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257
present a few insignificant or even no drainage defects.
That they are a common means of spreading the disease
indirectly by inducing a condition of low vitality, often
associated with sore throat, a condition rendering the
sufferer intensely susceptible to fall a prey on exposure
to infection, must be granted, and there is little doubt
in my own mind that in this manner the sewer openings
in the streets may have acted as one factor in swelling
the West Ham diphtheria returns. Nor is this view
controverted by the fact that the heaviest returns are
observable during the Winter months, and the lightest
returns during the Summer when the complaints of foul
smells are most rife. The foul smells may not be
noticed during the Winter, but the sewer gratings are
none the less acting as ventilators, discharging at times
noxious, if unobserved, emanations into the surrounding
air; and this, too, at the period of the year when
catarrhs of the throat and nasal passages are most
common, and the vital functions generally less able to
resist attack. With regard to the general drainage of
houses the same influence may be attributed. It is
alleged in the letter addressed to the Local Government
Board that in Forest Gate "the house drains are almost
uniformly found to be in good order." This is not so.
Mr. Roberts, who has acted as Sanitary Inspector in
the Forest Gate Ward during the present year, informs
me that he finds drainage defects as severe in character
and frequency in Forest Gate as he did while previously
inspecting in Canning Town, and my own more limited
experiences tend to confirm that statement.
4. ABSENCE OF HOME ISOLATION. West Ham may be
called, so far as the greater part of its inhabitants are
concerned, a two-storeyed, double-family, six-roomed
house town. On receipt of information as to the
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