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14
In inquiring into the cause of this epidemic, I carefully inspected
the sanitary arrangements of the institution, but found they
were in perfect order, and quite up to date; in fact, the drainage
had been entirely re-modelled and re-constructed under the supervision
of an eminent sanitary engineer only two years ago. Suspicion
as to the milk supply being the cause is entirely removed, by
the fact that the milk is always boiled before being used by the
children. The water used for drinking is drawn directly from the
mains of the East London Water Company, and there is no reason
to credit this with causing the disease. The only animal kept on
the premises was a oat, which was free from all disease.
I also made inquiries as to whether there had been any throat
illness amongst the attendants or teachers, but could not hear of
any; but on examining the Medical Register of the institution, I
found a record of cases of Tonsillitis, Pharyngitis, and Febricula,
treated at intervals so far back as 1892, thus—

And again in July, 1892, there is a note in the register by the
medical attendant: "There seems to have been a slight outbreak of
sore throats, but as yet showing no specific characters."
This refers to a series of cases numbering sixteen, which
occurred during that month in the institution