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13
It is satisfactory to record that the infantile mortality rate is
not only considerably lower than in 1908 but is the lowest ever
noted in Croydon. It is also satisfactory to find that there was a
similar drop in the rate for England and Wales. Part of this
improvement is doubtless due to the climatic conditions which were
exceedingly favourable for infant life. There can also be little
doubt that more care and more intelligence are now employed in
the nurture of infants and that this is having its effect on the
mortality rate.
DIARRHOEA AND EPIDEMIC ENTERITIS.
During 1909 diarrhoea and epidemic enteritis accounted for 19
deaths, of which 13 occurred in children under one year of age.
There were also 26 deaths from other forms of enteritis, of which 15
were under one year of age. Thus 2S out of the 45 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
" diarrhoeal " deaths were considerably less numerous than in 1908,
and this was one factor that led to the diminished infantile
mortality rate.
The accompanying chart shews the seasonal distribution of the
28 diarrhceal deaths under one year of age. Though the majority
of the deaths occurred in the third quarter, this seasonal
distribution is by no means marked, and offers a striking comparison
to the chart for 1906, which was the last year in which
there was a considerable prevalence of fatal diarrhoea. There can
be no doubt that the great difference between 1906 and 1909 must
be ascribed to climatic conditions, and especially to the cold wet
weather experienced in June and July. On the other hand it is
clear that seasonal changes are not directly responsible for diarrhoea
mortality, otherwise the short spell of hot weather experienced in
the first half of August would have been followed by fatal diarrhoea.
As far as they go the facts observed in 1909 lend some support to
the suggestion that fatal diarrhoea is, to a considerable extent,
diffused by the domestic fly, which in the year under review suffered
severely from the absence of sufficient warmth to allow rapid
increase in numbers. Whatever may be the exact route by which
diarrhoea infection finds its way into the alimentary canals of
infants, there is ample evidence that diarrhoea mortality falls
especially heavily on those who are brought up by hand. This is
clearly shewn in the following tables which have been prepared
from information obtained by the health visitors on their visits to
houses where children have been born.
* Deaths from Gastritis are sometimes classified as "diarrhoeal." If this
were done, a further addition of 6 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.