Epidemic!

Public health poster in Worthing during typhoid outbreak in 1893
West Sussex County Council

One of the Society’s Victorian predecessors, Dr Ridgway Lloyd, died from typhoid during the 1884 outbreak in the city. Here Tony Cooper explores its causes and effects.

Enteric fever outbreak in St Albans

In the early summer of 1884 St Albans was in the grip of an epidemic of enteric fever, now known as typhoid, a water-borne disease, and not uncommon. It was not the first time it appeared in the city; there had been three cases in the autumn of 1883, and nine more in early 1884. Investigation of the 1883 outbreak suggested the infection was caused by contamination of milk from Marshalswick Farm; it was thought that milk pans might have been washed with contaminated water, but boiled water had been used. By agreement with the City Medical Officer, Dr C.E. Saunders, the farmer temporarily suspended supplying milk.

It is not clear how long the suspension lasted, but it had resumed by October, by which time it was being supplied to dealers in London, and presumably in St Albans. After this outbreak, attention was given to a deep well on the farm and its proximity to a cesspit about 20 feet away. It was found that the roots of a sycamore tree had penetrated the wall of the well. As a result, the cesspit was cleared out and by September had been filled with clay.

Typhoid in St Pancras and Islington

In May 1884 typhoid appeared in St Pancras and Islington, and an inquiry there showed evidence of a link to milk from the St Albans farm. When in 1884 the fever returned to St Albans it was in a more virulent form; between May and early July more than 120 cases were recorded, including 23 deaths, causing great concern to the Council, and to the public. There was much speculation about the cause of infection.

St Alban’s new sewerage system?

The new sewerage system, then being installed, was suspected – there had been complaints about unpleasant smells from ventilation pipes and ill-fitting manhole covers. When reporting to the Council Dr Saunders went to great pains to show that this theory was untenable; fever had occurred in houses not yet connected to sewers, and “in houses where sanitary arrangements were beyond reproach”. (Herts Advertiser, 7 June 1884, p. 6) The only common factor among the widespread cases was the supply of milk.

Pollution at Marshalswick Farm?

Advice was sought from the Local Government Board’s Medical Department, and Mr Shirley Murphy, Medical Officer of Health for St Pancras, was asked to investigate and report. He and Dr Saunders, with the co-operation of the farmer, James Slimmon, made a detailed study of the distribution of milk from the farm to a number of milk-sellers, and considered the possibility of pollution occurring at the farm, but found no such evidence. By 28 June Dr Saunders was able to tell the Council that the fever was abating; in June there were 38 cases, compared with 93 in May.

Mr Shirley Murphy’s report to the Local Government Board was published on 17 October 1884. Despite the exhaustive efforts he had undertaken with Saunders and Slimmon, he could find no evidence of the cause of any infective quality of the Marshalswick Farm milk, but suggested that Slimmon’s milk had somehow retained from the outbreak of the previous year some power of infecting its consumers, and then for some unknown cause increased its severity in May and June. His advice was that all milk should be boiled as soon as it was received in the house. An editorial comment in The Lancet of 14 November, 1884 concurred with this conclusion and recommendation.

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