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28
Stoke Newington did not share in that increase. There is no doubt
that Summer Diarrhoea is a special form of Diarrhoea and must be
thought of as something quite apart from the Diarrhoea which figures
as a cause of death all the year round. The investigations of Ballard
and others may be taken as having established that fact, and to have
made it practically certain that this epidemic form of Diarrhoea is a
true infective process in which specific micro-organisms are concerned.
The death rate from Diarrhoea remains remarkably constant through
the winter and spring when the ordinary agency of injudicious dieting
is almost alone concerned in its production, but, with little preliminary
warning, as the hot summer weather sets in, an extensive outburst
of the summer type of Diarrhoea occurs, from which very few of
those at the extremes of life, or who are enfeebled, escape—although
the death rate is mainly swelled by the children of the poorer people
who do not obtain prompt and skilled attention and treatment until
it is too late.
This Summer Diarrhoea is the most fatal of all the Zymotic diseases
and (especially during the year in review) it exercises a considerable
influence in determining the death-rate of the Kingdom. There are
good reasons for believing that the essential cause of the complaint
resides in the soil and that under favourable meteorological conditions
(more especially of temperature) the infection leaves the earth
and gains access to air, water and food. It is very important,
therefore, to take every measure which will ensure the utmost
possible freedom of these necessities from contamination—especially
in the summer months. Infants who are fed artificially for the
first 9 months of life suffer much more from the complaint than
those fed naturally from the mother's breast, and where such artificial
feeding is necessary, much mortality would be prevented if
parents followed two golden rules: —(1) Give nothing but well boiled
fresh milk, or milk and water, for the first 9 months of life, and
(2) keep all milk vessels and feeding bottles scrupulously clean. Artificial
feeding, and the uncleanly and insanitary conditions of the
child's surroundings, were responsible for thousands of deaths under
one year of life during the past year.