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Dr. Abrahams shewed last year that the infectivity of favus was not great. Dust collected
from various parts of the school failed to give any favus cultures, thus shewing that the risk of re-infection
in the school is not great. Treatment has been beyond the scope of the work, but Dr. Abrahams has
supervised sanitary arrangements which prevent the dissemination of the fungus, and he also sees that
any treatment ordered by doctors or hospitals is regularly carried out. On the child's admission, the
consent of its parents being obtained, the hair is cropped short, and this is repeated weekly. This has
been done in all but three cases. The children who use applications under medical advice bring their
ointments or lotions to school, where the nurse takes charge and applies them at the stated times. Each
child has its own head-cloth, and these are washed by the nurse. In many cases when admitted the
head is covered with a thick mass of crusts, and the cleansing by poulticing is often a tedious process
of many weeks or even months duration. A considerable number of the children have no treatment;
some have given up attendance at hospital, having seen no benefit; others have been discharged "cured,"
or " further treatment unnecessary," others again are neglected through the ignorance or stupidity
of relatives. In these cases the following sanitary measure has been adopted as a hygienic routine,
not in the hope of cure, but as a means of preventing infection:—The head is kept shaved or closecropped
and is washed twice a week with 1 in 1,000 solution of perchloride of mercury. Every morning
and evening the affected parts are well rubbed. Notes have been kept of the course of cases. Thirteen
of the children were submitted to a change of treatment during the year, so that the cases appear below
as 103 instead of 90. The records are the course of cases up till March 31st. They are not intended
in any way as criticism, merely as a statement of facts. Cases recorded as cured are those in which
repeated microscopic examinations failed to detect the fungus.
Ten cases untreated. In three the parents refused to allow the hair to be cut; in others the
process of cleansing was still incomplete. Thirty cases treated at the London Hospital, without the use
of X-rays, but with various lotions or ointments. Twenty-eight cases treated at the London Hospital
with X-rays. Epilation usually resulted, but was hardly ever complete. The affected hairs appeared
to be the most resistent. The fungus was more than once found in the fine down returning after epilation.
The epilation produced a temporary appearance of improvement, but the figures shew the ultimate
result. Thirteen cases simply undergoing the hygienic routine of the school, most of them had had
previous treatment; some showed improvement in a month, some were unchanged after six months.
Four cases treated at Goulston-street Dispensary.
Three cases treated by Milofsky's depilatories and leeches.
Two cases treated by light at Guy's Hospital improved at first, but subsequently relapsed and
became worse.

These statistics bear out the plea put forward last year that to render the Favus school efficient
as a means of stamping out the disease regular treatment must be undertaken there. It has now been
resolved to do this, and the formal certificate of the Board of Education for recognition as a special
school under the Act of 1899 is only awaited, when the Council will have powers to treat the children
at the school. Having had considerable experience of the actual treatment of favus no medical treatment
shewing such successful results as the school routine has accomplished, has hitherto been known
to me. Meanwhile Dr. Abrahams reports that he is beginning to feel that in all but the most inveterate
cases the routine instituted—hair-cropping, repeated washing with solution of perchloride and mercurial
inunction really affords a reasonable hope of cure. For the worst cases, and as an accelerator to the
others, the X-ray treatment is required, and must be repeated until effectual.
INFECTIOUS DISEASES.
Notifications.—Diagrams X. and XI. are given to indicate the weekly rise and fall throughout
the year of Scarlet Fever and Diphtheria, among (a) all persons, (b) children attending public elementary
schools. The figures obtained for the formation of the curve shewing the latter class have been compiled
from the teachers' notifications allocated in the various weeks according to the date of the children's last
attendances at school, assuming this to be the date of the premonitory symptoms. During the holiday
periods a mean has been struck, owing to the fact that teachers notify all cases occurring during the
holidays on their return to school. In addition to curves, the rise and fall is indicated in the form of a
percentage above and below the mean, Diagrams XII. and XIII. The Measles Diagram XIV. shows a
comparison of this year's curve with that of last year.
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