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the 30 known cases only ten died, or 33.3 per cent. The high
rate of mortality among the sick who had partaken of milk from
the suspected dairy is, prima facie, an argument against the milk
theory.
But such an unusual fatality testifies to the virulence of the infective
agency, whencesoever derived. It also suggests the questions,
"11 ow was it that with a poison of such intensity distributed
among so many hundred persons—if milk was the vehicle of
the contagium—so few persons suffered, and they so sorely?" And
if milk was not in fault, "To what cause or causes are we to attribute
the outbreak ?" To the former question I can give no
answer, but to the latter I would reply, "Presumably to one or
other of those causes of water or air-pollution to which the occurrence
of ordinary cases of typhoid fever is usually traceable," viz.,
to defective sewerage or drainage—to the breathing of polluted
air, or the drinking of polluted water, leaving out of the question
whether specific pollution of air or water, is essential to the causation
of typhoid. And here I would observe that the possibility
of such an origin had not been overlooked from the first,
though the enquiiy was primarily directed to the discovery of the
source of the suspected milk infection; and inspection of the
houses where the disease had appeared did, in fact, reveal, in nearly
all of them, such sanitary defects as would, in almost any of the
16 cases occurring singly, have been deemed adequate to account
for the illness—the difficulty of admitting this explanation, however,
being increased by the coincidence of a common source of
milk supply.
It is needless to detail here the various sanitary defects referred
to; it may suffice to say that they comprised untrapped, unventilated,
and otherwise defective drains; cisterns and baths in communication
with drains by waste pipes; offensive water closets, in
some cases near sleeping rooms; and in some of the streets sewers
defective in construction or material, three of them having blind
or dead ends.
It will be conceded that such sanitary defects as the above are
sufficient to account for the occurrence of typhoid fever in the
individual cases; but excluding the milk theory of infection it is
not easy to account for the occurrence of so many cases within so
short a space of time, though at considerable distances apart. I
have thought, however, that an explanation of the difficulty might
be found in the facts—(1) that typhoid fever was unusually prevalent
in the Metropolis at the time of this outbreak, and (2) than
the streets in Kensington in which the disease appeared belong
to the same system of drainage. The sewers are affluents of an
underground river, known as the Counters Creek sewer, which
traverses the parish near its western boundary, from north to
south, teiminating at the Grosvenor Bridge Pumping Station.