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26
the year, but in comparatively few of the houses was thore any
defect in the drainage arrangements. In several houses the
sink-waste pipes were directly connected with the house drain,
in two the drains themselves were defeotive. In one rather
large house there were five cases but no deaths; the sink and
bath waste pipes were directly connected with the house drain,
and the smell was offensive with a strong current from the drain
into the house.
Typhoid or Enteric Fever —These names are used somewhat
indiscriminately for one another, but it is certainly better to
use the name "enteric fever." There were108 cases reported which
occurred in 104 houses, and defects in the drainage arrangements,
notably, sink-wastes connected directly with the drains were
found in 24 houses. Two patients contracted the disease in
Northampton, one coming from a house in which another case
of the fever existed; a third patient was said to have been
infected by drinking contaminated water; and another by either
an abominable smell from sewage much decomposed, or from a
little splashing against his (the patient's) mouth when he was
engaged in removing the accumulation. In the other cases no
assignable cause was mentioned, in answer to the enquiries, nor
was any drainage defect found on or in the premises they
occupied.
Although there has not been any notification to
me of an outbreak of infectious sore throat or of
diphtheria from sewer gas poisoning, yet the occurrence
is by no means rare. One very extensive outbreak was
reported in a medical journal in which as many as 80
children were attacked, and the disease ran a severe but not
a fatal course. The children's throats were covered inside with
a leather-like membrane resembling that of diphtheria. It is
described as being "extremely infectious, and undoubtedly arose
from the poisonous effects of sewer gas." In another similar
but less severe outbreak, the symptoms were similar to those in
the one just mentioned, and "the disease, which resulted from