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4
pounded that this form of diarrhoea is caused by the carrying of
these forms into the body by sewer air. An examination of the
old bills of mortality made by Dr. Buchanan afford much support
to this view, as in very many years deaths from this and
cognate diseases were comparatively rare, although cesspits
containing excreta existed on all premises, and house-drains
were unknown. The death returns for London since the present
system of registration has been in force also point to a similar
conclusion, as in 1840, when connections between houses and
the public sewers were much less common than now, there were
only 452 deaths registered from diarrhoea, and during the next
four years the average was only 680 ; whilst between 1869 and
1878 the smallest annual number was 2,479, viz., in 1877, and
the highest, 3,894, in 1871; the mean of the ten years being
3,436, against 632 for the five years 1840-4. Although these
facts cannot be considered sufficient to show that summer
diarrhcea results from sewer gas containing organisms finding
its way into houses, yet they certainly point to the necessity
for frequent flushing of water-closets and drains with some
disinfectant which retards or prevents putrefactive change,
especially when the summer is unusually hot.
As the infantile population suffers more in proportion to the
number living from summer diarrhcea than older children and
adults (and therefore should be better protected from the sun in
summer), I have calculated out the mortality from this disease
of infants under one year per 1,000,000 population in London
living at all ages in the years 1860-62 ; also in the years 1874-79.
The two former were calculated from the total deaths under
20 years, so that although they may not be quite correct, yet
they are closely approximative. This table shows a very close
correspondence between the mean temperature of the ten weeks
in July, August, and early in September, and the mortality, an
interval of one week being allowed for death to take place and
be registered, which is, I think, sufficient, as summer diarrhoea
is an acute disease.