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13
DIARRHŒA AND EPIDEMIC ENTERITIS.—As these diseases
are specially fatal in the first year of life they may conveniently be
discussed in connection with infantile mortality. During 1908 diarrhoea
and epidemic enteritis accounted for 52 deaths, of which 35 occurred
in children under one year of age. There were also 23 deaths from
other forms of enteritis, of which 15 were under one year of age. Thus
50 out of the 75 deaths from what are usually classified as "diarrhœal"
deaths occurred in infants under one year of age.* It will be seen from
Table VI. that "diarrhœal" deaths were considerably more numerous
than in 1907 though the number was below the average for the previous
10 years.
The accompanying chart shews the seasonal distribution of the
50 diarrhœal deaths under one year of age. It will be noticed that in
the week ending August 29th there were 7 deaths. Fortunately this
and the succeeding week were wet and cold and there was a corresponding
check in the "diarrhœal" mortality which remained low until
the week ending October 3rd when there was a marked rise in the
mean temperature of the air together with a spell of dry weather On
the whole this chart once more illustrates the fact that dry hot weather
is necessary for fatal diarrhoea to become prevalent. How these
meteorological conditions produce such serious results cannot altogether
be explained. In all probability a hot dry season is prejudicial in more
ways than one. It may be thought that a hot summer lowers the
resistance of infants and renders them more liable to fatal diarrhœa.
This is however improbable as the deaths under one year from other
than "diarrhœal" diseases are not unduly numerous under such
conditions. Again it has been suggested that hot weather increases the
number of domestic flies and consequently the risk of contamination of
milk and other infant foods. This question requires further elucidation,
though hitherto no close connection appears to have been established
between the prevalence of diarrhoea and the number of flies in a district.
On the whole I am inclined to the opinion that summer diarrhœa is not
a specific disease but may be due to one of several organisms derived
from human or animal filth and that the prevalence of the complaint
during hot summers is due, first to the amount of dust prevalent during
a dry summer, and secondly to the opportunity afforded by high
temperatures for the growth of the infecting organisms in milk and
other infant foods. Hand-fed infants are specially liable to fatal attacks
for two reasons, first because they run more risk of infective material
being introduced with their food, and secondly because hand-feeding,
unless conducted with the greatest circumspection, and with the most
*Deaths from Gastritis are sometimes classified as "diarrhœal." if this were
done a further addition of 12 deaths under one year must be made to the total
"diarrhœal" deaths. it has not however been the practice to include these in
former years and for the sake of comparison the figures have been prepared as in
past years.