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4
Surbiton." From subsequent enquiries I found this was
in all probability the case, and nothing was found amiss in
the house. The third case was almost certainly contracted
in London, or at any rate away from home, and was of a
most grave type from the first, as the patient died after
only a few days illness. Following this was the case of a
young man who really was residing in London and only
occasionally coming down here to a house, for as I understand
a few days at a time, the house being at the time
only partly furnished; there was nothing about the sanitary
conditions to justify suspicion. The fifth case and last was
that of a boy from one of the public schools. The case
was notified on December 27th, and the Doctor at the same
time wrote me " I believe the case was imported from-
School, where the patient has been until a week
ago." Unhappily the illness proved fatal in the course
of a week. I at once notified the Medical Officer of
Health of the District in which this school is situated. In
the preceding year there were 12 cases. There are points
of resemblance in both years in the incidence of this
disease such as the large majority being persons who either
habitually or frequently leave home, and who have been
doing so in the weeks immediately preceding their illness,
and have thus had ample opportunities of becoming
exposed to infection elsewhere. That being so, out of the
17 cases we naturally find a preponderance of males, the
proportions being 12 to 5, and of the women 2 most
certainly contracted it at seaport towns, returning home
with illness upon them. Then in neither year is milk,
water or food of any sort under suspicion, no evidence of
any spread from personal infection, and no sanitary defects
in the houses of a character to cause such disease or likely
to do so, and no two cases in any one house. In short,
while all care and watchfulness was required and given,