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given, if any person to whom the Manure or other Refuse Matter
belongs fails to comply with the notice, he shall be liable without
further notice to a fine not exceeding Twenty Shillings for each
day during which such non-compliance continues."
The districts sanitary inspectors were instructed to give special
attention to the poorer class districts, especially with regard to the
presence of accumulation of filth or refuse in the yards of dwellings
or in streets, and the accumulation of dung in stables, &c., and to
deal immediately with such nuisances as provided by the Public
Health (London) Act, 1891.
3rd—The Health Visitor was instructed where cases of infant
diarrhoea was brought to her notice to advise the parents to obtain
medical advice and treatment and in case of poverty to apply to
the relieving officer.
Outline of Suggested Scheme for Dealing more completely with
Summer Diarrhoea and Enteritis.
The difficulty in dealing with infant diarrhoea and enteritis
is that local authorities only know of its prevalence usually when
the deaths from this disease increase; and these do not as a rule
increase at the beginning of an epidemic, not until in fact the
disease is well established. It would, I am of opinion, be of
immense advantage to have knowledge of all cases occurring, and
especially of the first cases in any outbreak or the first cases in
any family. In order that this information may be obtained some
form of notification will be necessary. This notification may be
restricted to the three months of the year, July, August, September.
It should be obligatory on medical practitioners consulted by
parents, and parents or others in charge of infants and young
children.
Mere notification of cases without other action, would only
be useful to show the localities where the disease is most prevalent
and the extent of its prevalence and would not exercise any
control over the spread of the disease—the main thing to be