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such unrecognized cases spread of the disease through the
agency of schools may be reasonably attributed. By direction
of the School Managers the Infants' Department of the school
was at my request closed for a time for the purpose of disinfection
and cleansing.
In a few instances sanitary defects were found in the
invaded houses, but these were few compared with the total
number ; in some of the streets, moreover, offensive sewer manholes
or gullies were observed. But for the most part the
cases occurred singly in houses, and on the whole the
information collected seemed to point to direct infection,
especially through schools, as the more probable cause of the
spread of the disease.
HOSPITAL ACCOMMODATION FOR DIPHTHERIA.
I stated, in my Report for 1887, that the Managers of the
Metropolitan Asylums District had been willing, since 1886, to
admit sufferers from diphtheria to their hospitals, but that the
Local Government Board, acting upon a medical opinion that this
disease does not fall within the category of "Fever," as that
term is used in the Metropolitan Poor Act, 1867, deemed it
desirable that if cases of diphtheria were to be admitted there
should be express legislation for the purpose. The Board
promised to give their consideration to the question whether
such legislation slioidd be proposed. After waiting eighteen
months the Managers again resolved, in March, to direct the
attention of the Board to the subject. Nothing came of the
reference, and so in my ninth Monthly Report (September 10th,
page 86) I recommended " that the President of the Local
Government Board be asked to bring in a Bill (in the Autumn
session) to enable the Managers to admit cases of diphtheria,
and that the several Vestries, &c., be informed of the application.''
The report was referred to the Works, Sanitary, and
D