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discharging into the sewer, 207° F. The County Council were communicated
with, it being their duty to prevent persons discharging
water or other matters into the sewers above a certain temperature
and the condition eventually seemed to have been remedied.
Typhoid Fever.—Seventy-one cases of this disease were notified in
the City, as compared with 132 in the previous year, but three cases
were afterwards proved not to be so, while one case in barracks was not
reported ; there were also two cases notified as continued fever, which
may be included. These cases were equal to 4 per 10,000, which is the
lowest hitherto recorded, the average of the previous ten years being
7 per 10,000. The whole of London also showed a decrease, the rate
being 5.0 against 7'7 for the ten years. Fifteen deaths occurred from
this cause (being 21 per cent. of the cases), the mortality for London
being 16'5 per cent. of the cases.
In twenty-nine instances the complaint was ascertained not to have
been contracted in the City. It is not surprising that such occurs, as a
long period may elapse between the reception of infection and the
appearance of symptoms, long enough to allow people to travel to
Westminster from distant parts; thus of these twenty-nine, three came
from America, four from Paris, one from Ostend, three from Dublin,
twelve from various parts of England, and the remainder from othei
parts of London. Probably others might be included among these, but
the information was not obtained.
In many cases it is very difficult to discover the manner in which
the disease was contracted. This is due to several reasons, such as the
long period between the inception of infection and the appearance of
symptoms, and the removal of patients to Metropolitan Asylums Board
hospitals, so that information cannot be obtained from them. I have
gone over the list of cases, and so far as possible I have divided them
into classes:—In twenty-nine instances no sufficient cause was discoverable
; four cases probably contracted the disease from other cases;
in fifteen cases there appeared to be a direct connection with the
•eating of shell-fish (thirteen oysters, one mussels, one cockles); in one
with fried fish ; one fried fish or watercress; two with ice-cream ; five
with water (four abroad) ; five (two hospital nurses) were the result
of infection from other cases ; and in six serious sanitary defects were
found in the premises.
I find that among the patients were four cooks and twelve other
persons (butlers, waiters, &c.) who might in the course of their duties
have to handle shell-fish or other contaminated food; in only six was
there a history of sliell-fish having been eaten. Seven patients were
scholars; two ate ice-cream, one fried fish, one fried fish and watercress,
one mussels, and one cockles. Letters were addressed to all the clergy
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