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12 Parish of St. George the Martyr, Southwark.
It has been proved that the temperature of the earth is one of the most important
factors concerned in the development of the malady, and that the summer rise of
diarrhœal mortality does not commence until the mean temperature recorded by the
four-foot earth thermometer has attained somewhere about 56 degrees Fahrenhoit.
From investigations made by Dr. Klein, it appears likely that summer
diarrhoea is associated with the presence in the stools of a micro-organism, which he
has named "Bacillus enteritidis sporogenes."
This microbe presumably lives and multiplies in organically fouled and damp
soil, and is given off in the air to contaminate and poison food, especially milk.
The chief conditions of locality giving rise to diarrhoea in St. George's aro, I
believe, the following:-
(1) A loose damp soil polluted by liquid filth—e.g., from defective sowors.
(2) Density of population.
(3) Crowding of buildings upon areas.
(4) Hindrances to the free circulation of air, both about and within dwellings.
(5) Sewer emanations.
(6) Accumulations of domestic refuse in ashpits and dustbins.
(7) Absence of efficient control of dairies and of dairy farms supplying milk to
local dairies.
As regards tho conditions relating to the population, the chief causes predisposi
ng to diarrhœa are:-
(1) Poverty.
(2) Mode of feeding of infants.
(3) Maternal neglect and carelessness in infant management.
(4) Unwholesome or improper place of storage for food and vessels connocted
with food.
The main suggestions to bo made are—To provide :—
(1) Sound drainage system, both of houses and subsoil.
(2) Impervious flooring to houses, so as to exclude ground air.
(3) Free ventilation inside and outside houses.
(4) Careful storage of food.
(5) Systematic inspection of dairies, cow sheds, and dairy farms.
(6) Boiling of milk, especially in summer.
(7) Education of mothers as to the proper way of rearing infants.
Measles.
Measles is the mostdeadly complaint in your parish, and leads to a waste of
life which, in my opinion, may bo traced to tho following causes
(1) Measles, although highly infectious, is non-notifiable, and therefor#
outside the control of your Sanitary Authority.