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110
regards enteric fever, that this disease, under improved sanitary
arrangements, has "continuously and notably declined in
England during recent years." Chief among these causes, and
one, in my judgment, even superior in efficacy to notification
is the provision of hospital accommodation by the Asylums
Board, under the powers of the Metropolitan Poor Act, 1867.
So highly, indeed, do I value this provision that, were I offered
a choice between hospitals and notification, I should unhesitatingly
choose hospitals; for this reason, among others, that the
existence of hospitals leads, almost inevitably, to voluntary
notification; whereas even compulsory notification has
comparatively little value if such means of isolation does not
exist.
INTERRUPTION TO EDUCATION AT ELEMENTARY
SCHOOLS RESULTING FROM THE PREVALENCE
OF INFECTIOUS DISEASE.
It is the practice at Board and other elementary schools to
refuse admission to children from houses where infectious
disease exists, even when the excluded children are not
members of the family affected. The propriety of this practice
is beyond question, and to its existence we may reasonably
ascribe the fact that it has never been found necessary, in this
parish, to close a school on account of the prevalence of
infectious disease among the pupils. The Notification of
Infectious Disease, when it shall have been secured by legislation,
and the increased powers of removal to hospital of nonisolated
cases of infectious sickness, for which Sanitarians are
asking as a correlative measure, will probably have the desired
effect of limiting the occasions on which it will become necessary
to close schools on account of epidemics, e.g., of scarlet
fever. Sanitary Authorities have greater powers under the
provisions of the Education Code of 1883,* than they formerly
* "The Managers must comply with any notice of the Sanitary Authority
of the district in which the school is situated, requiring them for a specified
time, with a view to prevent the spread of disease, either to close the school, or
to exclude any scholars from attendance, subject to an appeal to the Department,
if the Managers consider the notice, to be unreasonable."