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16
The above figures justify the regular employment of antitoxine.
Yet hundreds of poor children in London die of Diphtheria, who have
never had the benefit of this remedy. The default is sometimes due to
the fact that the medical practitioner is not convinced as to the value of
the agent.
There can be no gainsaying that the continued prevalence of this
disease is determined to some extent by school attendance. The
Medical Officer of Health (Mr. Shirley Murphy), of the London County
Council, has placed the matter upon a solid statistical foundation.
He has shown that the increase in Diphtheria has mainly affected the
ages 3—10, and that the relative increase of the mortality at the
ages 3—10 commenced with the operations of the Elementary Education
Act of 1870. The effect which the closing of the schools during
vacation periods has in reducing the incidence of the disease is also
susceptible of statistical demonstration.
In view of these facts, and seeing the part schools play in the
dissemination of other infections, the precautions taken in the interest
of the scholars are in my opinion unsatisfactory. The Medical Officer
of Health should be kept promptly posted up as to those who are
absent through illness; he should possess the power of examining
any scholar or scholars at any time when he has reason to think
such action desirable in the public interest; and he should also
have the power of arranging for a medical inspection of all the scholars,
when he considers such a step advisable. Short of the adoption of
these measures compulsory education will continue to be linked in
some measure with compulsory disease. Medical Officers of Health
have been for some time pressing for such powers, but they can only be
granted by Act of Parliament.
TYPHOID FEVER.
The immunity which we have hitherto experienced from this
disease was unfortunately broken during the year.