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the house, refuse is frequently left about in the yards instead of being
burnt. Animals are frequently kept, and the yards belonging to the
smaller houses are in many cases only partly paved and therefore
filthy and damp. From the number of cleansing notices we find it
necessary to serve in the course of the year it will readily be understood
that we find the floors, walls, furniture, clothing and bedding
notoriously dirty in many of the houses. Other contributing causes
are:—(1) Density of buildings. (2) Low-lying building sites. (3) Lack of
ventilation and light. (4) Foul air from the accumulation of filth.
(5) The geological formation of the land. (6) The feeding of the child.
(7) The sex and age of the infant.
8. Temperature.—The higher temperature of the air in the summer
months has long been observed to be associated with high Diarrhœal
mortality, and the reverse with low air temperature. The maximum
mortality by no means coincides with the highest readings of the air
thermometer. The temperature of the soil being a less sensitive indicator,
and more steady in its record, is on the whole a better guide.
The maximum Diarrhceal mortality is generally attained in the week
in which the temperature recorded by the 4-ft. earth thermometer
attained its mean weekly maximum. It is a remarkable fact that for
the first half of 1911, which was a particularly severe year, the rate of
infantile mortality for the borough was only 93, compared with 143 for
the full year; and even more striking that in the East Ward for the
same period the rate was only 86 per 1,000 births, compared with 197
for the full year.
9. Rainfall.—Diarrhceal diseases are greater in dry seasons and
less in wet. Under the former conditions the micro-organism is capable
of getting abroad from its primary home, the earth, and having become
air-borne, fastens on food or other organic matter and uses it as a nidus
and pabulum in undergoing various changes in its life history. From
food and other organic matter it can manufacture a virulent chemical
poison which is the material cause of diarrhoea.
The value of rain, therefore, as a means of removing filth and microorganisms,
which cause so much of the epidemic summer diarrhoea, is
evident. Scavenging by water carts should take the place of rain in
dry weather, and the dust laid by water should be swept up and removed
before it has time to dry and disseminate in the atmosphere; and any
attempt at scavenging in dry weather without the aid of water simply
results in the more complete dissemination of dust into the atmosphere.