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24 FEVEK.
rate for the Borough was 0.04, less than half the decennial mean rate (0.11). In NorthWest
Paddington alone did the mortality anything like approach the averages. (See below).

In Hampstead only (rate 0.02) was the mortality lower than in the Borough (see Table 15),
while the local rate was lower than any of the other rates given in Table 10.
The following brief notes touching certain cases will be of interest—
Queen's Park Warp.- Two cases were reported on the fatal issue, but without post mortem examinations.
Both occurred in March, the first being an engine driver on the G.W.R. working between London and Wales. He
sickened on March 4th, and died on the 9th. The second was a married woman, with no occupation other than
house duties. .She sickened on March 25th and died on April 4th.
Harrow Road Ward.—A man, E. F., aged 28, came up on Nov. 8th, to see the Lord Mayor's Show. He
sickened that day, and was removed to hospital on the 24th. The Medical Officer of Health of the district where
E. F. lived communicated the following information:—"The well of the house is a bricked-in one, situated in the
living room, with the pump in an outhouse; outside the house is a rainwater tub; rainwater from the roof can get
into the well; the closet is an earth closet in good condition ; there are no other cases of zymotic diseases in the
town." An analysis of the water from the well gave fairly high proportions of both ammonias and chlorine.
Nothing was said of the soil, so that the value of the chlorine is doubtful.
Westbourne Ward. —Three cases in one house in M—Street. Two sisters sickened on Sept. 6th (to hospital
on 30th) and a third on (?) 24th (to hospital on 8th Oct.) The family had been to Leigh-on-Sea from the 5th
to 10th Sept. While there they ate cockles. It was ascertained that a brother of these patients was ill at his
home in Islington, and in consequence of a communication to the Medical Officer of Health of that Borough, the
case was promptly certified to be one of enteric fever. A nephew also had the same disease at Leigh-on-Sea.
The Medical Officer of the District expressed his opinion that all the cases were "undoubtedly due to polluted
cockles."
Two cases occurred in one house in A—Road, the first, a man aged 21, sickened on 28th Sept., and the
second, his son, aged 4, on the 10th Oct. The father did not go to hospital until 10th Oct. No trace of the source
of infection of the first case could be discovered. The son's case was probably due to personal infection from the
father.
Church Ward.—Of the 15 cases reported from this Ward, 12 occurred in the last quarter of the year. In the
first quarter two cases were reported, one undoubtedly erroneously diagnosed, and the second probably so. In
the second quarter, no case occurred, and in the third, one case (f. act. 29) who sickened on Sept. 9th. She had
partaken of mussels bought raw on the 7th, and cooked (? at home It was ascertained that the mussels came
from layings in Hadleigh Ray--a creek well known to be polluted with sewage.
Of the 12 cases in the fourth quarter, 6 were reported from A (lease and Ci—(5 cases) Streets. A
further case occurred in Willesden in an infected family which moved from the latter street shortly after infection.
Five of the cases were from 3 houses situated close together (Ci—Street). The first case (sickened (?) 2nd—to
hospital l(!th —died 25th Oct.) was a clerk employed in the City where he had some of his meals. The other four
cases were all suspected to be due to the consumption of shell fish—mussels and (or cockles. A hawker from West
Ham, well-known in the street, admitted that he obtained his cockles (and probably mussels) from Leigh-on-Sea.
The short intervals between the cases precludes direct transmission of infection—see below—
House A. f. 32 sickened Nov. 13 to hospital Nov. 20
f. 7 „ „ 19 „ Dec. 4
House B. m. 32 „ „ 18 „ Nov. 16 (to Infirmary)
f. 15. „ „ 22 „ „ 24
After the second case in House A the family moved to Willesden, and a third case was admitted to the Infirmary
there on Dec. 24. This case was probably due to direct infection from one or other of the earlier cases.
Two interesting reports have been recently issued, one by the Medical Officer of Health
of Hackney dealing with an outbreak of 110 cases of enteric fever traceable to the consumption
of sewage polluted watercress; and the other, issued by the Fishmongers' Company,