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cases of diphtheria in the same class-room, and to include in each instance the case occurring
after such interval among his "cases in which the evidence excludes the school as the
source of infection."
In view of these methods it could not be expected that his results would closely agree with
those of Dr. Hamer. Dr. Smith publishes, however, two tables, C and D, the study of which is not
without interest. C contains a list of "cases which had attended school within seven days of first
symptoms." The cases which had been preceded by an earlier case in the same house are printed
in italics. Table D contains a list of cases under the heading "no attendance at school within seven
days of first symptoms," and again cases which had been preceded by an earlier case in the same
house are printed in italics.

It will thus be seen that whereas of the 66 children who had attended school (of whom be it
noted 59 attended the Lewisham-bridge Board or National school) within 7 days of their first symptoms
83"3 per cent, were first sufferers in their houses. On the other hand, of 71 other cases, only 43"7 per
cent, were first sufferers. These figures, therefore, point to the existence in Lewisham in the recent
outbreak of some condition special to children who were attending school.
(Signed) Shirley F. Murphy,
Medical Officer of Health.
Public Health Department,
Spring-gardens, S.W.,
27th February, 1897.