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servant was said to suffer always from a bad throat. Bacteriological
examination proved that four, including the servant, had the organism
in their throats, and the probability is that the complaint had been
introduced into the family by the servant.
Four cases of diphtheria, in three families not acquainted with one
another, occurred in a large block of flats, but the source could not be
traced. Careful enquiries were made into the source of the milk and
cream which was supplied from the same source to each family, but no
evidence was forthcoming to incriminate them.
In twelve instances 2 cases occurred in one house, and,, in two
instances 3 cases, in one 4 cases, and in one 5 cases.
Bacteriological Examination.—Advantage was taken by medical men
of the means provided by the City Council to have the diagnosis of
their cases assisted by bacteriological examination of swabbings from
the nose or throat in 145 instances.
In 28 instances I had a bacteriological examination made of the
throats of the members of families in which a case has occurred, or
when children were excluded from school in consequence, and no medical
man was in attendance; the bacillus was present in nine of them.
In 2 instances examination was made on account of other cases
occurring subsequent to the first patient's return from hospital—both
were negative.
Bacteriological examination of a membrane found at the post-mortem
of a child who had died suddenly proved to be diphtheritic.
Typhoid Fevee.—The number of cases notified, both in London and
Westminster, show a continuous decrease. Of the 25 persons notified
in the City, 1 was eventually declared not to be so suffering.
As usual, a number of these cases resulted from infection contracted
out of London, often abroad, 14 of those whose history could be obtained
came under this class; infection was attributed to eating oysters by 3,
mussels by 1, and drinking polluted water by 4. Three persons
apparently contracted the disease by personal contact, one as a nurse, one
child from her mother, and one through visiting at a house in which
the disease already existed. In connection with this last case, the
Medical Officer for the Borough of Finsbury, in whose district the house
is situated, gave me the following information:— Two cases of typhoid
fever having occurred in a block of flats, one in October, the other in
December, inquiry was made, and revealed the fact that a child, the son
of one of the above, had been taken to hospital about the 28th September
suffering from diarrhoea, but was only detained one day. At
intervals attacks of diarrhoea occurred, and on examining a drop of his
blood a positive Widal reaction was obtained. This boy was removed
d