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50
CAUSATION OF EPIDEMIC DIARRHŒA.
The view that the disease is an infectious one, and due to a
germ is now generally held. It is also believed that the germ is
more likely to attack persons suffering from digestive disturbance,
and that it finds its way to the bowel with the food taken. The
following well-recognised facts lend support to this view, viz.:—
(1) It is commonest amongst infants artificially or improperly fed;
(2) Dirt and diarrhoea are very frequently associated in houses;
(3) Household and family outbreaks often occur; (4) It is most
prevalent in the warm summer months, when bacteria best flourish.
Investigation into diarrhoea deaths in Finsbury very well brings
out these characteristics:—
AGE.—Of the 80 deaths occurring in infants under one year, 13
were of babies in the first three months of life; 35 in the second
three months; and 32 in the last six months. Most of the deaths
occur at ages when, as is well known, additions to and changes
in the diet are commonly made, viz., at about the sixth month.
The digestion of the average baby is very easily upset, and changes
in diet readily interfere with the process and lower the resistance
of the bowel to attacks by disease germs.
In connection with this point reference may be made to the tables
on pages 31, 32 and 35, which contain analyses of the results of investigations
into infant deaths. In the table for 1908, it will be
noted that, of 55 diarrhoea deaths under one year, 40 took place
between the third and eighth months, just that period when changes
from breast feeding to artificial feeding are beginning to be made
and the baby is allowed to taste what the grown-up members of the
family are eating.
DIRT AND DIARRHŒA.–Finsbury experience seems to bring
out a distinct connection between these conditions. In the tables
already referred to, 7 houses out of 55 in which deaths from
diarrhoea had occurred, were dirty, while 18 were only fairly clean.
In 21 instances the tenement was one-roomed, and in 24, tworoomed.
In 8 cases there were 3, and in two, 4 rooms.