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58
In addition, there was reason to suppose that there had been
inter-communication between these four houses possessing
mangles, as inquiry showed that when it was found that fever ha J
broken out, or even inquiries were being made at a particular
house where mangling was done, the customers, or at least
some of them, got alarmed, and took their clothes elsewhere, thereby
spreading the disease and forming fresh centres, which had to
be traced out, and in connection with which precautions had to
be taken.
Interesting though the outbreak is, as being, so far as I am
aware, the first on record of such a medium of infection in typhoi 1
as mangled clothes, the preventive measures taken are the matters
of importance for a Sanitary Authority. The first step was to
find out all the cases—the whole extent of the damage, and this
was done by means of a careful house-to-house inspection. In
this way several cases were discovered, which were either unattended
altogether by medical men, or being attended as cases
of other diseases which are somewhat difficult to differentiate
from typhoid fever in its early stages. These unrecognised
typhoid cases appear to have started the outbreak, the after-