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49
Septic sore throat due to milk.
The annual report of Dr. Warry, the medical officer of health of Hackney, contains an
interesting account of an outbreak of throat illness which there was good ground for associating
with the distribution of a particular milk supply. The cases occurred in the north of the
district, and in reply to a circular letter to medical practitioners enquiring as to whether they had
met with "cases of sore throat illness accompanied by much enlargement of the glands of
the neck and considerable weakness," Dr. Warry was informed of 151 cases of throat illness
in 88 households, of which 138 cases occurring in 75 households received their milk from one
vendor. Having failed to obtain from the milk vendor information as to the distribution of his
milk supply, Dr. Warry selected two areas for house-to-house inquiry, and found that incidence
of recent throat illness had been almost entirely on persons receiving the milk under suspicion,
and further that "one or two remarkable cases occurred in distant parts of the parish, in households
supplied by X., but where his milk was not expected to be supplied."
Dr. Warry includes in his report the following account of symptoms of the malady met with
in ten cases occurring in the practice of Dr. H. S. Powell, of Upper Clapton, to whom he was
indebted for it—
(a) In every case there was tonsilitis (not follicular); (6) In two cases there was as well superficial
ulceration of the tonsil; (c) In every case there was considerable swelling of the cervical lymphatic
glands, more marked on the one side than the other ; in two cases the swelling was very great; (d) In
one case the lymphadenitis proceeded to suppuration ; (e) In every case the temperature was raised, in a
few cases it was 105 F., and there were rigors. In all the cases the temperature persisted after the
tonsilitis had disappeared, lasting in nearly all for at least a fortnight; (f) The temperature assumed
the remittent type, and there was in every case profuse sweating at nights; (g) There was great
prostration in most cases, and considerable cachexia in all ; (h) In one case acute septicaemia supervened,
followed by acute septic pneumonia and death; (i) In two cases in the same family, acute nephritis
with hematuria came on about a week after the onset of symptoms ; (J) In one case the child had an
attack of purpura hsemorrhagica ; (k) In all cases convalescence was protracted.
The symptoms described resemble broadly those met with by Dr. Kenwood in Horusey
in 1895, occurring in an outbreak attributed to the distribution of a particular milk supply. They
also present resemblance to cases described by Dr. Wheaton in a paper contributed to the
Epidemiological Society in 1894, and to cases described by Dr. Reid, medical officer of health of
Staffordshire, in a paper contributed to the Society of Medical Officers of Health in 1896. In the
two last-mentioned papers the cases were not attributed to milk.
Offensive Businesses.
The administration of the by-laws regulating offensive businessee was on the 9th November
transferred to the metropolitan borough councils. During the year the inspectors of the Council
made 4,470 inspections of such premises; proceedings were instituted in five instances in respect
of which fines amounting to £12 5s., with £8 11s. costs, were imposed by the magistrates. The
number of applications for renewal of licences to slaughterhouses was 405, of which 393 were
granted. The number of applications for renewal of licences to knackers' yards was five, all of
which were granted.

Complaints to the London County Council.
In 1900 the Council received 837 complaints concerning insanitary conditions in connection
with which 1,226 inspections were made by the Council's inspectors. Where complaint had
not previously been made to the sanitary authority, the complainant was advised to adopt this
course. In other cases the sanitary authority was coumunicated with. In all cases the matter
was kept under observation until the conditions complained of were remedied.
Nuisances.
Smoke Nuisances.
Reference is made to the action taken by the several sanitary authorities in respect of
smoke nuisances in the majority of the annual reports of medical officers of health. Proceedings
were instituted against electric light companies in Westminster and Lambeth. At the instance
of the Westminster Yestry the Westminster Electric Light Company, Millbank-street, was fined
£40 and costs on four summonses, and, as the result of proceedings by the Lambeth Vestry,
the South London Electricity Supply Corporation was fined £150 and costs on 16 summonses.