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there were but 115 deaths, of which 98 were of children under 5.
We have to look at the figures for the warm summer of 1893
for figures resembling those of the present year; in this year
the deaths amounted to 214, of which 171 were children. More
than two-thirds of the fatal cases took place in the third quarter
of the year 1895, the season in which diarrhoea is almost invariably
more prevalent than at any other time. There was but one
fatal case in Dulwich, while the figures for Camberwell, Peckham
and St. George's were 77, 82 and 93 respectively. The question
naturally suggests itself as to whether the higher mortality in
these districts in any way is due to the existence in greater
proportion of sanitary defects. I should unhesitatingly state
that in my opinion it is not, but that it is in great measure due
to the far greater number of children of tender years in the
three latter sub-districts. If we examine the numbers born in
the several divisions of the Parish it will be seen that, roughly
speaking, there were to each birth in Dulwich, 29 in each of
the other districts. Now we have abundant proof that children
in the first years of life are far more susceptible to fatal cases of
diarrhoea, hence, granting a greater number of children, so
surely shall we have a larger total of fatal cases of this disease.
Again, it is impossible that children can have the same
individual care when there is only the mother to nurse them,
see to her other children and attend to her household duties.
The only circumstance connected with the construction
of the house that might play some part in the greater prevalence
in these districts would be the fact that in the greater number of
the poorer houses the best means for keeping food in a proper
condition during hot weather are not present, and if they were
possibly might not be used. Milk, which is the staple article
of food of most of these cases, especially requires a place free
from all possibility of contamination. If mothers and those in
charge of children were to make a constant practice of boiling
the milk I believe there would be a considerable diminution
in the number of deaths ascribed to this disease. In connection
with this I might point out the fact that some years ago
an inquiry was made by the Medical Officer of Health of
Liverpool into the incidence of the summer diarrhoea of children,
and he found that nearly all the fatal cases were of children
who were not fed from the breast. Those who were so fed