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47
preceding week he had been engaged in unloading " Australian wool " and goat skins from a
vessel in St. Katherine's Dock. The pustule was excised, and the patient recovered.
(xiii.) J. C., male, aged 31, living at Aberdour-street, Bermondsey, employed in repairing
coal sacks, noticed a pimple on the right side of his lower jaw on December llth. On the
following day he was obliged to leave work, and on the 15th he went to Guy's hospital.
The pustule was excised, and the man made a good recovery. There was no clue in the first
instance to the source of infection in this case. It was ascertained however, subsequently, that
the man's wife was in the habit of manipulating horsehair, using as a workroom the
room in which the family lived. Bundles of horsehair and bristles were brought home by
the wife and made into brushes, and the husband took "a turn at the horsehair" if he
happened to be out of work.
The year's record is remarkable in respect of the number of cases which occurred among
workers in horsehair. Isolated cases have on a few occasions been recorded in London in
connection with this industry, and during 1893 a group of four such cases came under notice.
In 1895, however, there was evidence of more widespread mischief. Three cases occurred in
the neighbourhood of Tabard-street among persons who had handled horsehair. These three
persons were each in the employ of a different brushmaker. Another case was that of a sorter
of horsehair employed in St. Luke's by a firm doing a large business in horsehair. Two cases
occurred in East London in which the infection appeared to be traceable to a workplace at
Tottenham. The medical officer of health of Tottenham was communicated with, and he
stated that two other cases had occurred in Tottenham, the individuals attacked both being
workers in the workplace in question. Again, two other cases occurred in East London, the
men who were attacked being engaged in manipulating horsehair at a bass and fibre dresser's
in Mile-end Old-town.
There appear, therefore, to have been, including the two Tottenham cases, at least ten
cases among horsehair workers, the earliest (one of the Tottenham cases) developing in May,
the latest developing in December. The circumstances of the outbreak suggest that a particular
consignment of horsehair may have been handled by all the ten workers, and that a limited
quantity of infected material may have done all the mischief. The facts, so far as they were
ascertained with regard to the distribution of horsehair to some of the workshops involved,
suggest that such an explanation is the true one, but it was not found possible to conclusively
prove that this hypothesis was correct.
A further point of special interest in connection with cases of anthrax occurring during
1895 is the fact that in four instances persons who developed anthrax were found to have
been engaged shortly before the onset of symptoms in manipulating goat skins. Cases (vii.)
and (viii.) are two of the four cases referred to. The fact that the patient had been thus
employed was noted in these cases at the time, but as the patient had also handled hides, the
latter were thought of as a more likely source of infection. In case (xi.) however, goat skins
only were handled by the man during the few days preceding his illness, and some stress
was laid by the workers in the tanyard where the skins were manipulated upon the fact that
some of the skins were rotten and gave off a bad smell. It was subsequently ascertained
that the skins were " sea damaged " and were disposed of at a salvage sale. The fact of
the damage by water no doubt accounted for the condition noticed by the men in the
tanner's yard. In case xii. goat skins again came under suspicion.
During the first few months of 1896 a number of other cases of anthrax occurred, and
there is reason to suspect that in all these cases, with the exception, perhaps, of the first case
to be referred to, the patients were infected through the medium of goat skins. The
following are the facts ascertained concerning these cases—
R. D., aged 48, lived at Page's-walk, Bermondsey. This man worked at a large warehouse
where he had been employed in handling many kinds of hides and skins. No
particular class of material seemed specially open to suspicion. He noticed a pimple at the
outer corner of his left eye on January 8th, 1896. This pimple was excised at Guy's
Hospital on January 10th, and the man speedily recovered.
During the last day of January and during the first four days of February five men
who had been employed in a particular Bermondsey tanyard were admitted to Guy's Hospital
with anthrax, and on February 4th a sixth man, who had been working at a Tooley-street
wharf, was admitted with this disease. The five men from the tanyard were inclined to
attribute their attack to the manipulation of certain goat skins, and inquiry elicited the fact
that the suspected goat skins had been supplied from the Tooley-street wharf* at which the
sixth man had worked, and that this man had been engaged in carrying the said skins.
The following are the particulars concerning the six cases referred to. All the cases
were treated in a similar manner. The pustule was excised and sulphur was then applied
to the wound, powdered ipecacuanha being administered internally. All six men recovered.
J. K., aged 22, noticed a pimple on his left cheek on January 29th, and on the following
day suffered from shivering and lassitude. He was admitted to Guy's hospital on the 31st,
his temperature was then 102°. The fluid from the vesicles surrounding the pustule was found
to contain anthrax bacilli.
J. E., aged 42, noticed a pimple under his lower jaw on January 29th. He was
admitted on February 7th, his temperature then being 99'8°. Bacilli were found in the
serum from the neighbourhood of the pustule.
*Sun and Topping's wharf.—It may be noted that at this wharf cases had from time to time occurred in association with the
manipulation of goat ekins. Such a case occurred in September, 1893, and another in March, 1894. In September, 1894, a man who had
been working at this wharf was attacked, but in this case there is no information as to whether the man handled goat skins. Again in
October, 1895, two cases (cases yii. and viii.) occurred in which goat skins had been manipulated at the same wharf.