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from heart disease, consequent on the rheumatic fever; and on
placing myself in communication with the certifying surgeon he
admitted that there had been cardiac complication, but maintained
the existence of typhus. As, however, the patient was perfectly
conscious and rational to the last, I cannot but think there may
have been an error in the diagnosis—a view borne out in some
measure by the immunity of the other inhabitants of the house
under circumstances calculated to favour the spread of so
infectious a disease. The fourth and last case—whatever its
nature, was imported from Marylebone. It was that of a young
man who had been engaged in a large house of business in that
parish. The patient was seen by the medical man who attended
the previous case, but only once, viz., on We dnesday, the 23rd
January, the patient dying on Sunday, the 27th, at St. Luke's
Mews. The certificate given was "typhus:" and although the
account I had of the case from the mother and sister of the
deceased did not agree with my experience of typhus, I thought
it desirable to write to the employers of the deceased, pointing out
the posssible danger to their establishment, and requesting them to
hand my letter to their Medical adviser. This gentleman promptly
informed me that the young man, who had been under his care from
the 16th to the 22nd of January, was "suffering from typhoid
fever and not typhus." It would thus appear to be probable that the
diagnosis of typhus in at least three, if not in all four of the cases, may
have been an erroneous one, and being under this impression myself
I have felt it my duty to say so, and for this reason:—Typhus
fever is one of the most infectious of diseases—a disease it is
difficult to prevent from spreading, except under the most favourable
circumstances of isolation, &c. It is regarded, moreover, in
some degree, as an opprobrium upon the district where it occurs,
for its occurrence is a nearly sure sign of something very wrong
in the sanitary condition of the people or their surroundings.
Taking this view of the case, I presume, the Registrar-General
specifies in his "Weekly Return" the very house as well as the
street and parish where a death from this disease occurs. He
did so with regard to the deaths on which I have made the
foregoing remarks, and it therefore not only seemed incumbent
on me to make a careful investigation of the cases, but it seemed
to me equally a duty to your Vestry and myself that the conclusions
to which the investigation had led me should be frankly
stated.
Enteric Fever.—The deaths registered from enteric fever, were
fourteen in number. Ten of them occurred in the Town and four
in the Brompton registration sub-district. The ages of the deceased
may be ascertained by reference to Table 3, Appendix. The
quarterly numbers of the deaths were 5, 3, 1, 5, respectively.