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(i) Epidemic Diarrhoea was most prevalent during the months of July,
August, and September. It was highly infectious, as one found it
attacking one member of a family after another. It is also a fact that
this summer diarrhcea appears regularly, year after year, in an epidemic
form, and that it presents the same symptoms in each individual, and
there must be a common cause for it.
More than 140 years ago Dr. Cullen wrote concerning the disease,
"that it arises in summer and autumn after great heat has prevailed,
and especially after very dry states of the weather," and he further says
"that the effluvia from putrid animal substances readily affect the
alimentary canal, and occasion upon some persons a diarrhcea."
I think there are four main channels in which these putrid
emanations can reach us by—Milk, Water, Air, Insects.
Milk if used unboiled may undergo decomposition, and will cause
diarrhcea, especially in the young. We know that milk drawn from a
cow in the morning will often during the hot summer months be quite
"turned" by the afternoon, and milk in such a state will set up diarrhcea
in some people whether young or old.
If the milk is boiled, it will keep much longer, but unless
precautions are used in the storing of it, the danger will not be very
much lessened. After being boiled, the milk should be kept in a closed
vessel and in a cool place, for if it is kept uncovered the dust, which is
loaded with putrefactive germs, will fall into it.
Dirty feeding-bottles and teats are also undoubtedly often a cause
of diarrhcea in infants that are bottle-fed.
Water.—Drinking water may be a cause of summer diarrhcea.
During the hot summer months putrefactive changes are taking place all
along our water courses ; the banks of the reservoirs and streams are
lined with vegetation, much of which is often in a state of active
putrescence. The putrefactive gases are held in solution by the water,
and are not removed by filtration, and if oxidation is not complete, the
drinking of such water may cause diarrhcea.