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shrimps. She only ate a few, as the taste was disagreeable. Dr. Millson, the medical officer of health
of the district, who gave me notes of this case, states that she had eaten tomatoes, and had partaken
freely of pears with the peel on, prior to her illness.
Patient suffered from slight diarrhoea "on and off" from September 7th. At 2 a.m. on the
14th September purging and abdominal pain set in, and collapse soon supervened. In the evening her
condition improved. On the 15th she was distinctly better, but there was still profuse diarrhoea. The
improvement was maintained on the 16th. On the 17th, however, she was not so well. On the 18th
the severe diarrhoea returned, collapse became extreme, and the patient died at midnight. There was
no other case of similar illness in the house.
A post-mortem examination by Dr. Millson, at which Dr. Hamer and I were present, showed
the small intestine to be injected ; there were extensive adhesions (old) of the lungs to the chest wall.
A piece of ileum was sent to Dr. Klein.
Report by Dr. Klein—"The intestine was much congested and contained solid gelatinous stringy
masses. Microscopic examination showed numerous epithelial flakes, and in them crowds of bacillus
coli, but no definite commas. Cultivations proved altogether negative qua commas."
Case 7.
E. C. E. (male), set. 5, Gee-street, St. Luke's.
On September the 15th diarrhoea and vomiting commenced. The stools resembled rice-water.
Patient rapidly sank into a condition of extreme collapse, and on admission to hospital at midnight
appeared to be in extremis. The purging and vomiting however ceased, and on the 16th his condition
steadily improved, and he made a good recovery.
Report by Dr. Klein—"The stools contained numerous flakes, but they were not of the epithelial
character. Amongst crowds of various bacilli, there were few that looked like commas. Cultivations
proved negative qua commas."
Case 8.
J. E. F. (male), set. 11, 20 Block, Little Sutton-street, Clerkenwell.
Patient ate on 16th September some fried fish, which his friends say came from Grimsby. (His
brother also ate some of the fish, and he vomited shortly afterwards.) On the 17th September, patient
vomited and was purged. He was taken to St. Bartholomew's Hospital, and was then in a collapsed
condition; there were no cramps in the limbs. The stools were like rice-water. The next day patient
was much better, and he made a good recovery. Dr. Klein examined two of the evacuations passed by
this patient.
Report by Dr. Klein—"The stools contained in a slightly turbid fluid numerous whitish grey
flakes, which on examination were seen to be made up of leucocytes, not of epithelial cells. No definite
commas in them. Cultivations proved negative. Rice-water stools of same case was obtained on the
following day, September 19th. The microscopic examination of the flakes and the cultivation again
yielded negative results."
Case 9.
S. F. (male), set. 6, 22 Block, Little Sutton-street, Clerkenwell.
On September the 18th he ate some fried fish obtained from the same shop as the fish eaten by
J. E. F., case 8. On the 19th he ate an ice, and a few minutes afterwards was attacked with vomiting
and diarrhoea. He was admitted the same evening into hospital, and there passed two motions, not of a
rice-water character. The vomiting was frequent, and streaks of blood were seen in the material brought
up. There was suppression of urine for 28 hours, and considerable collapse. The patient made a good
recovery. No bacteriological examination was made in this case.
Case 10.
T. S. (male), set. 26, builder, Ottaway-road, Hackney.
On September the 16th he ate a bloater for breakfast, and he subsequently ate some whelks. On
September the 17th he ate pickled pork, which his wife and child shared, both remaining well. At 1 a.m.
on the 18th, vomiting and diarrhoea with cramps in the limbs set in. The stools looked like rice-water. On
the afternoon of the same day he was admitted into St. Bartholomew's Hospital in a state of collapse. The
diarrhoea had then ceased, and from this time his condition improved, and he made a good recovery.
One of the rice-water-like evacuations was obtained on September 18th by Dr. Warry, Acting Medical
Officer of Health of Hackney, and submitted to Dr. Klein on September 22nd.
Report by Dr. Klein—"Numerous whitish grey flakes were present, which under the microscope did
not show the epithelial character. There were present crowds of straight bacilli. Cultivations
proved entirely negative qua commas."
Case 11.
A. B. (male), set. 15, printer, Thesiger-road, Penge.
On the 20th September, patient began to suffer from diarrhoea and abdominal pain. After the
commencement of symptoms he ate a bloater, but does not recollect eating shell fish or fish of any
kind prior to his attack. The indisposition passed off for a time, but returned on the morning of tha
Sllst, when he was attacked with abdominal pain, vomiting and headache. At 10 a.m. he was admitted
into hospital, and was then much collapsed, suffering from vomiting and diarrhoea, but his voice was
unaltered. There were no cramps in the limbs throughout the illness. The stools were not typically
rice-water. He made a good recovery. There was no other case of similar illness in the house.
Report of Dr. Klein—"Microscopical examination showed numerous flakes, but they were not cf
the epithelial character, and they contained crowds of bacillus coli. No definite comma bacilli
could be detected in the stool. Cultivations proved negative."
Case 12.
R. N. (male), £Bt. 60, glass cutter, Artizans'-dwellings, Quinn's-square, Waterloo-bridge-road.
Patient came with his family to the block of buildings named above about four weeks before his
illness began. No strangers subsequently were entered as tenants in the block save a family which