Miscellanea 
433 
(C.) S R . In this house the servant died in 1862, aged 69, of cancer of the breast. 
The second case was that of a bricklayer who died in 1885, aged 73, of carcinoma of first part of 
sigmoid flexure of colon. The third case was that of a woman, whose husband had left her, 
who died here aged 55, in 1906, of secondary carcinoma. 
The adjacent house to this was also a multiple cancer house, being credited with two cases, 
one of carcinoma of the stomach and one of cancer of the womb. 
(D.) C 0 . The first case is that of a man aged 56, who died in 1869 of cancer of 
the breast. His brother had also died, but not in this house, of cancer of the rectum. On his 
death he was succeeded in his official position by his clerk, and the latter also retained the same 
housekeeper. She died in 1885, aged 57, of cancer of the stomach, and the clerk just mentioned 
died in the same house in 1894, aged 52, of epithelioma of the tongue. 
(E.) I B , F M . The first case in this house was that of a pattern maker 
who died of cancer of rectum in 1875, aged 53. His father had died of cancer before him. The 
second case was that of his widow who died in 1885, aged 69, of cancer of the rectum. The third 
case was that of their daughter in 1888, aged 39, after three years' suffering from cancer of the 
left breast. 
This case may show an hereditary constitutional tendency, but this does not account for 
both husband and wife dying of it. That must either be looked upon as fortuitous, or else 
it is evidence in favour of (d). 
(F.) G B , T 0 . The first case was that of a woman occupant who died 
in 1877, aged 52, of carcinoma of the large intestine. The second case was that of a man of 
superior social class who died in 1895, aged 73, of carcinoma of the stomach. The third case was 
that of the mother-in-law of the second case, who 'lived in the house with her daughter ; she 
died in 1902, aged 84, of carcinoma of the liver*. 
(G.) M W , B B . There is a group of five cases here, all in very close 
proximity. It is not clear how far they are in separate parts of the same original building, 
but, I think, we may assume three to have been. The first case is one of cancer of the breast 
in a woman aged 44, in 1862 ; the second of malignant disease of the stomach in the wife of a 
nail-maker, she died aged 77 in 1894, and the last one in a woman, who had suffered from 
epithelioma of hip in 1887, but died of bronchitis. The other two cases were those of a woman 
who died in 1897, aged 62, of malignant disease of the intestines, and of a blacking-maker, who 
died, aged 52, of cancer not further defined, in 1865. Undoubtedly this group (G.) is less definite 
than the others, because the information is less easy to interpret. It did not seem desirable to 
omit it, for we have clearly a considerable number of cases within a very circumscribed area, 
but the exact division of the tenements is not clear. If it be omitted, it will not substantially 
alter the extreme improbability of the general distribution. 
From the above specification of the individual " cancer houses," it seems improbable that 
occupation or heredity constitution had anything to do with the multiple cases ; in only one 
instance do we find parents and offspring ; and sex and occupations are most varied. Nor do 
we believe that the size of house can be concerned in the matter, as it is quite clear that we are 
dealing with small tenements. The cancer maps of the district show roughly a fairly uniform 
distribution of the cancer cases, in a district which is largely industrial. But the fact remains 
that the frequency of multiple case-houses is exceedingly improbable on the basis of a random 
* A case of cancer of the breast occurred in the next house in 1876, a woman aged 74. Dr Law 
Webb writes of the three-case house : ' ' Water, pump, often flooded with surface water, when stormy 
weather ; soon dry in summer, drains in close proximity." 
Biometrika vni 55 
