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being full. This was in many cases the cause of fresh spread
of the disease; and in order to as much as possible remedy
this, the Board of Works allowed one of the wards of the
Hither-green Hospital to be used for diphtheria. This was
on October 4, and the notifications showed a reduction almost
immediately, from 21 in the week ending October 11 to 5 in
the week ending October 25.
By this date, however, the ward was full, and the area
becoming once more congested, the cases again increased in
number. A second ward was therefore opened, and cases
again removed more quickly, with a corresponding decrease
in the notifications.
The fact of there being a large Board School—the
Lewisham Bridge School—directly in the midst of the infected
area, and also the fact that a considerable number of
cases occurred in children attending school, naturally drew
our attention at once to this school; and I was in constant
communication with Dr. Smith, the Medical Officer of the
School Board, on the advisability of closing these schools.
At no time, however, in my opinion, or in his, was there
sufficient evidence as to the schools being the source of infection
to make it necessary to close them; and I think that
the strongest reason to show that the schools were not the
source of the disease, is, that in spite of their not having
been closed, the outbreak came to an end as soon as the cases
could be quickly removed to hospital. Those in favour of
closing the schools argue that the outbreak came to an end
through the parents keeping their children away from school,
and the schools in consequence being morally closed; but, as
a matter of fact, when the abatement began to take place,
there were still over 500 children attending school.
On October 10th it was decided to thoroughly fumigate
and disinfect the schools—the schools being closed from the
Saturday afternoon till the Monday morning. On October
15th, Dr. Shirley Murphy, the Medical Officer of Health
to the County Council came down, after writing to me
to make an appointment. He did not consider that there
was any reason to close the schools, as the cases were