection, from
the date of notification.