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had nearly double the number of any other ward.
There were 700 cases during the year in Munster Ward,
while Barons Court Ward had the least incidence with
only 86 cases during the year. This outbreak rapidly
tailed off during the latter part of April, May and June.
In July the average weekly notifications had fallen to
25, and in the latter part of August to 5. From
August until the end of the year the maximum number
of cases of measles notified in any week was 6. Fortunately,
the majority of the cases were mild, but 41
deaths were attributed to this disease, whereas
diphtheria and scarlet fever added together accounted
for 45 deaths.
(2) Typhoid Fever.—A sharp and fatal outbreak of
typhoid fever occurred in one house in Walham Avenue
during July. There were 6 cases involved, of whom
2 died. The outbreak was very carefully investigated,
and the following is the result of our inquiries:—
"R. C., a female aged 13, commenced to be ill about the 3rd July.
She was removed to the Fulham Infirmary, where she died on
22nd July. A post mortem examination was performed, and
considerable typhoid ulceration of the last 4 feet of the small
intestine was found. The spleen was large and congested. Clinically
this patient suffered from typical typhoid fever. Mrs. M. R.,
a female aged 19, commenced to be ill on the 11th July. Mrs.
F. C., a female aged 41, mother of the above two patients, also
complained of symptoms about the 15th July, but on careful
inquiry it was found that she had been feeling ill since about the
21st June. A. C., a male aged 8, took ill about the 1st July, 1922.
W. C., a male aged 9, took ill about the 14th July, while D. C., a
baby, began to suffer on the 27th July. All the above patients gave
positive Widal reactions to B. Typhosus up to a high degree of
dilution.
"Careful inquiry and examination of the house, including the
drains, revealed no obvious source of infection, either in food or
dwelling-house. It is worthy of note that the husband of Mrs. F. C.
(and the father of the children) suffered twice while in the army
from P.U.O. Since his discharge in 1918, he has been a chronic
neurasthenic and is never in good health. Two specimens of stools
were examined from this man, and in both cases with negative
results. Against the possibility of his being a carrier, and the
source of infection, must be placed the fact that he had been at home
on and off since 1918 with no previous ill effects on his family, and
he had recently been in a convalescent home and did not infect
anybody there, I am inclined to think that the first case, and the