View report page

12
quiry into the history of the cases led me, as in former years, to
the conclusion that some of the deaths registered as from " typhoid "
were not cases of enteric fever, but different diseases, assuming at the
approach of death a "typhoid" character. Some of the cases were
imported. Two outbreaks attributed to milk call for notice. The
first, an unimportant one, occurred in October, and so far as I
know, comprised only eight or nine cases. Three children in a
dairyman's family were taken ill—one at home, and the other two
some days after they had left home on a visit, and these were the
only cases in Kensington ; but I was informed that other five or six
cases had occurred in two adjoining parishes—all children who had
partaken of milk from the suspected dairy. All the outside cases
appear to have commenced at about the same time as the first
case in the dairyman's family, in the treatment of which proper
precautions were taken under medical direction to prevent
the spread of the disease. The premises on inspection were found
in fair sanitary condition on the whole, some slight defects being
remedied forthwith. The milk, which was served out in the shop
to the carriers from the churns in which it had travelled, was obtained
from two sources—a suburban dairy and a Hampshire farm—the
latter supply through a South London milk dealer. I placed myself
in communication with the Medical Officers of the respective
districts, and ascertained that there had been no case of enteric
fever in the families of the cowkeepers nor in the neighbourhood, and
that there was no sanitary defect on the premises to which enteric
fever could be traced. I submitted samples of the milks to your
Vestry's analyst, who reported that the one contained 18 and
the other 30 per cent. of added water—a circumstance which did
not by any means invalidate the suspicion that the contagium
might have been conveyed in the milk. Happily none of the
cases, whatever their origin, proved fatal.
The other outbreak, much more serious and very fatal, began at
the end of November. The circumstances attending the cases
pointed to a probable community of origin in the large majority of
them, viz., from the use of a specifically infected milk. The mortality
from enteric fever in the fourth quarter of 1877 had been
rather below the average—but at about the middle of December I
began to be aware that cases of the disease were somewhat more
numerous than usual. At that time a medical man called on me
and reported a fatal case in his own practice at a house in Fopstone
Road. He stated that a second case had been sent from the
same house to one of the hospitals, and that there was a third case
at the adjoining house. Both families, he said, were supplied with
milk from the same dairy, and he expressed a suspicion that the
disease was due to the milk. Other cases came to my knowledge
in the course of the next few days, and the matter assuming a