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These figures must be taken with a certain amount of
reservation for the reasons stated before.
The chart illustrates the fact that dry hot weather is
necessary for fatal diarrhœa to become prevalent. In August
the number of deaths reached 74, whilst in September, the
next hottest month, there were also 74 deaths. In the first
week of October there were 7 deaths, but later in the month
the weather became colder and there was a corresponding
check in the diarrhœal mortality. On the whole, therefore, we
may say that dry hot weather is requisite for fatal diarrhoea.
Why meteorological conditions produce such serious results
cannot altogether be explained. It may be that a hot summer
lowers the resistance of infants and renders them more liable
to the disease. Again, it may be that hot weather increases
the number of domestic flies and consequently the risk of
contamination of milk and other infant foods. I am inclined
to the opinion that summer diarrhœa is due to organisms
derived from human or animal filth, and that the prevalence of
the complaint during hot summers is due, first to the amount
of dust prevalent during a dry summer, and secondly to the
opportunity afforded by high temperatures for the growth of
infecting organisms in milk and other infant foods. Hand-fed
infants are specially liable to fatal attacks for two reasons,
first because they run more risk of infective material being
introduced with their food, and secondly because hand-feeding,
unless conducted with the greatest circumspection, and with
F