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35
The decrease and subsequent increase were therefore most marked at the school age period of
life.
The frequency with which diphtheria behaves in this manner, and the similarity between the
behaviour of diphtheria and scarlet fever, tend to confirm the view already expressed.
In 1895 the greatest incidence of disease was upon the eastern districts of London generally, but
the district of Greenwich had the highest case rate (5.l cases per 1,000 of population). St. George,
Hanover-square, and Lee had the lowest case rates (1.2). Again, the eastern districts generally had
the highest death rates, St. George-in-the-East having a rate of 1.06 per 1,000 of population. This,
however, was equalled by the death rate of Greenwich. The district having the lowest death rate was
Stoke Newington.

The reports of the medical officers of health of the following districts contain references to the
spread of diphtheria among school children.
Fulham.—The report contains a table showing the number of children attending the London
School Board's and other elementary schools in Fulham who were notified in each month to be
suffering from diphtheria. The totals in this table are as follows:—
January 12
February 4
March 8
April 5
May 3
June 22
July 32
August 11
September 16
October 28
November 23
December 25
* See footnote (2), page 10.