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15
These facts must be considered in connection with a consideration
of the physical condition of the girls admitted into the
school.
The girls admitted are almost all of a low physical type, with
a great tendency to catching colds, enlargement of glands, and
relaxed throats, with poor circulations, etc., in a word their disposition
of body is strumous.
Such a condition of body needs only a slight departure from
what may be termed its normal condition of health—a condition
which may be called one of unstable equilibrium—to exhibit such
symptoms as those above recorded as prevalent during the years
1892 to 1895, and needs only the introduction of a specific material,
to confer upon a hitherto non-infectious and comparatively harmless
affection a specific infectious and harmful character.
I do not believe that the cases of 1892-1894 were of a
diphtheritic character, but they are a proof that the soil was ready
for the reception of the specific germ of Diphtheria, which being
introduced by some means in September, 1895, gave to the outbreak
in question its specific qualities. The alternative is open for one to
suppose that the cases of 1892-94 were diphtheritic, although of an
exceedingly mild type, and that they were connected in the way of
cause with the cases of last year, the latter exhibiting, owing to
some obscure cause, qualities more characteristic of Diphtheria than
the former.
Inquiry as to the means by which the disease could be introduced
was without any certain result. Suspicion fell upon the
relatives and friends of the children who are allowed to visit the
institution four times a year, but no proof that they introduced
the disease was established. The last visiting day before the
outbreak was in June. Although the means by which the disease was
introduced into the school could not be ascertained, it is very evident
from a study of the table supplied by the matron that it spread
by the associating of the sick girls with others, before they were