EPIDEMIC SUMMER DIARRHOEA 329 



Pasteurized and boiled milk constitute good media 

 for the growth of the bacillus, and when introduced into 

 these, the organism, having a field free from competition, 

 grows rapidly and remains virulent for a month or more. 



It is, therefore, very necessary to use clean vessels for 

 storing pasteurized or boiled milk, and cover them so as 

 to prevent access of flies and dust, which might reinfect 

 the milk. 



In cream the typhoid bacteria become more abundant 

 than in milk, especially if the acidity is abnormally low, 

 and butter prepared from it is infective. 



The time during which they remain in a living or virulent 

 condition in butter appears to depend on the acidity of 

 the cream from which it is made ; in ordinary acid-cream 

 butter they probably die out in a week or ten days. 



5. Epidemic Summer Diarrhoea is one of the most 

 fatal ailments to which infants are subject, the death- 

 rate among children up to five years of age from this 

 disease alone amounting generally to over i o per i ooo ; 

 its elimination would very materially alter the vital 

 statistics of young children. 



The fatality from this disease is highest in the 

 warmest part of the year, namely, in the months of July 

 and August, and is especially prevalent among children 

 of the working classes in urban areas. 



Many investigations have shown that it is essentially 

 a trouble connected with the use of cows' milk, hand- 

 reared infants being most affected by it. 



The disease is apparently due to poisonous compounds 

 in the milk,manufactured by swarms of bacteria introduced 

 from dirty surroundings, the production of the deleterious 

 substances taking place either before the milk is taken 

 or after it enters the stomach and intestinal tract. 



