Report by the Medical Officer on outbreak of enteric fever in Royal and Western Infirmaries, and Fever Hospital, Belvidere, Glasgow, in August, 1884.

  • Russell, James Burn, 1837-1904.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Report by the Medical Officer on outbreak of enteric fever in Royal and Western Infirmaries, and Fever Hospital, Belvidere, Glasgow, in August, 1884. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of whicli had been carefully planned and tested, any derangement of sncli extent and gravity as to impregnate the whole building with specific effluvia, and yet have escaped the observation of the senses, could exist. Still, to set that doubt at rest, as well as to make sure that the specific poison, however introduced, should not spread secondarily by any defects in drains or soil-pipes, the whole system was carefully examined with the smoke test by the officers of the department. Only a few insignificant defects were discovered. As regards the question at issue it was clear that the medium of infection did not exist in that direction. The Superin- tendent gave orders that all milk should be boiled before use. Application was made to the milk-contractor for a list of the farmers from whom he obtained his supply. A long experience in such inquiries has taught me that in the distribution of the milk consigned to a milk-dealer, while he may correctly state from Avhat sources individual customers are usually supplied, there is no certainty that these sources are alw^ays the same. On Sundays, from the stoppage of trained mUk, thei-e must be a deviation from the system which prevails during the week, and in general from a variety of causes, there is so much chance of variation and intermixture that portions of any one farmer's milk may, especially in the afternoon delivery, find their way to any customer at one time or another. The practical result of this system of business is that in any investigation for a con- taminated source, while it is well to follow up first such indications as the agent can give, nothing short of an examination of every farm on his list is satisfactory. In the present case there were 40 farms in the list supplied, scattered over the counties of Stirling, Dumbarton, Lanark, Renfrew, Ayr, and Wigtowni. A cu-cular letter was at once issued to each one enquiring as to the health of the farmer's household, his enq^loyds and their families, and the cattle, since the 1st of June, and at the date of reply. At the same time an inspection by the milk inspectors was begun, and I went in person to the three farms designated as the chief source of the hospital supply. In this way seven farms were visited in Renfrewshire and Ayrshire without result. Meanwhile I knew that the milk supply of the Royal Infirmary and Belvidere Hospital was from the same agent. I heard from Belvidere that a nurse who had been sent from the Royal Infirmary as a case of scarlet fever was foinul to be suflering from enteric fever, and that she had sickened at the same time as the Westeni