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9
Annual Report of the Medical Officer of Health—1897.
diseases. Of this number 88 deaths occurred under the age of one year, 23 between
one and five, and 4 at the age of five and upwards.
In addition to the 111 deaths from diarrhoea coming under the general heading
of "Specific Febrile or Zymotic Diseases" there were 23 deaths from enteritis placed
under the class " Local Diseases."
During the six years 1892 to 1897 more deaths were due to diarrhoea than to an y
other of the seven principal zymotic diseases. This is seen in the following table.

The reason for the exceptional mortality from diarrhoea in 1897 was probably
connected with the hot and dry weather of the third quarter of the year.
It has been proved that the temperature of the earth is one of the most important
factors concerned in the development of the malady, and that the summer rise of
diarrhœal mortality does not commence until the mean temperature recorded by the
four-foot earth thermometer has attained somewhere about 56 deg. Fahr.
In recent investigations made by Dr. Klein it appears likely that summer
diarrhoea is associated with the presence in the stools of a micro-organism which he
has named "Bacillus enteritidis sporogenes."
This microbe presumably lives and multiplies in organically fouled soil, and is
given off in the air to contaminate and poison food, especially milk.
The chief conditions of locality giving rise to diarrhoea in St. George's are, I
believe, the following:—
(1) A loose damp soil polluted by liquid filth, e.g., from defective sewers.
(2) Density of population.
(3) Crowding of buildings upon area.
(4) Restriction of and impediments to the free circulation of air both about and
within dwellings.
(5) Sewer emanations.
(6) Filthy accumulations of domestic refuse in ashpits and dustbins.
(7) Absence of efficient control of dairies and of dairy farms supplying milk to
local dairies.
As regards the conditions relating to the population the chief causes inviting
diarrhoea are:-