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17
"These are the results of tests for agglutination against the
most likely bacteria to cause diarrhcea in the way described.
As you see, they are all negative for practical purposes.
If I were to speculate on the pathology it would be that
the products of bacterial growth in sewage-contaminated water
are the actual irritants and not necessarily living pathogenic
bacteria."
In the case of E. there was "a colony of B. Dysentericus
(Sonne)." A second sample of blood was taken 10 days later, on
which Dr. Scott reports as follows:—
"Thank you for procuring for me another sample of blood
from patient F.S.
It gives only a trace of agglutination with the B. Dysenteriae
(Sonne) at 1-20 dilution and none higher, so one must
conclude that the infection with that strain was too mild to
excite a serum-reaction.
I regard the traces of agglutination with the two Flexners
as of no significance, as they are common in c normal' sera."
As will be noticed from the analyses of the Canal water, the
condition varies markedly from time to time.
There is definite evidence of greater pollution at the dates
nearer the outbreak than on later dates, e.g., the B. Coli figure on
March 5th is 10 times greater than on the 18th; also the Free
Ammonia on 5th March is 2½ times greater than on the 18th.
There is no doubt that the outbreak was caused by the introduction
of Canal water into the drinking water system. When
that occurred the authorities cannot state definitely. The Engineer's
idea is that it was only the day before. If the entry had
existed some time, the odd cases of intestinal disorder may be accounted
for, and the very bad analyses nearer the date of the outbreak
would lend colour to the possibility of some fresh pollution
gs the cause of the exacerbation,