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character of the disorder is realized; no precautions have been taken during this
period: a mother, or sister, or daughter as the case may be, has been waiting upon
the sick one, besides attending to household duties and looking after the wants of the
other members of the family, preparing food, cutting bread and butter and so forth,
without disinfecting her hands; or, as not infrequently happens, the patient has been
sharing a bed with another member of the family. In the following series of cases the
patients were all members of the same family:—
(1) Annie B—, aged 18, was observed to be ailing about the middle of July.
She gradually became worse, and on August 1st, was obliged to give
up her work. It was thought that she was suffering from a very
"bad cold." She kept her bed for about a week; she lost her appetite,
and suffered from diarrhœa, and is said to have been feverish. She was
certified to be suffering from enteric fever on September 19th, and it does
not appear that she was quite well until the end of September.
(2) Louisa B-, aged 16, sister of above patient. Her illness began about
the middle of August; she lost her appetite and suffered from diarrhoea
and feverishness; she did not keep her bed, and was quite well again by
the end of September. This patient slept in the same bed as her sister
Annie.
(3) Mrs. B-, aged 43, mother, was taken ill towards the end of August;
she was obliged to take to her bed on September 10th, and kept her bed from
that date until October 7th.
(4) Rosie B-, aged five, sister, was taken ill during the first week in
September; she was seen by a medical man on September 15th, was
certified to be suffering from enteric fever on September 19th, and kept her
bed until October 7th. This child slept in the same bed as her sisters
Annie and Louisa during the greater part of the time they were ill.
(5) Charles B-, aged 38, father, becamc unwell about September 10th, was
obliged to give up work at the end of that month, "sat about" until
October 7th, took to his bed until the end of October, and returned to his
work on November 20th.
The house in which the above cases occurred contains six rooms and a scullery;
its condition, from a sanitary point of view, was unsatisfactory. The inhabitants
consisted of Mr. and Mrs. B-, with their six children, who occupied four rooms,
and a young married couple, who had two rooms. Three boys, aged 12, 10, and 7
respectively, remained well, as was also the case with the married couple. Although
only two of the foregoing cases were certified to be enteric fever, viz., 1 and 4, there is
no doubt, from their histories, that the other three cases were cases of enteric fever.