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17
partly social and partly sanitary, and that it is easy, according to the
point of view adopted, to magnify unduly the importance of one set of
factors. The effects of unsatisfactory domestic and war conditions are
fairly obvious, and their consequences fall most heavily on the poorer
members of the community. Of these domestic forms of insanitation
to be noted in Deptford, overcrowding and lack of cleanliness are
probably the most important. For the infant it means exposure to a
stuffy atmosphere, and the storage of milk in a contaminated and
vitiated atmosphere. Outside 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 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 assoiated 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 Diarrhœal mortality is generally attained in the week
in which the temperature recorded by the 4-ft. earth thermometer
attained its mean weekly maximum.
9. Rainfall. —Diarrhœal 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 diarrhœa.
The value of ram. therefore, as a means of removing filth and microorganisms,
which 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