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64
So that although at first sight it might appear that these
diseases should be controlled by intelligent public health
administration, yet in practice such control is thwarted by the
social conditions and housing accommodation of the families
concerned.
In other words public health is thrown up against a back
ground of economic difficulties.
Syphilis-—Forty-six deaths have been accredited to Syphilis
in 6 years, or an average of 7 per year. These deaths are all
preventable by the mother's treatment during early pregnancy
and during its continuance.
Unfortunately the existence of the disease in the mother is
often unknown to her, and even if known is neglected becausc
she cannot afford the time to attend a hospital or dispensary.
She is unable to suffer the loss of a day's work or to run
the risk of losing her employment altogether.
By the time the public health staff know of the disease the
child has been born, and medical treatment is then less likely
to be successful. The disease is not notifiable. The prevention
of the disease is largely a question of public morals.
The means to be adopted in preventing the deaths vary from
case to case, and are decided by personal visitation and a
knowledge of the home conditions. These babies are not as a
rule received into public nurseries.
Diarrhoea, Gastritis and Enteritis.—In six years, 379
deaths were ascribed to these diseases, an average of 63 deaths
per year. The incidence of these diseases is very considerably
influenced by the weather, and is low in mild, wet summers,
high in dry, hot summers. They may be prevented by seeing
that the food of the infants is clean, and by keeping clean every
object which is likely to be put into their mouths. In a word
they may be prevented by a high degree of domestic cleanliness
in a sanitary environment. As such they are more or less controllable
by public health administration, and respond to the work