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apparently some three miles above the place from which the ice was taken. Opposite the hospital
the river, it may be noted, is a mile and a quarter wide and has an average depth of from 12 to 20 ft.,
while the current flows at the rate of three miles an hour.
On examination of the ice it was found that " some of the cakes contained foreign substance
in the form of black or dark brown granular matter frozen in the ice." The number of bacteria
per c.c. was " on agar plates, 30,400 ; on gelatin plates, 50,400." The report continues: "Five
colonies were selected, which presented characteristics resembling the typhoid bacillus, and fresh
cultures were made from them. Of these cultures three proved to be the colon bacillus, one was a
bacillus not identified, while the fifth was a pure culture of the typhoid bacillus as shown by the
following tests. On nutrient agar it grows readily; in broth no pellicle is formed; in lactose media
no fermentation occurs; on potato the growth is invisible; in litmus milk the reaction is faintly
alkaline, and no coagulation occurs; with the serum of typhoid patients characteristic clumping
is produced ; it is an actively motile bacillus having the appearance of the bacillus typhosus." The
reporters add: " the disease was identified clinically by autopsies in three of the cases, in all of
which the intestinal and abdominal lesions were demonstrated." Finally they state: "with the
discontinuance of the use of the infected ice the epidemic gradually subsided. There were in all
thirty-nine cases, the last of which developed in November."
The evidence in this case, it will be seen, is based exclusively on the bacteriological finding,
and while it might have been regarded as fairly satisfactory three or four years ago, recent growth
of knowledge would appear to render it by no means conclusive. Nothing, for example, is said
as to the degree of dilution in the clumping experiments, nor are particulars given as to the
serum used; nowadays importance would be attached to the employment of serum from an
immunised animal. Thus, that the ice was the cause of the outbreak cannot, in this instance, be
regarded as being definitely proven.
It remains to add, in connection with the supposed spread of enteric fever by ice, that
charges have been made in New York journals to the effect that much of the enteric fever of the
city is attributable to the impure Hudson River ice, and in support of this view it has been
alleged that the very poor who use no ice suffer comparatively little from the disease. There may
be something in the suggestion, though it must be noted that several other considerations might
equally well account for the escape of the very poor, supposing always the statement to be well
founded that immunity from the disease is enjoyed by them.
Refrigerated Produce in Relation to Disease.—As regards the risk of the spread of infectious
disease by refrigerated produce, it may be stated at once that there is really no evidence at the
present time bearing upon it. Many persons, including, it may probably be assumed, some of those
interested in the trade in home-grown meat, have from time to time been inclined to entertain
gloomy forebodings as to the evils which might result from use of frozen meat, and public attention
has been repeatedly drawn to the subject. Thus a writer, " Medicus," addressing a London
evening paper, considers that appendicitis is caused by frozen meat; again, in a paper in the
" British Medical Journal" of 12th December, 1903, reference is made to the increase of cancer in
Ireland, and there follows the statement that " cancerous diseases . . . are caused by the longcontinued
consumption of unwholesome animal food, and that this unwholesomeness is produced
by modern economic conditions." "Physical deterioration of certain classes of the population,"
also occupies the attention of the same writer in a similar connection. Quite recently a question
was asked in the House of Commons as to the relation between frozen meat and cancer, and the
President of the Local Government Board, after communicating with the Executive Committee of
the Cancer Research Fund, replied that that Committee believed the consumption of frozen and
chilled meat was " not in any degree accountable for the increase in the recorded number of cases
of cancer in this country."
I have not been able to trace any allegation of a more precise kind as to injury to health
caused by meat or other refrigerated food. A complaint, however, was made to the London County
Council in November, 1903, to the effect that thousands of cases of bad eggs were sent into cold
storage by traders who wished to prevent seizures being made by inspectors ; the medical officer
was thereupon instructed to confer with the medical officers of Bermondsey, Southwark, and
Stepney, with regard to this subject, and at his request I made inspections, and saw numbers of
eggs examined for " spots." 1 I found that a number of bad eggs had been destroyed in the boroughs
named from time to time, but for the most part these had been voluntarily surrendered and their
destruction had been paid for by the egg merchants.
The Bacteriology of Lce.
In England comparatively little attention has been directed to the bacteriology of ice, but in
America, Germany, and Italy, countries in which ice is much more largely used than it is here, the
subject lias not been altogether neglected. The popular opinion has no doubt been that freezing
tends to purify water, and three lines of reasoning seem in the main to have been responsible for
fostering this notion. In the first place, reference must be made to the old observation that water
in freezing rejects impurity.
The Rejection of Impurity by Ice.—Dr. Prudden, in reporting on the ice supply of New
York some eighteen years ago, had drawn special attention to the " filthy condition of the
Hudson (from which much ice was derived) just below Albany," and he thereupon remarked " a
certain proportion of New Yorkers have gone on amiably consuming their distant neighbours'
1 " Spot eggs " are the eggs which present evidence of growth of mould, &c. An explanation, given of the
cause of the appearances in question is to the effect that if the egg is allowed to rest on its side, the yolk is apt to
shift and attach itself to the shell, producing a "spot." Eggs should, it is maintained, be packed resting ou the
small ends, a? in that position the yolk is least likely to be displaced.