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have occurred." It is not, however, clear how far this conclusion is based upon a complete application of
the method, for he also writes "In regard to diphtheria, an attempt is sometimes made by the Education
Authority to exclude what are termed carrier cases. These are cases having the disease in such a
mild form as to permit attendance at school without detection. A bacteriological examination is made
in regard to a selected few, and the children who are reported to be suffering from pseudo-diphtheria
or diphtheria are excluded. There is much to be said for this plan, provided that a swab is taken from
every child in the classroom. The mere selection of a few is not sufficient nor can absolute reliance be
placed upon bacteriological examination of one swab only." In this connection the sufficiency of the
administration for this purpose may well receive the attention of the Council. Information is much
needed concerning the relation of so called carrier cases to clinically recognisable diphtheria. The extent
to which carrier cases may exist in schools which are clinically free from the disease, the existence in the
home of other carrier cases with the case of the child attending school, the evidence which is to be found
in the home of the ability of the carrier case to infect other members of the family with clinically
recognisable diphtheria, and the conditions under which such cases acquire an infective ability are
matters much needing investigation, and further, the question whether a child harbouring the
Klebs Loeffler bacillus can by convenient treatment be freed from this organism is well deserving of
experimental inquiry.

In the annual reports relating to Paddington and Fulham the distribution of cases of diphtheria
in houses is shown. Thus in Paddington, where 160 cases were notified, in 13 instances two cases, and
in three instances three cases occurred in one house. In Fulham, where 536 houses were invaded,
in 40 instances two cases, in eight instances three cases, in three instances four cases, and in one instance
five cases occurred in one house. In Fulham in each of two houses in which cases occurred the diphtheria
bacillus was isolated from the throat of a cat which had shown signs of illness.
Proportion of cases of diphtheria removed to hospital.
It will be seen from diagram XII. that the proportion of cases of diphtheria removed to the
hospitals of the Metropolitan Asylums Board was about the same as that in the preceding year.
whooping - cough.
The deaths from whooping-cough in the Administrative County of London during the year 1907
(52 weeks) numbered 1,786, as compared with 1,226 in 1906.
The death-rates from this disease in 1907 and preceding periods have been as follows—

18560
1 See footnote (1), page 8.