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Inquiry into the cause of infection of the first case failed to show that he had been in
association with an antecedent case of typhus, and Dr. Dudfield attributes the illness to the conditions
which prevailed in the rooms this family occupied, which he thus describes—
The two rooms, apart from the scullery, contain—the living room, 1,353 cubic feet of air space; the
bedroom, 948 cubic feet. In the living room the deceased young man, John B-, slept. The remaining
members of the family (excepting Julia, who was in service), slept in the bedroom. They comprised the
parents and five children, aged 18, 11, 8, 6, and 4 years respectively. The air-space, without deduction
for the bodies of the sleepers, two bedsteads, &c., and other furniture, was at the rate of 135 cubic feet
for each person, the minimum required under registered and common lodging-houses by-laws being
300 feet. But this is not all. The bedding, clothing, &c., was in bad condition, and a considerable
accumulation of underclothing was found, which, like some of the bedding, was soiled with excreta:
vermin abounded. The atmosphere of the rooms was offensive, and it was stated that the rent collector
would never go beyond the door. Such a state of things—overcrowding and stench, one would think,
could hardly have been unknown to the owner's representative, and it is to be regretted that it was not
made known to the sanitary inspector. Foul air, constantly rebreathed, as was inevitable in the circumstances,
appears to me adequately to account for the illness of Thomas B-, which commenced at a
time when he was more or less pulled down by the excessive strain, mental and bodily of overwork, just
before Christmas. The same conditions, plus infection, sufficiently account for the subsequent cases in
this man's family.
The group of three cases also referred to occurred in Kensington in October. The following
extract from Dr. Dudfield's report gives particulars of these cases—
"In October another slight outbreak of typhus occurred comprising three cases. The first was that
of a married woman, who had been removed to the infirmary from a house in Kenley-street (Potteries),
where, with other persons, she had been in illegal occupation of an underground room which had been
closed, upon proceedings taken by the sanitary committee in 1895. The symptoms of the illness were
suspicious but obscure, and a positive diagnosis of typhus was not made until one of the nurses who
had been in attendance upon the sufferer fell ill. This nurse was removed to hospital, and subsequently
a second nurse, both of whom had unmistakable typhus. Happily all three cases did well. The drain of
the house in Kenley-street was found to be defective. Proceedings were taken against the keeper of the
registered house for permitting the illegal occupation of the underground room where the disease is
believed to have originated."
In addition to the case of typhus previously mentioned in connection with the first group
of Kensington cases, a second case of typhus in St. George-the-Martyr was notified in October. The
patient was a brushmaker, aged 19 years, whose illness was recognised on his presenting himself at
the out-patient room of Guy's Hospital. He lived with his parents, two brothers, and a sister. His
father was a casual riverside labourer, and both his brothers were earning wages. The source of
infection could not be discovered. Dr. Waldo's report supplies the following information as to the
house accommodation of this family—
" The house contained two rooms, a living one on the ground floor (with a capacity of 132 cubic feet
and floor space of 22 square ft. per person) and a bedroom upstairs reached from the lower room by stairs.
The whole family of six adults (counting as an adult everyone over 10, as laid down in the by-laws of
this parish for lodging-houses) slept in three beds in the upstairs room. The cubic space of the bedroom
(making no deduction for beds or other contents) was 1,095 cubic feat, leaving 182 5 cubic feet per head,
whereas the minimum allowance under the above-quoted by-laws is 300 cubic ft. for each inmate of a bedroom
used exclusively as a sleeping apartment. I may add that, in my opinion, the allowance per head
should be at least 1,000 cubic feet, and that only in the presence of free ventilation. In this particular
bedroom under notice there were two windows, an open fireplace, and a doorway. The windows were on
one side of the room, opposite a sloping roof on the other side, so that there was no opportunity of cross
ventilation. Turning next to the floor space, we find it a few inches over 25 square feet per inmate,
which is, in my opinion, inadequate. The general condition of the house was fairly clean. The watercloset
was at the back in a small yard closely hemmed in by houses.
A case of typhus was notified in Battersea in the beginning of the year. The pavent was a
district nurse who had, until three days before the beginning of her illness, lived in Wellingborough.
She was not known to have been in contact with any antecedent case of typhus, and she
was not removed to hospital.
In March one of the nurses in the South-Eastern Hospital was attacked with typhus. There
does not appear to have been any recognised case of typhus in the hospital at the time of her infection.
Cases of alleged typhus, but not later deemed to be such, were notified in Kensington,
Islington, St. George Southwark, and Lambeth.
Enteric Fever.
The number of cases of enteric fever notified in the Administrative County of London in
1898 (52 weeks) was 3,031, and the number of deaths belonging to the Administrative County was
554. compared with 3.113 eases, and 559 deaths in 1897.

1 See footnote ('), page 3.
* The Infectious Diseases (Notification) Act only came into force in 1889.