used by all the evening guests, among whom there was but little scarlet fever; the former, or four-o'clock, cream was distributed essentially to the family and to the dinner guests. It was again used at luncheon the next day, and thirteen persons who were known to have had opportunity of partaking of it suffered from scarlet fever within five days. The bulk of this four-o'clock cream was used in the preparation of articles which had to be boiled previous to their being used in a cool or frozen form, and those persons who partook of such articles alone were not specially attacked. But of this cream some that was in excess of the cook's requirements was put into at least one jug along with the five-o'clock cream.
This mingling of the two creams added materially to the difficulty of the investigation, because it was that remnant of the four-o'clock cream which had not been boiled previous to use to which interest was now found specially to attach. For "no less than seven ladies who were at the dinner, and who took cream in their coffee in the drawing-room, afterward became ill, none of them who took that cream having escaped." There was, however, no such incidence of disease on the gentlemen who took coffee down-stairs. And further, whereas all who partook of cream on the day following the dinner were ill, none of those who did not partake of it suffered. Now, it was known that it was the four-o'clock cream that was used at the luncheon on the 10th, and if it so happened that the cream which was sent up into the drawing-room with coffee for the ladies who had left the dinner-table was the jug of mingled cream, then that four-o'clock supply from the London dairy comes strongly under suspicion.
The complicated nature of the conditions which had to be contended with in pursuing such an investigation in the metropolis forbade any conclusive demonstration as to the exact method by which this special cream-supply may have become infected. It was, however, ascertained that upon one section of the London dairyman's customers there had been a large incidence of scarlet fever, and a suspicious history as to scarlet fever in the person of one of the dairy-staff who was engaged in milking and carrying out the milk was also elicited. In short, there is little doubt that the cream supplied from this dairy was the vehicle by which the infection of scarlet fever was conveyed to that household in South Kensington.
Some years ago I conducted a somewhat similar inquiry. The same disease had attacked a large proportion of persons who had met at a London dinner-table, and the source of infection must have been some article of food. In this case, fruit as well as cream came under suspicion, and the employment as strawberry-gatherers of persons in the desquamative stage of scarlet fever seemed as likely a source of infection as that which might have operated through the agency of a dairy. The circumstances were, however, too complex to be unraveled, and further inquiry was abandoned.