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28
which I was a member, to consider the certification and
classification of deaths from diarrhoea. That Committee
issued the following Report, which was subsequently
adopted by the College, and which it is desirable should
be as widely disseminated as possible:—
(1) We find on enquiry, and especially from evidence
furnished by Dr. Tatham, of the General Register
Office, and by other Members of the Committee, that
many different terms are employed to designate the
disease officially known as "Epidemic Diarrhœa,"
whereby its specific character is in danger of being
ignored and great confusion ensues.
(2) The results of this confusion are serious and important,
since this form of diarrhoea causes a large portion
(about one-fourth) of the deaths attributed to zymotic
diseases.
We gather, from a statement furnished to us by
Dr. Tatham, that his main difficulty lies in the impracticability
of picking out, from the long list of fashionable
but unauthorised synonyms, all the deaths which in their
nature are indistinguishable from deaths by diarrhoea,
and which ought to be called by the authorised name.
At present he classes as diarrhœa (and therefore under
zymotic disease) deaths certified as follows
Diarrhœa
Epidemic diarrhœa
Dysentery and dysenteric diarrhœa
Intestinal (or enteric) catarrh
Gastro intestinal (or gastro-enteric) catarrh.
But the following he classes not as diarrhoea, but as
diseases of the alimentary canal (thus excluding them
from the zymotic class):—
Gastro-enteritis
Muco-enteritis
Gastric catarrh
This second group of cases ought, he points out, for the
most part, to be regarded as identical with epidemic
diarrhcea, inasmuch as their age, incidence, fatality-curves
and general epidemiological character correspond closely
with those of that disease.