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septic character, confined principally to North Hackney. As near as
I could ascertain, the disease was prevalent during nearly the whole
of April, and the first week in May. The following analysis of the
symptoms met with in 10 cases occurring in the practice of Dr. H. S.
Powell, of Upper Clapton, to whom I am indebted for the same,
clearly shows the exceptional character and course of the affection.
Symptoms.—(a) In every case there was tonsilitis (not follicular).
(b) In two cases there was as well superficial ulceration of the tonsil.
(c) In every case there was considerable swelling of the cervical
lymphatic glands, more marked on the one side than the other—in two
cases the swelling was very great. (d) In one case the lymphadenitis
proceeded to suppuration. (e) In every case the temperature was
raised, in a few cases it was 105° F., and there were rigors. In all
the cases the ten perature persisted after the tonsilitis had disappeared,
lasting in nearly all for at least a fortnight. (f) The temperature
assumed the remittent type, and there was in every case profuse
sweating at nights. (g) There was great prostration in most cases,
and considerable cachexia in all. (h) In one case acute septicaemia
supervened, followed by acute septic pneumonia and death. (i) In
two cases in the same family, acute nephritis with haematuria came
on about a week after the onset of symptoms. (j) In one case the child
had an attack of purpura haemorrhagica. (k) In all cases convalescence
was protracted.
In addition to the above there was a marked tendency for multiple
cases to occur in families, also while no age or sex was exempt, a
very large number of the sufferers were children; these features
helped to direct suspicion to the milk.
During my enquiries I learned that in some of the families where
sore throat existed the milk supplied to the household was boiled
before use. I was informed by the medical attendants that generally,
where this had taken place, the sore throat disease had been of a
milder form. Of course, the degree of sterilization of milk which is
sought for by boiling, depends both upon the temperature to which