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87
(ii.) Special Visits respecting Summer Diarrhoea.
Owing to the number of cases of epidemic diarrhoea occurring in infants during
the summer, and especially in August, it became necessary to make arrangements
to ascertain the existence of such cases. In response to my request, the Almoners
of the Great Ormond Street Hospital for Children, the Metropolitan Hospital, and
the Queen's Hospital, kindly consented to send notices of the cases occurring in
infants attending as out-patients. I received a great many, of which 41 related to
those resident in this Borough. All these were specially visited, the mother informed
of the dangerous and infectious nature of this illness, the home conditions
investigated, and any sanitary defects reported. Advice was given as to special
feeding, the need for careful food storage, and the precautions to be taken against
the spread of this disease. The number of cases thus notified can be safely
considered to be only a small proportion of the number which occurred, and the
number of visits paid in connection with these notified, represents only a part of the
educational work in this connection. The large amount of illness from this cause,
and the attention drawn to its prevalence, created some alarm and quickened
interest in the nature of the disease. When visiting a house, perhaps for ordinary
routine work, I frequently found several people who were anxious to discuss this
matter and who were in a very educable frame of mind, and I spent much time,
which could not be definitely accounted for, in talking to these people.
According to your instructions, special stress was laid on the necessity
of the washing of hands before handling or eating food. It was, indeed, always
necessary to give this advice, for this simple and effective precaution was nearly
always neglected, and very few had any previous idea of the connection between
the spread of infection and dirty hands. In many instances, however, this advice
was much more easily given than carried out. There are so many families in this
Borough whose so-called " homes " are just one or two rooms in a large house, with
no facilities for cleanliness. In these circumstances, the frequent washing of hands
entails a great deal of labour in the carrying to and fro of clean and dirty water.
Again, in regard to the cleanly storage of food, few, if any, of these same people
have any proper place for storing food ; an unventilated cupboard in the fireplace
recess is all that is provided, and it is extremely difficult to keep milk in a fit state
for a baby's food, especially in hot weather. Considering the housing conditions,
the wonder is that there was not a greater mortality from epidemic diarrhoea
during the exceptionally hot summer.
It is a noteworthy fact that of the 65 cases referred to below as having died of
epidemic diarrhoea, only three occurred in blocks of dwellings, which have facilities
for cleanliness ; and no deaths among infants from this cause have occurred in the
Sutton Model Dwellings, where even the one-room homes are entirely self-contained
and there is every facility for cleanliness.