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33
Typhus Fever.
During the year 1893, 22 persons were certified to be suffering from typhus, and 5 deaths
from this cause were registered.

Inquiry as to the cases notified in London in 1893 gave the following results. In my last
report I pointed out the frequency of error in the diagnosis of this disease, and the record of 1893
resembles that of the preceding year in this respect.
January.—A case was notified as typhus fever in Marylebone, on removal to hospital the
diagnosis was not confirmed.
February.—On February 10th a girl aged 7 living in Batter sea sickened, and a day or two
later a diagnosis of typhus fever was made, and she was removed to hospital. The case
was then found to be one of enteric fever. It appeared that the brother of this girl
had been removed to hospital on February 2nd, the case having been notified as one of
scarlet fever. The diagnosis of scarlet fever in this latter case was confirmed on
admission to hospital.
March.—A boy aged 12 living in Fulham was certified to be suffering from typhus, and was
removed to hospital on March 6th. The case was there found to be one of enteric
fever.
A young man aged 19 living in Mile-end was certified to be suffering from
typhus on March 19th, and was removed to hospital, when it was found that his disease
was not typhus.
April.—A man aged 63, who had recently arrived in Paddington from Russia, was certified
on April 12th to be suffering from typhus. Patient was ill when he first came (about
one week before April 12th) into the district. He was not removed to hospital.
On April 30th a case of typhus was notified in Marylebone. The man died, and
his death was then certified to have been caused by heart disease.
May.—On May 9th a girl living in Bermondsey was certified to be suffering from typhus; the
rash was not typically developed, however, and the girl died on the following
day. There remained some doubt as to the nature of her illness.
On May 20th a boy aged 6 living in Poplar was certified to be suffering from
typhus ; there was some difficulty, however, with regard to the diagnosis, and the nature
of the malady appears to have remained doubtful.
A case was notified on May 27th in Kensington, but subsequently proved to be
one of pneumonia and not of typhus.
On May 28th a man aged 46 living in Lambeth was certified to be suffering
from typhus fever at the house where he had lived for several years; he died after 7
days' illness. He was not removed to hospital.
June.—On June 16th a man aged 19 living in Whitechapel was certified to be suffering from
typhoid fever. On removal to hospital his illness was found to be typhus fever. The
patient had been residing in the house where he was taken ill for three or four years,
and no source of infection could be traced.
July.—On July 8th a woman living in Limehouse was certified to be suffering from typhus,
but the case was subsequently found not to be bne of that disease.
On July 26 a girl aged 16, whose place of residence was in St. George, Southwark,
was removed to hospital, having been certified to be suffering from typhus fever.
The opinion subsequently formed, however, was that her illness was not typhus fever,
but that she was suffering from an affection of the pelvic organs.
August.—Two children living in Lambeth were certified first to be suffering from diphtheria,
and then from typhus fever. They were not removed to hospital. No other cases
of typhus existed in the neighbourhood.
September.—A child living in Holborn was certified to be suffering from typhus on September
20th. The disease, however, proved to be typhoid, and the sister of the patient
developed typhoid fever a few weeks after the commencement of the first child's illness.
Two notifications with respect to patients coming from Limehouse were made on
September 20th. One of the patients, a girl aged 18, had been certified on September
14th to be suffering from typhoid ; on the 20th she and her brother, aged 10, were
certified to be suffering from typhus, and were removed to hospital. The nature
of the illness in both cases, however, was ultimately determined to be enteric fever.
October.—A girl aged 14 living in Battersea was certified to be suffering from typhus fever
on October 10th. She had been resident in the house where she was taken ill about
8 years, and was attending school. The commencement of the illness dated from
October 3rd. The patient was removed to hospital. No source of infection could be
traced.
November.—A man aged 27, a milkseller in Battersea, was certified on November 4th to be
suffering from typhus, he was removed to hospital. Dr. Kempster writes: "Enquiry
made as to the possible source of infection has failed in this case. Patient had been
" in no house where infectious disease had occurred as far as could be ascertained."
† See footnote (†), page 6.
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