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20
All conditions which might be supposed to bear on the
causation of diarrhceal diseases are enquired into and reported
upon; for instance, what kind of food is given, how it is stored and
prepared for use, the kind of bottle used, how it is cleaned and so
on. Practical instruction in these matters is given, and the visits
are made systematically until the baby is a year old. There can
be no doubt that domestic cleanliness, and proper food properly
prepared, are the greatest factors in the prevention of diarrhceal
diseases, and I certainly think that the appointment of a woman
health visitor is a matter which is well worthy of your consideration.
I feel sure that it would result in a permanent diminution
in the rate of infantile mortality, and the effect of this on the
total death rate would be such as to make it lower than most
districts of similar character and population.
Zymotic Death Rate.
The total death rate from Zymotic diseases is a popular
standard of healthy conditions, but as a matter of fact it is of little
value for this purpose, since it is liable to great fluctuations owing
to the prevalence of diseases which are included in it, as Measles,
and Whooping Cough, which are neither usually nor truly
dependent upon defective Sanitary conditions. It rises and falls
too, with the infant mortality, since it includes Diarrhoea and
Enteritis. In order to make the rate a more reliable test, I have
tabulated the various rates, so as to show the deaths from Zymotic
diseases which are notifiable, and those which are non-notifiable.
The tables will be found at page 9.
The death rate from notifiable diseases is the most
satisfactory criterion. Of the six deaths recorded, Erysipelas was
responsible for three, and of the two deaths from Scarlet Fever,
one was a patient from this district who contracted the disease in
a London Hospital, so that although the rate is 0.1 higher than
last year, the causes show that the conditions have been much
more satisfactory.
Of all the Zymotic diseases, the death rate from Enteric
Fever is the most reliable criterion of sanitary conditions. There
has been no death from this disease for many years past.
Death Rate from Respiratory Diseases.
This rate furnishes some evidence of sanitary circumstances,,
since the diseases comprised in this rate are prevalent and fatal,
in proportion to density of population, and dampness and
overcrowding in dwellings, workshops, &c.
The rate 26 per 1,000. The average rate, England and
Wales 1881-90, was 3.7.