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60
mortality in childhood.
centages) of all visited children on each diet with the diet-distribution of cases of diarrhœa
(see below) affords evidence of the importance of the method of rearing of such children as a
factor in the prevalence of the disease.
Ages. Breast. Artificial. Mixed. Not stated.
Months. B. D. B. D. B. D. B. D.
0— 82.7 — 9.1 100 6.5 — 1.5 —
1— 78.6 33.3 12.2 55.5 9.1 11.1 — —
2—3 71.6 43.4 13.5 47.8 10.4 4.3 93 4.3
" B."—as found on Birth Visiting (1st visits)—1,732 observations.
" D."—as recorded on Diarrhœa Inquiries—33 observations.
Taking the 57 deaths among the children under 2 years of age reported to have diarrhœa as
fatal endings of their disease (in 6 instances death was due to causes other than diarrhœa), the
fatality among known attacks was 1472 per cent., 1314 among males and 16.66 among females.
It will be seen from Table 38 that there was not a death at ages under one month among
children who were being fed at the breast. The fatality rates during the first year of life were—
breast fed, nil ; artificially fed, 84.6; on a mixed diet (i.e., having the breast and other foods), 96;
and among the children whose method of feeding was not stated, 57. If the last group be
transferred to the first, the rates are 28 3, 58.6, and 12.9 respectively. Below is given a statement
of the fatality rates and ages under three months, distinguishing the methods of feeding,
obtained by combining the numbers of unreported deaths (as cases and deaths) with the cases
known before death. The conclusion to be drawn from the figures is that the natural method
of feeding infants not only prevents attacks, but is also a powerful factor in preventing a fatal
issue to attacks among children so reared.
Ages. Months. Breast. Artificial. Mixed. Not stated.
0— nil 100 nil nil
1— 25.0 86.6 100 nil
2—3 16.6 82.3 nil 100
There were 54 relapses among the 387 known cases, equal to a frequency of 13.9 per 100
cases, 38 of the patients being under one year old (frequency 17.4 per cent.), and 16 aged one to
two years (frequency 9.4). Females appear to be more liable to relapses than males, the
frequency in the former sex being 16.6 per 100 cases as compared with 11.7 in the latter.
Among the cases with relapses there were 9 deaths, equal to a fatality among such cases of 16.6
per cent. As, however, all the deaths occurred at ages under one the fatality would be more
correctly stated at 23.6 per cent., as compared with 23.8 per cent. among cases without relapses.
Inquiries were made by the Inspectors when visiting infected houses for unreported cases of
diarrhcea. By the inquiries made in connection with the 359 reported cases and 69 deaths
(attacks not reported), 132 other attacks of diarrhoea were traced, making the total number of
known attacks (reported and unreported) 560, occurring in 419 houses and 4 canal boats. It
should be mentioned that at 3 houses all information was refused, and that inquiries were not
made at all the homes of the infirmary patients. Multiple attacks were known to have occurred
at 84 houses. The results of the inquiries made at 412 houses are summarised below.
Of the houses invaded and visited, 412 in all, In 84 houses with 2 or more cases,
2 cases occurred in 59 houses ; 1 family was infected in 41 houses.
3 ,, ,, 13 „ ; 2 families were „ 38 „
4 ,, ,, 11 i, , and 3 ,, ,, 7 ,,
7 1 house. 4 3 „
The age-distribution of 556 cases and 130 deaths was—
Ages. Cases. Deaths.
0—1 year 288 116
1—2 years .,. 180 11
2—5 „ 48 3
5— „ 40 —