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In discussing the causes of enteric fever in London, the reports of several medical officers
of health give account of the communication of infection from one person to another. Dr.
Reginald Dudfield observed this in four instances; Dr. Parkes shows the extension of the disease
in Chelsea from one member of a family to seven others; Dr. Sykes gives account of two
households in St. Pancras, in one of which the first case of the disease was followed by six
others, and in the second by nine others. Dr. Newman connects directly or indirectly nine
cases in Clerkenwell with one or other of three cases occuring among children attending the same
Sunday school; Dr. Bryett gives particulars of six series of such cases occurring in Shoreditch;
Dr. Kempster attributes a group of cases, occurring in a street in Battersea, to the same cause;
and Dr. Bond mentions two nurses who were infected while in attendance upon cases of the
disease.
Shell-fish is mentioned in several of the reports as a cause of enteric fever. Dr. Sykea
refers to an inquiry by him into a localised prevalence of enteric fever in St. Pancras, comprising
fifty-seven cases (of which a very few were in Hampstead), and occurring in November
in a circle with a radius of three-quarters of a mile. He found that " a large proportion of
those falling ill gave a history of eating mussels from the same source." Dr. Newman states
that in five cases occurring in Clerkenwell " the only traceable source was the eating of oysters
and other shell-fish, procured in each case from a particular stall in a certain street."
Dr. Caldwell Smith states that in six cases in Wandsworth "the patients had eaten shellfish
within the period of incubation of the disease," and Dr. Millson, referring to special prevalence
of enteric fever in Newington from the middle of September to the middle of November,
reports that he camel to the conclusion that the disease was due to some article of food, and
that shell-fish had been eaten by a large proportion of the persons affected. Dr. Kempster
1 See footnote (1), page 5.