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(3.)—.Defective Water Closets, or House Drainage, or Offensive Smells should be at
once reported to the Sanitary Authority, at the Town Hall, Old Street, E.C.
(4.) House Refuse should be removed from premises at frequent intervals, and
whilst awaiting removal should be kept in properly constructed dust bins.
Complaints of non-removal should be at once addressed to the Scavenging
Superintendent, 287, Kingsland Eoad.
(5.) General Health.—Attention should be paid to the general health, as neglect
of it renders an individual much more liable to be attacked.
Intemperance, in eating and drinking, by lowering the vitality, is a strong predisposing
cause of this malady. In hot weather, any looseness of the bowels
should have immediate attention and treatment.
Too much stress cannot be laid upon the boiling of milk before use, and it
will be observed that 73 per cent. of the deaths from diarrhoea, were children
under 12 months old, who are, or should be, at this age fed mainly upon this food.
Cholera.—Included amongst the deaths from diarrhoeal diseases are 3 which
were registered as being due to cholera. Seven cases of cholera were notified;
of these, on investigation, 5 were found to be cases of acute summer diarrhoea.
In two cases, however, death ensued so rapidly, that grave suspicions were
awakened as to the nature of the disease, and careful investigation and precautions
were deemed necessary.
The first case was notified on August 19th, and died before the notification
was received at the Town Hall. The history was as follows. The patient, a lad
aged 10, living in Wimborne Street, was taken ill about 6 o'clock in the evening
of the 18th August, with diarrhœa, vomiting, and cramps. He became collapsed
during the night, and died at 9 o'clock next morning. A post-mortem
examination was made by Dr. Tighe, in the presence of Dr. Home, an Inspector
from the Local Government Board, and myself. The contents of the stomach and
portions of the viscera were reserved, and the coroner communicated with. The
result of the inquest was that death was due to English cholera. Dr. Luff,
Analyst to the Local Government Board, stated that he had found poison
called ptomaines in the contents of the stomach, but whether they were
introduced with food, or resulted from the decomposition of the stomach itself,
after death, it was impossible to say. The enquiries made by Dr. Home and
myself failed to elicit any history of the lad having taken anything likely to have
produced the symptoms exhibited, nor had he, so far as we could determine, been
anywhere where he was likely to have been exposed to cholera infection.
The second case was notified on August 22nd. The patient, a young man
aged 25, living in Singleton Street, was taken ill in the early hours of the morning
of the 20th August, and died about 11.45 p.m. next day. The medical man who
was called in some two hours before death, was of opinion that "death had
resulted from cholera of some sort." Under the circumstances, I directed steps