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under treatment in the Richmond Hospital for
strumous disease of the knee joint, and some
discharge continued. It seems possible that the
infection was conveyed by means of this discharge.
D., a young woman of 19, was attacked not
having been out of the house for weeks, being
under treatment for debility. It was found that all
her younger brothers and sisters suffered from
enlarged tonsils, but there were no signs of
desquamation or history of a rash.
There were some signs in October of the
commencement of an epidemic of Scarlet Fever,
isolated cases breaking out in different parts of the
Borough, mostly in children attending two schools.
At the same time the disease was rife in Richmond,
Wimbledon, and Surbiton, so that there were
numerous sources of infection near at hand. I
communicated with the School Managers, and
arranged to visit and inspect the schools, should the
number of attacks increase. Happily, however,
the numbers fell off, and this I attribute to the
discover) of two families of children who were
partly absent from school, and some of whom were
found to be desquamating, whilst others showed
suspicious symptoms. They were all notified and
isolated. The parents pleaded ignorance of the
nature of the disease, and as it appeared that the
children had not shown any symptoms of illness
beyond the desquamation no proceedings were
taken. These cases were discovered through the
School Attendance Officer, and it is very desirable
that arrangements should be made so that all
children absent from school for more than three
days should be visited promptly. Such cases as
those mentioned above would then be readily
notified and isolated. I would suggest that a clerk
should go round to the schools daily and make out a