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(whereas the ravages of Zymotic Diarrhoea are almost entirely restricted
to infants and old people), and partly by the fact that the
former disease has become recognised as more preventible than the
latter.
This is a disease which mainly produces mortality among handfed
infants reared under unsatisfactory home conditions. It is largelydependent
on the tilth contamination of food.
In this connection I would emphasise what I stated in my last
Annual Report in reference to the public health importance of
keeping down the number of flies in and around dwellings (more
especially by the prompt removal and destruction of all dust and refuse
matter) and of protecting food from them. We have good reasons
to believe that these precautions play an important part in the reduction
of infantile mortality and even of preventable adult sickness
during the summer months.
It was formerly believed that the sole means of conveyance of
infection by flies was by the hairy legs and feet of the insect; dirt,
and maybe infection, retained by the legs and feet being left behind
on the food when the fly crawls over it. But more recent experiments
have demonstrated that the dejecta of flies may contain the germs
which have been taken in by food, and that such germs may remain
for many days in the crop or intestine of the fly. Thus the Sanitary
Authority itself may be indirectly responsible for fatal Diarrhoea, by its
failure to provide efficient scavenging and watering in the summer
months; for among the chief breeding places of the house-fly are
collections of decaying and fermenting matter, such as are to be found
in middens containing horse manure, and ashpits or dustbins containing
fermenting vegetable matter.
At the meeting of the Public Health Committee on July 12, 1911,
I urged the desirability, on public health grounds, of providing for the
collection of the household refuse twice weekly from the poor-