EPIDEMIC ENTERITIS 361 



not produce the disease, but cream which could not be boiled pro- 

 duced the disease." There were a number of other cases beyond 

 the 42 of which record was not kept In several of the families 

 affected, the disease only attacked persons who had consumed 

 some of the cream, and left out those who had not 



These nine sore throat outbreaks will suffice as illustrations of 

 throat illnesses the infection of which was conveyed by milk. 



E. Epidemic DiarrhoBa 



Definition of epidemic diarrhoea. — The term diarrhcea is 

 obviously only the name of a symptom arising in relation with 

 many diseased conditions. By " epidemic diarrhoea," however 

 {zymotic or epidemic enteritis), is meant a specific disease, which for 

 brevity and convenience may be defined as an acute infective 

 disease, affecting chiefly children under two years of age, occurring 

 during the summer months in epidemic form, and characterised by 

 the occurrence of diarrhoea, vomiting, and wasting, accompanied in 

 severe cases by toxaemia and collapse, which generally end fatally. 

 This disease is a large contributor to the bills of infant mortality, 

 and in many urban districts it is the most serious of all infant 

 diseases, if measured by fatality. It is now believed that there is 

 an intimate relationship between epidemic diarrhoea and the milk 

 supply. 



The Cause of Diarrhoea 



The exact cause of epidemic diarrhoea is not at present known. 

 In 1887, Ballard formulated certain propositions which have ob- 

 tained general acceptance. They are as follow : — 



" That the essential cause of diarrhoea resides ordinarily in the 

 superficial layers of the earth, where it is ultimately associated in 

 the life processes of some micro-organism not yet detected or 

 isolated. 



" That the vital manifestations of such organism are depend- 

 ent among other things, perhaps principally, upon conditions of 

 season and on the presence of dead organic matter which is its 

 pabulum. 



" That on occasion such micro-organism is capable of getting 

 abroad from its primary habitat, the earth, and having become 

 air-borne, obtained an opportunity for fastening on non-living 

 organic material, and of using such organic material both as 



