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Dr. Scott, of Westminster, stated that a post-mortem examination showed the intestines to be
injected, the lower part of the ileum being quite pink. A portion of the ileum was taken to Dr. Klein
by Dr. Sweeting, medical inspector of the Local Government Board, who was present at the post-mortem
examination.
Dr. Klein subsequently stated that the case was one of undoubted Asiatic cholera. "The
symptoms of the disease and the pathological condition of the intestine, the microscopic characters of
the rice-water stool and of the intestinal contents, and the cultivation tests, were in every respect most
typical of Asiatic cholera."
Case 2.
H. T. (male), set. 25, printer. Chapel-street, Clerkenwell.
On the evening of September 7th he drank a pint of beer, and ate some fish, an egg and a
sandwich for supper. On the 8th September, at 8 a.m. diarrhoea set in. The diarrhoea continued,
and at 10 a.m. cramps in the limbs began, and, on admission to St. Bartholomew's Hospital, he was
cold and blue. Temperature 96.2 in the axilla, 100'4 in the rectum. There was suppression of urine.
On the 9th he passed a motion, which was sent to Dr. Klein for examination. Patient's condition
improved, and he soon became convalescent. No other case of similar illness occurred in the house.
Report by Dr. Klein. "The evacuations were of a rice-water character; in a slightly turbid
watery fluid were suspended numerous greyish-white flakes. Examined under the microscope, these
flakes consisted chiefly of leucocytes, but not of epithelial cells like the flakes of typical cholera. In
microscopic specimens crowds of bacteria (bacillus coli) were seen, some also that looked like commas.
Cultivations proved entirely negative qua comma bacilli."
Case 3.
A. B. (female), set. 54.
Patient had been an inmate of the Fulham Union Workhouse for a long time, and was engaged up
to September the 9th in washing the dirty clothes of workhouse inmates. September 10th, at 1.80 p.m.,
patient had" an attack of convulsions," followed by vomiting, diarrhoea, and cramps. At 3 p.m. she was
blue and collapsed; the vomiting and cramps continued, and at 9 p.m. diarrhoea again set in, the
motions being of a rice-water character. She died at 5 a.m. on the 11th September.
The assistant medical officer of the infirmary stated that a post-mortem examination made the
same evening showed there was acute inflammation of the upper part of the small intestine, with some
patches of extravasated blood. The intestinal contents were grumous and blood-stained. Dr. Klein
reporting on the specimen submitted to him stated that "although the microscopic characters of the
intestinal contents were not so typical as in the Westminster case (case 1), the cultivations were
positive, and in every respect characteristic of Asiatic cholera."
Case 4.
J. E. (male), set. 61, master sculptor, Kennington-road.
Patient was at Ramsgate with his three daughters from September 2nd to 4th. He then came
home, and only went out to go to his office a short distance away. While at Ramsgate he ate some
shrimp paste. On September the 5th he suffered from colic and began to feel "out of sorts." On the
9th he slept badly; on the 10th he was rather better; on the morning of the 11th he suffered from
vomiting and purging with cramps, became rapidly worse, and at 11 a.m. was almost pulseless, blue
and cold. In the evening at 7 p.m. he was transfused and seemed a little better for a time, but died
between 5 and 6 next morning. One of his daughters was said to have had slight diarrhoea on the 6th.
A post-mortem examination showed some injection of the coats of the small intestine, particularly
of the ileum. There were old adhesions binding together coils of intestine. The contents of the
bowel were like watery mucus.
Report by Dr. Klein—"In microscopic specimens there were seen numerous epithelial flakes
containing amongst numerous straight bacilli some distinctly comma and S-shaped ones. Cultivations
were made in peptone salt, and yielded in 18 hours a crop of comma bacilli which, in sub-cultures in
the various media, proved identical with the choleraic comma bacilli. Distinct cholera-red reaction."
Case 5.
W. N. (male), set. 19, lighterman, Park-street, Poplar.
Patient was quite well when he left home for Purfleet one week previous to his attack of illness.
He worked with three other men on a barge, the " Memory," and they were engaged at Purfleet on the
12th September loading up with sand.
They started for London at 10 p.m. on the same night, and patient had a bun and some beer
at Erith. He subsequently complained of being thirsty, and was cautioned not to drink river water,
but could not recollect whether he had done so.
About 11 a.m. on the 13th September pain in the belly commenced, and was succeeded by vomiting
and severe diarrhoea, with cramps in the limbs. He was admitted into St. Bartholomew's Hospital during
the afternoon, and on admission at 5 p.m. was semi-comatose, cold and dusky. About 9 p.m. his
condition was rather more hopeful; his voice was husky, but he was quite conscious, and the diarrhoea
had ceased ; there was, however, still occasional vomiting.
On the 14th reaction had set in, the face being flushed, the temperature just below normal
(97.8). No action of the bowels had occurred for 24 hours, and no urine had been passed during
that period.
The patient gradually improved. There was no action of the bowels for a period of some days,
and no bacteriological examination could in consequence be made. His barge mates remained in
good health.
Case 6.
S.B. (female), set. 53, Tabard-street, Newington.
Patient was housekeeper at a mission-house in the above street. She rarely went outside the
house; on September the 8th, however, she went with a friend to Greenwich, and there bought some