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75
There was reason to believe that the outbreak of paratyphoid fever in London referred to
above was associated with the consumption of cream, and in view of the many statements
which appeared in the Press that the outbreak would not have occurred if the Public Health
(Preservatives, etc., in Food) Regulations prohibiting boric acid in cream had not been in
operation, it is interesting to note the results of experiments made by Dr. Robert Donaldson
of the Pathological Department of Guy's Hospital. Two different samples of cream were
dealt with, a week or 10 days elapsing between the submission of the samples. The samples
were collected in sterilised bottles directly the cream came from the pasteurising plant. Boric
acid was added to the cream in varying amounts so that the cream contained 0.25 per cent,
boric acid (the amount previously in use as a preservative), 0.33 per cent, and so on up to
cream containing 4 per cent, boric acid, far more than would ever have been permitted by
any Local Authority. These various samples containing different amounts of boric acid
were inoculated with Bacillus paratyphosus B-the organism responsible for the summer
outbreak.
In one set of creams the boric acid was added before the organisms, and in another set
organisms were added first and the boric acid later. An uncountable number of colonies of
B. paratyphosus B grew on every plate, or in other words boric acid even in a concentration of
4 per cent, entirely failed to inhibit the growth of the infecting organisms. In fact the
colonies of paratyphoid B obtained from 1/1000 of a c.c. of the 4 per cent. boric acid cream
were for all practical purposes uncountable.
The fact that the boric acid was added before infecting the cream seemed to make no
difference. Moreover, similar results were met whether the infected cream containing boric
acid was incubated at 37°C. or was left at room temperature for 24 hours. The organism
B. paratyphoid B used as an index of the inhibitory effect of boric acid was not present in
the cream when it was received in the laboratory. When B. paratyphosus B gained access
to the cream (by deliberate implantation) even 4 per cent, of boric acid failed to prevent its
growth.
These experiments furnish a complete answer to those who maintain that if boric acid,
as previously allowed in cream, had not been prohibited the summer outbreak of paratyphoid
fever would not have occurred.
Typhus Fever.
No case of typhus fever was notified during the year in the Borough.
Two cases were notified in London.
Cerebro-Spinal Fever.
One case of cerebro-spinal fever was notified, namely, a male infant, aged
8 months.
This child was one of twins. In consequence of persistent crying after food the chiid was
taken as an out patient to a hospital for children where cerebro-spinal meningitis was diagnosed.
The cerebro spinal fluid was found to be under increased tension and to contain many pus cells
and a few Gram-negative intracellular cocci, cultures showing organism to be meningo-coccus.
The total protein present was 0.08%, an excess of globulin; no reduction of Fehling's
solution occurred; 67 % of the cells present were polymorphs, 33 % lymphocytes.
The child died under anæsthesia (general) for lumbar puncture.
Seventy cases were notified in London.
Bacillary Dysentery.
Two cases of bacillary dysentery, both fatal, were notified.
(1) A male, aged 21 years, became ill about the middle of July and was finally admitted
to the hospital on the 28th July and notified as suffering from bacillary dysentery. He died