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48
and other holiday places. Several instances of this sort
occurred in the parish. Three of the sufferers were men
holding official positions, of whom two died ; the wife of one
of them contracted the disease from her husband. A fourth
case was that of a railway porter. Three other cases were
female domestic servants, and one case was that of a lady
recently returned from the continent. The infective material
of enteric fever is not infrequently conveyed by shell-fish,
derived from specifically contaminated water, and it is worthy
of remark that in several of the cases locally recorded, the
sufferers had partaken of oysters, mussels, etc., at seaside
resorts, within such periods of time antecedent to date of
illness, as to suggest a relationship of cause and effect.
Endemic of Enteric Fever.—The most serious outbreak
of the disease in Kensington originated from cases
occurring in Haddington in May and June. Some six households
in the two parishes furnished 11 or 12 cases; but, with
a single exception (case 9), we had no knowledge of any of
them until after removal to hospital or death. Two of the
cases, the first and the last, were not notified, and some doubt
was felt as to the character of the illness, though there was
very strong suggestion, amounting to conviction, of typhoid
in respect of the first case, which, in the subjoined account
(from the ninth monthly report), will be taken as the initial
case in the group. Of the twelve cases four were young
children, all of whom recovered, and eight were adults, six
of whom died; all save the first and the last cases.
Case 1.— Minnie S—, aged 31 years, wife of a painter,
mother of four young children: occupied two
kitchens in Paddington; was described as of dirty
habits, living under unwholesome conditions generally,
and not particular as to quality of food. She