234 Tvmehri. 



The main results arising out of his visit was a hurrying up of many 

 of the recommendations of the Mortality Commission of 190G, mainly 

 directed against the propagation of mosquitoes, the cutting down of 

 trees, the filling up of canals and trenches, and the immediate creation of 

 a separate department of Public Health for the city, all of which have 

 been given effect to without, so far as 1 am aware, any great or marked 

 improvement, except in regard to a very satisfactory reduction in the 

 abnormally high infantile mortality, which, naturally, has had also a 

 reflex action on the general death-rate of the city, which is certainly a 

 matter for congratulation : hut apart from this pleasing feature, probably 

 resulting from the appointment of Lady Health Visitors and the estab- 

 lishment of Mothers' Clubs and training schools, the other results appear 

 to fie of a Bomewhat negative nature: the mosquitoes. 1 hear, are as had 

 as ever; the filling up of street reservoirs, with their stock of Victoria 

 Regia and other water lilies, and the cutting down of trees have re- 

 moved some of the characteristic features of Georgetown, as '• the garden 

 city of the West Indies " : enteric fever has been greatly on the increase 

 since 1908; and the extra expenditure involved by the upkeep of the 

 separate department amounts to over $12,000 per annum. 



Taking the figures from the Registrar General's returns as embodied 

 in the last annual report of the Surgeon General, the deaths from 

 typhoid fever in the colony, and mainly contributed by the city of 

 Georgetown, have risen from 8 to 93. averaging 60 deaths per annum. 

 as against an average of 8 deaths per annum over the previous twenty- 

 two years, three of these years recording a single death only. These 

 figures are significant as pointing to a very alarming and continued 

 increase of enteric fever within recent years, aggregating, probably, as 

 many as 500 cases in a single year. Writing as a mere layman, I have 

 no hesitation in attributing the cause to infection from drinking water 

 stored in vats, containing impurities washed down from the collecting 

 roofs and left without any natural means of purification. 



For this reason I had been for years trying to impress on the com- 

 munity the importance of sterilizing bv heating and boiling the vat 

 stored water before use, but I was like •• the voice of one crying in the 

 wilderness " for any good J did. A contrary opinion. I am aware, pre- 

 vailed for some time, that the infection arose through the milk supply, 

 and I believe a few isolated cases were traced to that source. Much as I 

 approve of every possible effort being made to obtain a clean and pure 

 milk supply, yet in view of the fact that almost every drop of milk drunk 

 in Georgetown is effective!} sterilized before use. through the necessity 

 of '• scalding'' or boiling it in order to prevent it from souring. I con- 

 sider this general theory of infection from milk alone to be untenable. 80 

 far as Demerara. or any tropical city similarly conditioned, is concerned : 

 and this -i ie^ I believe, ie now more generally accepted in at 1< 

 minimising the danger 



Coming now to the :onclusion of my paper, I nay say that I have 

 been porsonally acquainted with no fewer than eighteen Mayors of 



