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hospital. As time wont on, the organisms in these 37 throats became less and less typical in form
(although some remained typical for a considerable time), and by June 15th all had disappeared. So soon
as the children were free of infection they were removed to a home in the country, but one of the
children who returned from hospital on the previous day brought with her the infection of scarlet fever,
which she developed on the night of the party's arrival in the country, and also infected several others.
The premises during their absence were thoroughly cleansed, and it was hoped on their return that
there would be no re-appearance of either disease. Unfortunately several cases occurred in November
and December, and were apparently coincident with the return of one of the girls from hospital where
she had been for six months. The outbreak was again stopped by the giving of a dose of antitoxic
serum to the remaining children."
Holborn—" For five weeks, from the 20th August, there was a small outbreak, limited to a
small portion of the western part of the district, for, of 27 cases notified in the whole district in
this period, 23 occurred in the small portion west of Lamb's Conduit-street, north of Theobald'sroad,
the northern boundary being formed by East-street, Boswell-court, and Gage-street. Of the
remaining four cases, two occurred at houses near the same area first mentioned. In many cases
the transfer of infection from person to person could be traced. Many of the children of the neighbourhood
play together in the streets after school hours."
Aewington—"Two spots, one at Lion-buildings and the other at Guinness's-buildings,
Brandon-street, were much affected in August. In this epidemic of diphtheria I was astonished to
see how the disease cropped up in different parish of the parish, for, although the particular house
was thoroughly disinfected after the speedy removal of the patient to hospital, and no further case
occurred in the family, yet the disease made its appearance at spots the most unlikely imaginable,
and the patient affected was very often a child that had not been out of the house for weeks past,
nor in contact with school children. I believe that this diphtheria is in a large measure due to the
folding of the subsoil by sewage during severe rain storms, of which we have all complained for
years past. In fact, the commencement in the increase of diphtheria appears to coincide with the
time at which complaints were first made of the periodic flooding of different parts of the parish.
I am sure that this matter of flooding calls for the serious attention of the London County Council
in regard to the capacity of their sewers."
Wandsworth (Clapham)—Reference is made to 45 cases which occurred in the months of
September and October, and to a less extent in November, in Cornland-grove, Union-grove, and
the streets adjacent thereto. "It was not possible to point to any school, or part of a school, that
appeared to be specially spreading infection, children taken ill having been attending all the
elementary schools in the neighbourhood, viz., Gaskell-street and New-road Board Schools, and the
St. John's and Christ Church Parochial Schools. . . Besides these cases, others, not in welldefined
groups, were distributed throughout the sub-district, and in no instance was there any evidence
that a milk supply was instrumental in spreading the disease."
Diphtheria and elementary schools.
The annual reports of medical officers of health give the following information concerning
the prevalence of diphtheria among school children—
Paddington—During the last six months of the year 12 primary attacks of children attending
the Harrow-road Board School, and 9 other primary cases occurred in families sending
children to this school. All the school children attacked, except one, attended the girls' and
infants' schools; these schools having the same entrance and playground. The medical officer of
health states that he regards this series as " very suggestive."
Fulham—A table is published showing the number of children attending each of the Board
and other elementary schools in Fulham who were certified in each month to be suffering from
diphtheria. The totals are as follows—
January 17 April 11 July 34 October 28
February 22 May 21 August 7 November 18
March 14 June 29 September 17 December 16
Dr. Jackson's annual report contains the following statement—
"In the following instances in which three or more cases occurred in one class-room, the prompt
closure of the affected class-room, together with the exclusion of the children living in the same house
as the children attending that class-room, was attended with successful results.
"Between May 23rd and 26th there were four cases among children attending class-room E in the
infants' department of St. Dunstan's School, and the room was in consequence closed on May 27th until
June 13th, and on May 30th two cases having occurred in class-room F in the same department, that
room was also closed until the same day. There were subsequently five other cases among children who
had been attending the affected class-rooms, but none among the children in the rest of the school."
"Between June 18th and 20th three cases of diphtheria were reported in class-room D. in the infants'
department of William-street Board School, and on bacteriological examination it was also ascertained
that another child must have been attending that class while suffering from a mild attack of the disease.
The room was at once closed at the request of the vestry for a fortnight, and though two other children
belonging to the same class were subsequently affected, there were no other cases in the rest of the
school.
"On October 10th and 11th four children attending class-room E of the infants' department of
Ackman-road Board School were notified as suffering from diphtheria, and the room was closed until
October 26th. Four other children who had been attending the class were subsequently notified, but
with the exception of four secondary cases occurring in the families of the affected children in class-room
E, there were no other cases in the school until October 30th.
" It was subsequently ascertained that a child had been attending classroom E between October 1st
and October 10th, who from the results of a bacteriological examination had undoubtedly been suffering
at the time from a mild attack of diphtheria."
Chelsea—" The fall in notified cases following the closure of the schools at midsummer
was well marked in the home district; but in Kensal-town eleven cases of school age were notified
during the four weeks following the closure of the schools, as against seven in the preceding four
weeks. The decline in Kensal-town set in with the thirty-third week of the year, some three
weeks after school closure, only two cases of school age being notified from the thirty-third to the
thirty-sixth weeks, as against eleven cases in the four weeks preceding the thirty-third week."