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64
1908]
low temperatures and excess in the rainfall tending to control it, and the opposite
characteristics to favour its increase. It is not proposed to enter into these
matters now because they have been discussed frequently in the reports of your
Medical Officer of Health; besides their relationship to the disease is fairly well
known and defined. It may, however, be stated once more that the sanitary state
of houses, and the conditions of their yards, have more than a passing effect on
the disease, for it is just in those premises that are most neglected that
it is most constant. The milk that infants are fed on is also a considerable
factor, for according as it is clean or dirty so will it be wholesome or unwholesome,
always supposing it is diluted to suit the infant, and this milk also will
be good or bad according as the cowkeeper and purveyor practices cleanliness,
and as it is protected from dirt and dust in the homes of the people. It is
difficult to say positively how many deaths occur annually in England
from polluted or unclean milk alone, but they must number many
thousands. This may seem an alarmist statement, but it must not be
forgotten that diarrhœal diseases cause annually in England and Wales
nearly 13,000 deaths (between 1891 and 1900 they actually were
accountable for 126,841); therefore to say that it causes many thousands of
deaths is only to assert what every medical man knows to be a fact. Dirty cowsheds
and dirty cows, and dirty milkers and dirty cans, create an abnormal
number of bacteria, these bacteria set up fermentation, which means sour
milk, sour milk creates Diarrhcea, and Diarrhoea causes death. Recently a
magistrate was so surprised, when it was stated in court that several thousand
deaths could be attributed annually to such uncleanliness of milk as that which
has just been mentioned, that he requested the press to suppress such an
alarming statement. It is an alarming statement, but it is a true one based on
knowledge, and known to the medical profession, especially to that portion
engaged in preventive medicine. Many years ago your Medical Officer of Health,
in company with the late Dr. Ballard, of the Local Government Board, and
formerly Medical Officer of Health of this parish, investigated many hundreds
of cases of Diarrhcea in Sunderland, and again and again, and yet again, it was
demonstrated that the cause of the disease was the souring of the milk, intended
for the childrens' food. The causes of this souring was not as well understood then
as now, for now we know that the chief of them is undoubtedly the dirty
conditions under which the milk is drawn from the cow. It is not by suppressing
these truths, but by letting the people, whose health and lives, and whose
children's health and lives are at stake, know them, that reformation will come,
as come it will, and perhaps sooner than may be expected, for it is not to be
supposed that once they understand this question that they will long tolerate
a grave and insidious danger to the public health.