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lodgers ; and in 6 to travelling or visiting hospitals. The
number of mild cases undetected or concealed, which go about
and attend school, is no doubt very large, and mainly accounts
for the spread of infection. There were, however, no special
school outbreaks last year.
45. The Annual Report for 1905 contained a special report
on a statistical investigation into school incidence of scarlet
fever and diphtheria during the ten years 1896-1905.
46. Absence on account of illness is not now, as it was till
recently, a barrier to obtaining a school medal. The mere
records of school attendance are, however, still the basis of
school grants, and consequently it is the main object of
teachers to keep up the attendance. This leads to children
being encouraged to go to school at an age when they are unfit
to leave home, and when they are more liable to succumb to
infectious disease. It also indirectly leads to children attending
school in an infectious state.
47. Information was obtained as to the date of calling in
medical attendance in 81 cases of Scarlet Fever. In only 10
was the doctor summoned on the first day of illness; and in
more than half the cases the attendance was deferred for more
than two days.
The following instance shows how inability to pay for
medical attendance leads to concealment of illness and exposure
of patients in an infectious state:—
On the 8th May, 1908, I was informed by a London County
Council school nurse that she had excluded from Earl
Street school a girl of 13 who was peeling. I visited
the house and found the girl there alone and in charge