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of drinking cups, the liability of children in a feverish
condition during the early stages of sore throat to use
such drinking vessels more frequently than their
healthier schoolmates. These and many other conditions
inseparable from school life undoubtedly tend
not only to aid in the spread of the disease when once
introduced into school from without, but also tend to
what Sir R. Thorne Thome has called the "manufacture
of a type of disease of particular potency."
2. DISINFECTION. West Ham is at present without a
central disinfecting station with an efficient steam disinfector,
consequently all textile articles and bedding
have to be disinfected at home. The methods employed
are (1) disinfection by sulphur dioxide or Formalin (a
solution of formic aldehyde), (2) scrubbing of floors, etc.,
with disinfectants, and (3) stripping and cleansing the
walls. Sulphur dioxide is not a potent disinfectant, but
it does kill the diphtheria bacillus, and has the merits
of ease of application, of reaching crevices which otherwise
might escape, and of allowing dust to settle which
is subsequently removed by scrubbing. In actual
practice the above methods appear to be efficient, as
secondary cases after official disinfection are rare in the
the extreme; at the same time much greater confidence
would be felt if all fomites were submitted to the potent
action of steam.
-3. FOUL - SMELLING SEWERS AND DRAINAGE
DEFECTS. These are associated with diphtheria in
the public mind in the direct relation of cause and
effect, though no such direct relationship can be traced
to any great extent on investigation. Houses of the
worst sanitary type sometimes remain free of the
disease, while others in which diphtheria is prevalent