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.
If, then, we ask where the milk obtained the contagion it held, as a question preliminary to how it obtained it, the answer must be-upon the premises of the dairyman. My investigation was now localised, and the question came to be what possible sources of Typhoid contagion existed upon the dairyman's premises? And now I must tell you something about their geography.
The cowhouse was situated on one side of a large open yard, communicating with a narrow lane, at the entrance of which were the stables and dwelling-house of a cab-proprietor, into whose family, although supplied by the dairy with milk, Typhoid did not enter. With this trifling exception, there were no houses very near it; its neighbourhood was mostly unoccupied land and gardens. The cowhouse formed part of a range of stable buildings on one side of the yard. On the adjoining side was a row of buildings used as warehouses. The cowhouse was well paved, and always kept clean. There was no drain but the surface one, which conducted liquid matters along a channel to the centre of the yard, where they entered a gully opening, and passed away into the drains. The stables were drained by pipes towards the same gully, the pipe being continued into a small sewer in the lane. The dung was stored against the wall of the stable. I have no record of any complaint being made at any time against these premises on the score of uncleanness. They were always clean when I have seen them. Ten or eleven cows were kept here. At the time of the outbreak, and for a long time before, there had been no disease among them-they were a fine and valuable lot of cows. The young man who carried on the business up to the time of his illness, milked them himself, and saw to their being properly kept. In the centre of the yard, the paving of which had, from the heavy traffic on it, got a good deal out of repair, was a large gully grating, which it was always believed was properly trapped, but which on examination in the course of the inquiry, was found not to be so. Beneath it was a receiver about three feet deep, from which the drain passed. I perceived no offensive smell from it, nor can I hear of any one who ever noticed any; but, on guaging it with a fork, a violent gush of offensive gas was evolved, almost explosively. On the side of the yard opposite the warehouses was a cottage of two rooms, occupied by one of the workmen, his wife, daughter and little son. All but the man had fever. The daughter was taken ill the same day as the dairyman-namely on July 9th. This was the girl I have mentioned who had left a situation as nurse, where the milk in question was supplied, a fortnight before her illness. Above the cottage was a large open iron tank of New River water. When I saw it, it was foul. It had no waste-pipe.
It was used for the cows and horses, for washing vans, and for all domestic purposes by the occupants of the cottage.
The milk business, however, was not carried on here, but at premises about a hundred yards off, to which the milk was carried in cans prior to distribution. I am assured that none of the water from the tank over the cottage was ever added to it.
The premises where the milk business was conducted consisted of a dwelling-house, covered yard, stable and offices. With respect to the stable, I must say that it was large, airy, admirably paved with iron bricks, and always very clean. It was provided with pipe drainage beneath, the channel entering an old brick drain, and with patent stable traps. Prior to the outbreak in these premises, I am informed that some of these traps were broken, and that the smell was very offensive, and diffused into the yard beyond, especially when a closet, used by the workmen on the premises, which communicated with this drain at the further end of the stable, was flushed. During the illness of the dairyman at this house, the new traps were put in, and I am informed there was no accumulation in the pipes. At the side of the stable was a cart-shed, and near its entrance a wooden and glass office, attached to which, on the outside, was a flap-table, above which, on the wooden work of the office, the cans used in the business were hung up. The kitchen of the dwelling-house projecting backwards, had a window looking upon this table. The water-closet was situated in a narrow strip of yard at the rear of the kitchen. There were two receptacles for water on these premises. One was a cistern situated in the back yard. It was closely and well covered, and when examined, found to be scrupulously clean. The waste-pipe did not pass into a drain, but discharged upon the surface of the paved yard. From this cistern a pipe proceeded to a tap at the side, and a little below the level of the flap-table mentioned. The other was an underground tank, situated beneath the flag-stone paving of the office against which the flap-table was erected. The water was drawn from it by means of a pump situated at the entrance of the stable from the yard. I may mention, for what the fact is worth, that this pump, although in view from the office, was not in view from the window of the kitchen looking upon the flag-table. This tank, like the cistern, was supplied from the mains of the New River Company. It was constructed about sixteen years ago, and during that time no examination had been made of it. It had, however, been open occasionally, when it became dry from fixing of the ball-cock. But the time had now arrived for a thorough examination to be made. This examination, however, from the absence of the occupier of the premises during the convalescence from his attack of fever, had to be delayed, and it was not thoroughly examined until the beginning of November. There was no objection to this delay, inasmuch as the death of the young man who carried on the business led to the trade being given up, the cows being sold off very shortly after his death, which took place on August 12th. I may mention here, again, for what it is worth, that only eight fresh houses amongst the customers of the dairy were invaded after this date, six of them in the fifteen days between the 12th and the 27th, and only two later.