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.
It was not until the return of the family from the country that I could get the tank exposed; and what I found was this: The description given me of the tank was correct; but the woodwork had become rotten, and at one corner towards the cart-shed, had broken down to the depth, from the edge, of about eight to ten inches, forming a considerable gap in that side of the tank. Between the part of the tank where this gap existed and the adjoining wall (distant about twelve inches), the earth, present everywhere else between them, was wanting, a conical hole being formed to the depth of about two feet. At the bottom of this hole, on letting down a candle, I noticed a rounded, smooth shoot with a wet clay bottom, inclining towards the cart-shed, and, on introducing my hand, I was convinced that it was a rat-burrow. A stone was raised in the direction of the cart-shed, a hole dug, and the burrow was again reached, and found to cross above a stone-ware pipe leading from the water-closet towards the stable. Fortunately, at this moment the water was turned on from the main. It rapidly filled the tank, which overflowed at the gap; the water ran into the hole dug outside, and filled it to the level of about four inches above the burrow. It then ceased to rise any more, and carrying my hand round this level, I found another burrow, by which, evidently, the water was running off. On the flow by the supply-pipe ceasing, the water sank rapidly to the level of the lower burrow, and was seen running away by that also. It sank no lower for a long time. The inference I drew was that by these burrows the water was very freely conducted away into some drain or cesspool. On taking up the pavement of the yard, and exploring, three old and imperfect brick drains of various sizes were discovered, into one of which the pipe from the water-closet had been carried. The other two were disused, but one of them contained some wet slush; the other, containing only a quantity of dry deposit, could not have been the conduit for the overflowing water. In making these excavations, the burrows were necessarily trodden in, but the soil was found saturated with wet up to the brick drain in the stable that the water-closet pipe ran into, and up to the old drain at a lower level that contained the wet slush. With the exception of the drain which received the water-closet pipe drain, these old drains were disused, and evidently had been disused for many years. With respect to the old drain, it is believed that it was once an overflow drain running into an old cesspool or ditch which is known to have once existed outside these premises, and the remains of which, beneath a collection of old oyster shells, were discovered about June last in laying down a pipe drain for the drainage of some neighbouring houses.
This being the condition of affairs, it is evident that the underground tank was, by these rat-burrows, in communication with two old drains; and it is scarcely necessary to point out that, where rats could pass and water rapidly flow away, foul gases from the drains could pass, and must have passed, to the tank. Moreover, any accidental or temporary arrest of the flow of sewage from the brick drain, such for instance, as may have occurred at the time of the alterations of the drainage of the adjoining houses, must, at the time the water flowed from the main into the tank, have filled up the drains and rat-burrows, and the hole between the tank and the wall, and have caused an overflow of sewage into the tank at the gap. Either such an accident or the completion of the burrows to the tank, or the incursion of a rat carrying foul matters with him, might serve to account for the suddenness of the outbreak, supposing this water to have been used habitually for addition to the milk. However this may have been, we have here a fouled water-tank, the addition of the contents of which to milk distributed in the neighbourhood would be sufficient to account for the communication of Typhoid fever to those who used it.
Is there, then, any reason to believe that this water was ever added to the milk, or that the water alone ever produced Typhoid? I was assured by the men about the premises that none of them ever drank the water; it was understood generally on the establishment that it was provided for the horses, for washing the cans, and for cleaning purposes generally, I only met with one boy who drank of it, and he used it Sit his dinner, and whenever he was thirsty. He had fever; but then at that time he was living upon the premises, and had his meals there, with the usual quantity of milk at his breakfast and tea. He was there for a week at the beginning of August, and was taken ill on or about August 14th, after he had returned to his mother's house. This boy agreed with the other men in saying that he had never seen anybody else drink at the pump. The family of the deceased dairyman also informed me that at no time was the pump used for the addition of water to the milk; "if ever any was added it was from the tap." Certainly the tap was the more conveniently situated for this purpose, close on the right side, and a little below the flap-table. So far as their knowledge extended, I have every reason to give credit to this statement, which, moreover, has been confirmed to me independently by several of the men employed. But then it was added that those of the family I inquired of had little or nothing to do with the milk business, which was entirely under the management of the young man who died; and it is to be recollected that persons in the trade are very much dependent upon the honesty of their servants, and that the pump, although in full view of the office when occupied, was not in full view of the window in the house which looked upon this part of the yard. And in connection with the hypothesis that contaminated water had on some occasions been added to the milk by some one is a fact communicated to me that one family while suffering from Typhoid discontinued the use of milk "because it had a bad taste, and was dis-agreeble;" and another person asserts that "she had several times complained to the dairyman himself that the. milk when kept became stinking, not (as she said) merely sour; and also of its poorness." This, if true, must have been prior to July 9th. We are dealing now with probabilities, and one point to be weighed in estimating them is the fact that the dairyman and his household were among the very first attacked with the fever. Did they use milk diluted with this water in their family? Probably they were not very particular. But, supposing that it is absolutely true that no water from the pump was purposely added by any one to the milk, we have yet left the admitted fact that the cans were washed at the pump. Is it probable that the small quantity of foul water left in them after this process would suffice to contaminate the whole bulk of milk subsequently introduced? I confess that, to my mind, this is not an impossibility. We all know how small, almost infinitesimal, an admixture of sewage will poison a well or running stream: nor is the idea of reproduction of the Typhoid contagion out of, within, or in the presence of an appropriate organic material at all foreign to the prevailing opinions upon the subject. Future experience may show that milk, which has remarkable relation to chemical ferments, is a substance peculiarly adapted also to the reproduction of morbid contagion, or to the contagion of Typhoid in particular. Nor do we know even now how minute a quantity of contagion is sufficient to introduce the disease into any individual. Scarlet fever has recently been shown by Dr. Bell, of St. Andrews, to have been conveyed by milk to the customers of a cow-keeper of that place, the cows having been milked by persons convalescent from the disease. I claim, now, to have shown, what I have long suspected to be probable, that Typhoid fever may be similarly conveyed by milk. Whether I have also correctly referred the contamination of the milk in this case to its source in contaminated water, others are better judges than myself. At all events, I have spared myself no labour in the investigation, which, if it has resulted in nothing else, has demonstrated one of the dangers connected with the mode in which the trade in milk is conducted in this metropolis.