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35
International Council, but it was recognised that such restrictions could not be
enforced without the sympathetic support of the industry. In commenting upon
the decisions it was pointed out in the Annual Report for 1922 that " the use of
these grounds should, from a public health point of view, be carefully watched."
In the annual report for 1923 (p. 32) it was noted that while the sale of immature
plaice in London practically ceased with the outbreak of war, already in 1921 and
1922 reports were being received that this particular kind of fish was again in evidence.
Moreover, in 1923, there was "an approach to the development of a slight autumnal
rise (in typhoid fever prevalence), a feature which had been absent for some 12 years
past." The facts were submitted to the medical officer of health of the City, and
an opportunity was taken of conferring with him on the question. In September
1924, a quite definite autumnal increase in London typhoid fever occurred, and this
increase was practically accounted for by the prevalence in Bethnal Green which has
already been referred to. The main features of this outbreak were felt, therefore, to
be deserving of detailed investigation and, working throughout in co-operation with
Dr. Oates, the medical officer of health of Bethnal Green, careful study of the epidemic
has been made. In the course of the enquiry, in addition to the information available
in Bethnal Green which has been obtained by Dr. Oates, the patients who were
removed to hospitals have all been seen by Dr. Brincker, Dr. Forbes, or Dr. Chaikin
of the Council's public health department. Dr. Oates, in due course, prepared a
special report on the prevalence, and much assistance has been derived from this in
compiling the following statement.
Bethnal
Green
prevalence
in the
autumn of
1924.
From the middle of September to the middle of November, 1924, a sharp
autumnal prevalence of typhoid fever was developed, practically the whole of the
cases occurring in Bethnal Green and within a comparatively small area in that
borough.
The cases were distributed on either side of the part of the Bethnal Green Road
and its continuation, Green Street, lying between Vallance Road and Bonner Street,
a distance of about three-quarters of a mile. The area affected was roughly rectangular
in shape and could be divided into an eastern and western half, separated by
the Cambridge Road running north and south. In the north-western section of this
area the cases were fairly uniformly scattered; in the south-western they were more
aggregated together; eastward, in the north-eastern and south-eastern sections of
the area, the cases were quite closely grouped, the majority being clustered in, or
just off, Globe Road which, running more or less north and south, divides the eastern
half of the affected area roughly into two: it is noteworthy that there were four
times as many cases in the northern as in the southern half of that part of the affected
area lying to the east of Cambridge Road. The distribution of cases generally
over the affected area was thus rather "patchy."

There were in addition 15 cases in houses fronting on Bethnal Green-road and
Green-street.