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159
satisfactory in diminishing the mortality from diarrhoea in Woolwich.
This is shown in Table VII., which gives death rates from diarrhœal
diseases in the summer quarter, and infantile death rates for the year
in London and Woolwich during the past five years. With this is
also given the maximum temperature of the 3 ft. ground thermometer,
and the average temperature of the same thermometer for the 13
weeks of each summer quarter of the years 1901 to 1905.
It is well known that diarrhoea is much more prevalent during
warm summers than cool ones, and it has been shown that the
greatest prevalence follows the highest point reached by the 3 ft.
ground thermometor. It would appear that the maximum height of
the 3 ft. thermometer is a more important point to consider than the
average temperature during the quarter. The summer quarter of
1904 had the highest maximum of the past 5 years, although the
average temperature was highest in 1901. Both in London and
Woolwich the diarrhœal mortality was much higher in 1904 than in
any year since 1900. The maximum temperature in 1905 was a little
lower than in 1904, but otherwise the highest in the past five years.
The average temperature was higher than in 1904, but lower than in
1901. It was therefore to be expected that the diarrhoeal mortality
would nearly have reached that of 1904. As a fact, however, in
Woolwich it was less than half of 1904 and less than that of 1901. In
London there was also a reduction, but not so great as in Woolwich.
It is a striking fact that in spite of the high summer temperature,
the infantile mortality during the past year has been lower than
that of any year on record. This I attribute partly to the notification
of summer diarrhoea, but even more to the systematic education
on infant feeding of all mothers of children requiring it who were
born during the year. This has been possible on account of the
receipt from the Registrars of weekly returns of births registered
during the week.
Diagnosis. One objection made to the desirability of notifying
this disease, was that as diarrhoea is a common symptom of other
diseases, and also a result of errors of diet, drugs, etc., many cases
of diarrhoea would probably be notified which were certainly not of
an infectious nature. Experience has shown that little, if anything
of this kind took place.
Only 11 cases over 5 years of age were notified. Probably a few
cases were notified which were not Zymotic Enteritis, but this is
necessarily the case in every system of notification.
Conclusion. I consider that the results of the experiment justify
its repetition for three more years, and would therefore recommend
that the payment for notification of Zymotic Enteritis be continued
during the three ensuing summer quarters.