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diarrhoea was determined by the fact that the mean daily
temperatures had been exceptionally high, for there are sufficient
reasons for believing that the essential cause of the complaint
resides in the soil, from which it issues under favourable meteorlogical
conditions (more especially of temperature) to gain access
to air, water and food. It is especially important, therefore,
in the summer months to take every possible means of ensuring
the freedom of these necessities of life from contamination.
The death-rate from diarrhoea always remains at about the same
figure throughout the winter and spring, when the ever-present
agency of injudicious dieting is almost alone concerned in its
production, but with little preliminary warning, as the mean daily
temperatures rise, an extensive outbreak of the summer type of
diarrhoea occurs, from which very few of those at the extremes of
life—or who are enfeebled—escape. This increase in the death-rate
is always mainly due to deaths among the children of the poor, and
slightly over 95 per cent. of the total deaths occur during the first five
years of life. Infants fed artificially for the first nine months suffer
much more from the complaint than those fed naturally from the
mother's breast. The chief means of reducing the mortality from
summer diarrhoea is by giving nothing but well-boiled liquid food
for the first nine months of life, and by keeping all milk vessels and
feeding bottles scrupulously clean. For the neglect of these simple
precautions, the infants of these islands alone are paying an annual
toll of many thousands of deaths. Summer diarrhoea is the most
fatal of all the zymotic diseases, and if the deaths certified as due
to gastro-enteritis were included (and at the summer period of the
year they probably all have a common origin) the loss of life from
summer diarrhoea would be still further increased to the extent of
some 30 per cent.
MEASLES AND WHOOPING COUGH.
In the early part of the year I was compelled to advise the
closure of the infant departments of three of the schools in the
Parish on account of the great prevalence of Measles. Each school
was closed for three weeks and there was reason for believing that
the closure effected some good in checking the extension of the
disease. At the same time handbills of advice as to precautions
which should be adopted in the presence of this disease were
distributed at each house in the infected streets.