214: NURSING STATISTICS FROM STUDY OF 1500 CHILDREN 



"colitis," is present probably in the minority of cases, for we 

 find so little change in the stomach and intestines at post-mortem 

 examinations. Bacteria as an etiological factor might cause 

 these deaths either by decomposed milk or by infection from 

 one to the other child. The question of decomposed or bad milk 

 is an important one and has been in the foreground for a number 

 of years. By the term "bad milk" we usually mean one that is 

 very acid or even sour. Yet during the past few years it has 

 been clearly demonstrated that an acidified milk is certainly not 

 dangerous to a great many infants. That epidemic diarrhoea 

 occurs, especially in hospital services, has been shown especially 

 by Escherich. Proper methods of feeding, no matter what kind 

 of milk used, is a most important factor. In investigating this 

 subject Park and Holt 1 came to the conclusion that the most 

 important factor for securing good results is intelligent care. 

 Leaving out the very worst store milk in the summer, the 

 results were much less affected by the character of the milk 

 than they had anticipated. The importance of the kind of mix- 

 tures, the amounts at each feeding and the frequency of the 

 feeding cannot be overestimated. 



Finally, the temperature of the atmosphere itself seems to be 

 a great factor in the production of this summer mortality. In 

 order to make this more evident I have prepared a chart by 

 taking the daily maximum temperatures and daily mean humidity 

 during the months of June, July and August of 1910 and com- 

 paring them with the number of children dying each day in 

 Manhattan during these months. The chart shows very well 

 how the temperature and mortality curves follow almost par- 

 alleled lines, lower in June, going up in July and down again in 

 August. A day of high mortality being preceded by 24 hours of 

 high temperature. The humidity, on the other hand, was high 

 in June, low in July and high in August. Wherever the tem- 

 perature was high and the humidity low, the death rate was 

 high ; wherever the humidity was high and the temperature high, 

 the mortality was low. In other words, hot dry days seem to 

 be more dangerous to the infant than hot moist ones. From 

 the experience of Rietschel we have seen how children placed 

 in superheated rooms soon get temperatures and intestinal symp- 

 toms. Holt in his work drew attention to great atmospheric 

 heat and its effect upon the infant, no matter what its care. It 

 is easily conceivable, then, that an infant improperly fed upon 

 cow's milk is always more or less alimentarily disturbed, and 

 when a hot wave comes is directly affected by the heat and dies. 



'Medical News, December 1903. 



