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41
The weather of August was again unusually warm and sunny
as well as notably dry. With the exception of 1911 it was the
warmest August since 1841. Day readings of 90° F. or above were
recorded at a large number of stations on several days. Abundant
sunshine was one of the noteworthy features of the month.
September was an unusually warm and sunny month. On
several occasions in the early part of the month a maxima of 80 °F.
was recorded and in isolated places readings of 84 °F. were
recorded.
But in spite of these conditions there was no Diarrhoea.
The disease was negligible, and in many parts of the country it
was entirely absent. If these climatic conditions had obtained
30 years ago, Diarrhoea would be rampant and many deaths of
infants would have resulted. But though Diarrhoea was associated
with certain climatic conditions, no one explained what were the
changed circumstances which initiated an epidemic enteritis, and
in view of this year's experience we have to abandon the view that
there is any connection between an epidemic and the rise of the subsoil
temperature.
The early pioneers of sanitation attributed most diseases
to filth, and in particular summer diarrhoea was supposed to be due
to milk infection. Different epidemics were said to have been primarily
caused by the Shiga, Flexner, Morgan, Welch and other
bacilli, and the exponents of the filth theory would probably claim
that our efforts towards cleanliness have been successful in combating
these organisms and resulted in a diminution of summer
diarrhoea. The explanation is not such a simple one.
It is true that vast strides have been made to secure cleanliness
both inside and outside the home and this probably has exercised
a most beneficial influence, but it is not the only cause of the
lessened incidence of summer diarrhoea. Concurrently with the
lessoned incidence of diarrhoeal diseases in the summer there has
also been a marked diminution of deaths from respiratory diseases
in the winter. The usual and commonest cause of disease in children
is probably the abnormal activity of the normal denizens of the
bowels and respiratory tract. These latter organisms avail themselves
of an exaltation of virulence and are able to pass the usual
barriers and to pour their poison into the blood. In the case of
diarrhoea infection never came out of a clear sky, and previous
digestive disorders paved the way for the invasion. As long as we
concentrated our attention on the prevention of outside contamination,
our efforts were not successful. The success achieved in the