View report page

8
suggests that the bacillus of diarrhœa may not only exist, but
multiply in condensed milk, and thinks enquiry on this point
is necessary. On the whole it appears probable that in most
cases the milk and other food which conveys the infection is
infected in the house, and not beforehand. The mode of
infection is through dirt conveyed by hands, flies, and perhaps
wind. The germs may come from previous cases, or from
horse dung, or from impure soil on which houses stand. It
appears to me probable that most cases are infected by
previous cases; the fact that in 40 out of 135 cases information
was obtained as to two or more members of a family
suffering from the disease, with a few days' interval between
the first and subsequent cases, is strong evidence of this.
Uncleanliness is certainly a contributory cause; 37 out of
105 diarrhœa houses inspected were found dirty. In 124
houses where phthisis occurred, only 28 were found dirty,
although dirt is a contributory cause of phthisis.
Out of 51 cases having fresh cows' milk in 48 instances
the milk was always boiled before use. It follows that the
infection can not often be conveyed from the farm or other
place outside the house by milk.
Previous Health.—Out of 56 cases, 41 were stated to have
been previously delicate, and 15 strong; 10 were twins, and
5 illegitimate. Of those breast fed, 9 out of 12 were delicate.
Whether the delicate are more prone to the disease, it is
impossible to say ; but certainly they are much more liable to
die of it. The excessive mortality of infants generally from
diarrhœa is not due so much to the disease attacking them in
larger proportion than adults, as to the fact that they easily
succumb. Diarrhœa arrests nutrition, and infants are specially
susceptible to anything that dœs this.
Duration of Illness.—Out of 110 cases, 25 died within
three days of the onset, and 64 within one week. Thus in
half the cases the duration was under one week.