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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 diarrhoea to become prevalent. 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 diarrhoea 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 the most careful
adaption to the digestive capacity of the individual child, is apt to
induce intestinal catarrh or other digestive disturbances, which render
the bottle-fed babies unduly susceptible to diarrhœal disease.
The Prevention of Epidemic Diarrhoea.
Following up their circular letters of the 18th August, 1911, and
25th July, 1913, with reference to mortality among children in the
summer and autumn months arising from epidemic diarrhoea and other
infectious diseases of infants, the Local Government Board on July 10th,
addressed another circular to sanitary authorities reminding them of the
importance of taking all practicable measures for the prevention of such
diseases and of promoting hygienic conditions in the feeding of infants.