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These writers further demonstrated that the summer pyramid was entirely
due to infantile mortality, and that by eliminating the deaths under one year
of age the pyramid of mortality in London in the third quarter of the year
entirely disappeared.
Infantile Diarrhœa.—The same writers further showed that the summer
pyramid of mortality was almost entirely due to bowel complaints. Diarrhœa
and Enteritis form the bulk of bowel complaints, and of the cause of death
amongst children under one year of age bowel complaints bulk largest. The
conclusions are that the excessive number of deaths during the third quarter
of the year is due to the deaths of infants, that these infants die of bowel
complaints—diarrhceal diseases—and that the primary cause of these seasonal
diseases is heat.
In what manner does heat act in causing diarrhœal diseases? Briefly, by
encouraging the growth of micro-organisms, and quickening the infection and
decomposition of food within the bowels after consumption, but commencing
in the air before consumption. Improper food, that is, food of a kind or
material that should not be given to infants, exerts its influence more or less
all the year round, but only produces fatal diarrhœal disease on a larger scale
during the third quarter of the year. Improper kind of food, therefore, is
but of secondary influence as a predisposing cause, aggravating the effects of
food infected with the causative organisms of diarrhœal diseases. This is
corroborated by the fact that the number of deaths from diarrhœal diseases
during the summer of infants fed directly from the breast, and whose milk is
not subject to external pollution, is only a tithe of the number of those fed
upon cows' milk (in various forms), which is subject to numerous opportunities
of pollution during shorter or longer periods. The contamination is
cumulative—the shed, the cow, the hands, the pail, each add their quota;
the mixing vessels, the hands again, the churns, the carts, the station depot,
the railway vans, the railroad dust, the terminal platform, add something
more; the milk dealer's cart, the milkshop, the open counter vessels, the milk
cans, the dippers, the hands again, and the dust of the street, complete the
mixture.
The first question is, How can the contamination of milk be prevented in
its passage from the cow to the house? and the second, How can the mother
in the home be taught to properly handle and administer the milk when she
has obtained it?
The answer to the first indicates that a complete revolution in the present
primitive mode of milk collection and distribution is necessary; and to the
second, that education is required in the feeding of infants as part of the
greater knowledge of the rearing of infants and young children.
Tuberculous—The only satisfactory method of preventing the distribution
of milk containing tubercle bacilli derived from cows with tuberculous
udders is for the Board of Agriculture to make the periodical examination of
the udders of cows by Veterinary Surgeons obligatory throughout the whole
country, and for the Inland Revenue Department to cause imported milk to be
examined for the presence of tubercle bacilli.
The Life of Tinned Condensed Milk.—Tins of milk are supplied by certain
producers unlabelled and unmarked, and the wholesale dealers or middlemen