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this cause the Zymotic death-rate instead of being 2.0, would
only have been -52.
The importance of this disease cannot be overestimated,
its prevalence is associated with certain climatic conditions
beyond our control, such as a high temperature and a dry
season, there are however other equally well determined factors
over which we may exercise control more or less, the most
important of which are—
(i.) The density of population or overcrowding.
(ii.) Domestic darkness and general dirtiness of
dwellings (these conditions are only to a small
extent under the influence of the Sanitary
Authority). During the year 102 houses have
been cleansed and limewashed, this however is
of little avail unless some effort is made on the
part of tenants themselves as regards cleanliness,
etc.
(iii.) Filthy accumulation of domestic refuse in
dilapidated brick ashpits, boxes, etc.—this cause
is especially liable to produce foul emanations
in the hot summer months, the smells caused by
animal and vegetable refuse are greater and
create more nuisance than at other times, for the
simple reason that decomposition takes place
more quickly in hot weather. I should like if
possible a bi-weekly collection of refuse during
the summer months.
(iv.) A still more common cause of this complaint
is the badly arranged artifical feeding of infants;
the mortality amongst hand-fed chddren being
much heavier than amongst breast-fed. Much
good might be done in this direction by district
visitors and other lady workers in the poorer
neighbourhoods, by using their influence in