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35
for several weeks, although the patients were removed as soon
as the disease was diagnosed, and the rooms and bedding freely
disinfected, partly by the officers of this Board and partly by
the officers of the Institution, under my direction. When I
inspected the rooms and drainage arrangements I found everything
satisfactory, and ascertained that the utmost care and all
reasonable precautions were used for preventing the spreading
of the disease. The endemic has long since subsided, as there
has not been any case for several months past in this Institution.
The other outbreak took place in the Convent, Hassett Road,
and was one of typhoid fever, as many as 8 cases having
occurred in the course of two months. The first three cases
occurred within three days of one another, and two more on the
thirteenth day after the first case, so that it was evident that
there was some common cause for the outbreak. A very careful
enquiry was made respecting the milk supply, which was
extended to other customers who received milk from the same
purveyor, and also respecting the dairy farm from which it
came, but there was not any other known case of typhoid
amongst those who used this milk and from whence it came.
The milk was examined chemically and microscopically, also the
tinned meat, and lard used for making pastry, but nothing
wrong was discovered. The drains were in good order, but the
trough forming the watercloset occasionally smelt, although it
was automatically flushed twice a day. I advised this to be
more carefully attended to, but do not think it originated the
outbreak, and am therefore unable to assign the cause, which is
certainly unsatisfactory, as I am not a believer in the spontaneous
origin of typhoid fever.
The filthy condition of the River Lea caused me much
anxiety and considerable additional work, as I visited the river
frequently, especially during the summer months, and tested the
river water and the effluent from the Tottenham Sewage Works
on many occasions. I carefully compared the condition of the
river above and below the Tottenham Works, and found distinct