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the most scrupulous cleanliness on the part of the nurse and
patient, with immediate and efficient disinfection of the excreta,
without doubt the main vehicle of infection. The first three
of these points come within the sphere of this Department, and
have received constant and careful attention. The fourth point,
which is of vital importance in the prevention of the spread of
the disease, must always be most largely in the hands of those
nursing the patient. The further suggestion may be made, that as
far as possible only persons beyond middle age should act as
nurses to typhoid cases.
Epidemic Diarrhoea (Epidemic Enteritis).—Under this term is
included all forms of zymotic diarrhœa and epidemic enteritis.
The Royal College of Physicians has recently (1900) laid down
that "gastro enteritis," "muco-enteritis," "gastric catarrh,"
and such synonyms of epidemic diarrhoea in medical certificates
of death should be discarded. The College recognises that
epidemic diarrhoea is a general disease of a specific character in the
same sense as enteric or other fevers, and it therefore authorises
the use of the term "Epidemic Enteritis" (or if preferred "Zymotic
Enteritis" or "Epidemic Diarrhœa") to designate the disease in
its various forms and degrees. There can be no doubt that the
adoption of this common standard will prove of great value in the
future, and it is satisfactory to note that medical practitioners
generally are following the suggestion of the College of Physicians.
During 1900 there were 81 deaths attributed to this disease, 66
of these cases being infants under one year of age. This gives a
death-rate for Epidemic Diarrhœa of 1.2 per 1,000. In 1899 the
death-rate for this disease was 1.9 per 1,000 (126 deaths), and in
1898 it was 2.02 per 1,000 (134 deaths). So that the present deathrate
compares favourably with previous rates in Clerkenwell. It
should not however be forgotton that the London rate for 1900,
was as low as 0.78 per 1,000. Hence there is still much room for
improvement in this particular district.
Epidemic Diarrhoea is chiefly an autumnal disease of urban life,
affecting most largely the children of the industrial classes, and