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fined twenty shillings and three shillings costs, a somewhat inadequate penalty for such reckless
behaviour."
Diphtheria and elementary schools.
The annual reports of medical officers of health contain the following references to diphtheria
in connection with school attendance—
Paddington.—A series of cases occurred in the area west of Queen's-road, many of the sufferers
being scholars of St. Matthew's Church School. This was the only instance during the twelve months
of any special spread of disease among the children of any one school, and even in this there were so
many other factors to be considered that it is not certain that the school should be indicted.
Kensington.—Ten cases occurred in connection with the Board school in Allen-street. The
dates of notification of the cases extended from the 29th August to the 25th October.
Fulham.—"In May there was an outbreak of diphtheria among the girls in the second standard
at Harwood-road Board school, six children living in Fulham and one living in Chelsea being notified
as suffering from diphtheria." The Vestry of Fulham, acting on the recommendation of the medical
officer of health, made an order for the closing of the class-room for fourteen days. The result was
satisfactory, as apart from secondary cases occurring in houses already invaded there were only two
other cases among the children attending the school. The medical officer of health however states
that later four "children residing in a house in New King's-road were notified as suffering from
diphtheria, and on investigation it was ascertained that another member of the family who was in the
second standard in the girl's department at Harwood-road school had been ill with a sore throat about
a fortnight or three weeks before, but the illness had been of so mild a character that no medical
practitioner had been called in. This child had probably had a mild attack of diphtheria, and as she
was attending school up to May 26th, when the school was closed, it is quite possible that the
outbreak in the particular class-room originated with her."
Chelsea.—"The fall in notified cases following the closure of the schools was not at all marked
until the thirty-third week of the year, but from the thirty-third to the thirty-fifth week only three
cases at school age were notified, as against eleven in the preceding three weeks. The diminution of
diphtheria notifications in London usually commences in the thirty-third week and continues to the
thirty-sixth, and is, no doubt, dependent on antecedent school closure in the thirtieth week. In 1897
the Board schools closed on July 22nd, which is about a week earlier than usual."
St. Pancras.—In reply to inquiry as to the cause of increase of diphtheria in St. Pancras in
October, the medical officer of health informed me that the increase was due to an outbreak in the
National Schools, Islip-street, Kentish-town, and that the sanitary authority had made an order for the
closing of the schools from October 20th to the 9th November; at the same time one of the managers
promised to stop during this period the meeting of children connected with the school and various
societies, including the Band of Hope, Sunday school, and the mothers' meetings. The medical officer
of health also requested the managers of the Leighton-road Mission-hall and St. Barnabas Sunday
school, both of which some of the children attended, to take the same course.
Islington.—The medical officer of health considers the prevalence of diphtheria in Islington in
the period 1890-7, and classifies his cases in three age groups, 0-3 years, the pre-school age; 3-14
years, the school age; and 14 years and upwards, the post-school age. He shows that in the months
of June, July, August and September, the number of cases notified respectively were 56, 48, 62 and
49 at the pre-school age; 98, 136, 139, and 188 at the school age; and 247, 256, 247 and 325 at the
post-school age. He urges the necessity of excluding from school, children with throat illness, and to the
necessity of strict compliance with the rules for the guidance of teachers in the Code of Regulations of
the School Board. He instances as a case of breach of regulations the action of a teacher in allowing
two children to attend school from a house in which a case of diphtheria was known to have occurred.
The two children were kept in a room separate from that occupied at the time by other children, but
the class-room was used by other children when they had gone.
Stoke Newington.—School attendance is either alleged by the parents, or surmised by the
medical officer of health, on good grounds, to be the cause of four attacks during the year, and to be
responsible for 7.5 per cent. of the cases, as against 12.7 per cent. in the preceding year.
Hackney.—The medical officer of health reports that in 1897 schools have not appeared to be
conspicuous in causing the disease.
Holborn.—Reference is made to an outbreak of diphtheria confined to that part of the district
between the Gray's-inn-road and the Farringdon-road, the medical officer of health writes:—"There
was a much greater incidence on children of school age, and a large diminution in the number of
cases in the month of August, following closure of the schools for the holidays."
Shoreditch.—"Of the cases investigated, in 130 instances the patient was a school-going child.
In 105, the child had been attending school within one week of the onset of symptoms. In 95 cases,
the patients were not school-going children, but children, members of the same family or living under
the same roof, were attending school."
Poplar (South district).—The medical officer of health discusses prevalence of diphtheria in the
Isle of Dogs, and states that "Cubitt-town was the principal sub-division on the island where the
inhabitants suffered mostly from the complaint. The Cubitt-town and Glengall-road Board schools
were the schools in the affected area, but most of the cases were in attendance at the former school."
He communicated with the medical officer of the School Board with a view to each child having his
or her slate with pencil attached, so as to limit any infection. He adds—"Fortunately there was no
need to close any part of the school and after the Christmas holidays the disease much diminished in
the island." In connection with his expression of desire to have bacteriological examination of cases
he says—"During the prevalence of the disease children were known to have suffered from bad throats
and yet have not been notified as suffering from dipththeria. Subsequently the common symptoms
which occur after diphtheria set in thus clearly proving the patient had had the complaint." Referring
to the amount of space provided in Board schools for children, he states that—"The London School