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infection." The medical officer of health of Hampstead states as the result of his inquiries, "It is
certain that typhoid fever was epidemic in London during the close of the year, and most of our cases
occurred at that time. No satisfactory explanation of the outbreak was arrived at, but there was some
reason for thinking that the consumption of oysters that had been fattened in the estuaries of rivers, to
the water of which typhoid material had access, had been a cause of the infection." The medical officer
of health of the Strand district, in discussing 15 cases notified in the district, states that "no less than
seven were persons employed in hotels and restaurants, one of them being also an oyster merchant."
The evidence which is supplied by the inquiries made by medical officers of health in London
does not do more than establish the fact that, antecedent to attack by enteric fever, certain of the
sufferers had eaten oysters. There is, however, no information as to the proportion of persons in the
general population who are in the habit of eating oysters.
More precise evidence, tending to incriminate oysters as a cause of enteric fever, comes from
Connecticut, where in October, 1894, were attacked, subsequent to a supper at the Wesleyan College,
residents in the college and visitors not so resident, who were present at the supper and ate oysters,
and these to the exclusion of other persons at the supper who did not ear oysters. Beyond this, oysters
from the same source were sent elsewhere, and enteric fever followed their consumption. Lastly, the
oysters, it was found, had been laid down in a creek where they were exposed to the drainage from a
house in which cases of enteric fever had occurred.*
Other suggestions as to the cause of enteric fever in London are made in the reports of medical
officers of health. In Plumstead the drinking of water from a canal, used in the arsenal for engines,
was thought by the medical officer of health to be the cause of a case of enteric fever. The medical
officer of health of the Strand district writes, " It is also possible that the floods in the Thames in late
autumn, by washing down the deposits in its bed, together with the contents of numerous cesspools on
its bank may have exercised some influence on the disease," and the medical officer of health of
St. George, Hanover-square writes, " Of the 65 cases of enteric fever, no fewer than 29 were certified in
"November and December, and only 14 in the three previous months, when the seasonal prevalence of
"that disease usually takes place, and on investigation I find this is usually the case as is shown by
"the following table—"

"This follows upon the delivery of insufficiently filtered Thames water when the river is in flood,
"which was especially noticeable last year, the samples taken in November being very bad indeed.
"Some cases of this disease in London and elsewhere were believed to have been traced to the con"sumption
of sewage-polluted oysters, but this cause would apply equally to September and October."

* The "Oyster Epidemic," or Typhoid Fever at Wesleyan University, by W. H. Conn, Ph.D., Professor of Biology, Wesleyan University,
Middletown, Connecticut. (Medical Record of New York, December 15th, 1894.)