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48
events which had taken place at Western Dwellings. The doctor
saw her again on April 11th, and having then been informed
of the facts of the outbreak at Western Dwellings, he recognised
the illness to be typhus, and notified the case, which was
removed on the following day to the South-Eastern Hospital,
where the diagnosis was confirmed : she recovered.
Causation.—Needless to say, every effort was made to
trace the illness in the first case to its origin. It was thought
that Thomas B — — might have come into contact with a
source of infection in the course of his employment, a supposition
to which probability was lent by the fact that a man
living in another parish, but employed with him at the same
office (the two sitting next to each other at meals) fell ill
suddenly on Christmas Day, when he " became weak all at
once and had to leave work." This man was seen by his
doctor the same day, and was treated at home for three
weeks for bronchitis. No spots were observed. During his
illness he slept with a brother, who continued well, and the
doctor assured me that there was nothing in the nature of the
case to suggest typhus or any other complaint than the bronchitis,
to which he was subject. Typhus (or " jail ") fever, when
commonly prevalent, in byegone days, was largely due to
insanitary conditions, to overcrowding and dirt. These conditions
prevailed at Flat 20, and their existence, I think,
accounts for the outbreak. The two rooms, apart from the
scullery, contain—the living room 1,353 cubic feet of air-space,
the bed-room 948 cubic feet. In the living room the deceased
young man John B — — slept. The remaining members of
the family (excepting Julia, who was in service) slept in the
bed-room. They comprised the parents and five children,
aged 18, 11, 8, 6, and 4 years respectively. The air-space,
without deduction for the bodies of the sleepers, two bedsteads,
&c., and other furniture, was at the rate of 135 cubic feet for
each person, the minimum required under registered and