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28
Diarrhœa.
Under the heading Diarrhoea are included several
different affections, confounded with one another on account
of the presence of Diarrhœa as a symptom, but there is no
doubt that Summer Diarrhœa, which is so fatal to young
children, is essentially a specific disease.
133 deaths were ascribed to Diarrhoea, the average for
the nine previous years, allowing for the increase of the
population, being 107.
In addition to these deaths, the majority of the deaths
of infants, 32 in number, ascribed to Gastro-Enteritis, or
Gastro-Enteric Catarrh, were probably of the same nature.
The death-rate from the disease was 1.2, and for the
whole of the Metropolis .8.
In the 33 large towns the mortality caused by Diarrhœa
was 1.2, and considerably exceeded the average rate, .8, of
the preceding 10 years. The lowest rates were .48 in
Huddersfield, .52 in Plymouth, .56 in Croydon and *58
in Halifax; the highest rates were 2.1 in Burnley and
Blackburn, 2 4 in Hull and 2.5 in Preston; the high
mortality being mainly due to the hot summer.
With but four exceptions, all the infants who succumbed
were hand-fed. Although the atmospheric heat by its depressing
influence acts directly as a predisposing cause, it is
mainly harmful indirectly by facilitatingthe putrefaction of the
milk, and other artificial foods on which the infants are fed.
The agency which in midsummer, in our crowded districts,
causes fatal Diarrhoea among hand.fed children, does not
reside in the animal milk per se, but must be sought solely in
the alterations of the drawn milk, resulting from the access
of atmospheric air more or less polluted with emanations
from sewers and decaying refuse, and from the imperfect
cleansing of the vessels in which the milk is kept, and of the
bottles, tubes and mouthpieces through which it is
administered.
Most of these conditions are dependent on the habits of
the parents of the children; still, much can be done by the
Sanitary Authority by a more frequent removal in summer
of house and other refuse, and by the abolition of that fertile
source of danger, the present system of sewer ventilation.