This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
Probably enough has been stated to satisfy you, as I am satisfied, that the distribution of the Typhoid was connected with the distribution of the milk from the particular dairy referred to. But at the risk of being charged with heaping Ossa upon Pelion, I shall mention some other observations which add confirmation to the inference. They are interesting apart from this use of them.
1st. It is remarkable how the Typhoid picked out, as it were, the customers of this dairy in particular streets and rows of houses. Thus, in one long road, and a street issuing from it, at a distance of a mile or more from the dairy, it supplied three families; of these two had Typhoid. It supplied two families in a street with about thirty houses; one suffered from Typhoid: in the other died the old lady already mentioned from "Choleraic diarrhoea." It supplied four families in a new neighbourhood with about seventy houses; three of these families had Typhoid. It supplied four families in a crescent with twenty-five houses; all four had Typhoid; (in one only a single mild case recovered). It supplied four families in a row of nine houses: Typhoid occurred in two of them, and in the other two, cases of a mild febrile character (not enumerated) occurred. It supplied four families in two opposite rows of houses, altogether about sixty-seven; three of them had Typhoid. It supplied four families in a square with fifty-nine houses; all four had cases of Typhoid in them, etc, and these were, as far as I can ascertain, the only cases in these several localities.
2nd. It is to be observed that there were comparatively few solitary cases in the 10 families. Solitary attacks only happened in 22 of them, * * * * * There was, moreover, no instance within the quarter mile radius in which two families were attacked in the same house, except where both families used the same milk. On the other hand, there are several instances in which more than one family residing in a house, (the different families using milk from different purveyors), that using the milk from the dairy in question alone suffered.
3rd. The attacks in families appeared to have some relation to the quantity of milk consumed. It is a matter of common remark that milk is more largely consumed by females than by males, and by children than by adults. The first attack in the house only occurred in a man or youth nine times out of forty-seven. Some curious illustrations of this relation came out under the inquiries instituted of individual houses. Thus in the family living at the cow-yard, the daughter, while engaged as a nurse in a situation, alone got the dairy milk with regularity, and she was first attacked: the second case in this house (her mother) was a month later. In a family consisting of the father and mother, who never took any milk at any time, two servants and four children, all had Typhoid except the father and mother, the children commencing. In another family, consisting of mother, two servants, three girls, and a boy of 17, one of the girls and the boy took milk porridge daily at breakfast; the other girls, with the mother, took little milk comparatively. The servants, complaining that the beer was sour, asked permission to take milk instead of beer. The girl and the boy who ate porridge, and the two servants were alone attacked. In another family, where a daughter aged 18 and a son aged five years were attacked, the daughter, I was told, was a great drinker of milk, and she was attacked a fortnight before the son. In a house occupied by several families, using one privy, where the drain-smells from an over-filled cesspool were very offensive, only one elderly man and woman were attacked. They alone drank milk from the dairy; the other families being poor, had never any milk at all, and altogether escaped. In another family, the only person attacked was a young girl, who, being in delicate health, took more milk than all the rest of the family. Mr. Clifton also told me of a case of Typhoid, which is not enumerated here, in the person of a young lady whose family were supplied by some other purveyor, but who fancied to drink daily a glass of milk from the dairy in question. No one else in the house ever took this milk, and she alone suffered.
How did the Typhoid contagion get into the milk f In considering this question we shall be considering the origin of the outbreak.
It is clear that it must have got into it either before it was sent out from the dairy, or subsequently. The only possible way in which it could have got into the milk in its passage from the dairy to the customers is by the addition of foul water by the milk-carriers, in pursuance of a fraud upon their master. But against this supposition we have the fact that the young man who managed the dairy business-the master, indeed, (who was one of the first fatally attacked,) himself carried out a great part of the milk in a cart, and also the fact that the disease, even in the first week of the outbreak, was so widely sown as to preclude the idea of such a fraud having been perpetrated unless by general concert between the master and the men. Neither will it serve to explain the fact that the family of the dairyman was itself attacked very early in the outbreak. The milk that they got is not to be supposed thus fraudulently contaminated by a milk-carrier outside the premises.
But, besides sending out the milk furnished by his own cows, this dairyman often bought milk for sale from other sources. Sometimes, when the demand was greater than his supply, or when two or three of his cows ran dry, he bought considerably. Was this milk that he bought and served out to his customers together with his own, that which contained the contagion? I inquired where the milk under such circumstances was obtained, and the answer was, from neighbouring cowkeepers, and several that I know were mentioned to me. This was quite sufficient to clear the purchased milk from suspicion; because, if that supplied from any one of these dairies had been the dangerous milk, I should have found the principal cases of Typhoid in families supplied by that dairy. Now, as a matter of fact, in my inquiries throughout the parish, into cases occurring during the whole ten weeks, I scarcely heard the name of any other dairyman mentioned twice.