10 associated with a high rate of mortality.
Especially noteworthy among th -insanitary circumstances in which a considerable proportion of the x}q^] *?•**
*e Dublin lives.
Large tenement houses, each room occupied by a separate faml* i5 house itself in a state of dilapidation ; water supply inconvenient of access • dirty staircases ; inadequate water-closet accommodation in a foul state; back'yards '^^Sl and littered with refuse and excrement; are conditions of life 'in Dublin wnT frequently encountered in connection with the dwellings of the poorer classes ^Th^ conditions tend to the production of a state of lowered vitality favourable to tt contraction of disease, and to fatal result of disease when contracted.
They also direct!
encourage the spread of maladies of the infective class, which includes not Zymotl diseases only, but also ailments such as Phthisis and other forms of Tubercular disease which are excessively prevalent in fatal form in Dublin.
Conditions favourable U strict cleanliness in the home are of the first importance in the limitation nf the spread of Phthisis, and these favourable conditions find no place in most of the houses occupied by the Dublin poor.
And in this connection it has to be borne in mind that tin proportional amount of poverty in Dublin is very large, so that these unfavourable conditions associated with the houses of the poor are widely spread throughout tht city.
The poverty of much of the population of Dublin is in itself, apart from ti* insanitary conditions referred to, a serious factor in the high death rate of the city.
The concomitants of poverty, more especially insufficient and unsuitable food aii scanty clothing, both directly and indirectly exert a marked influence upon the deati rate.
In considering the relationship between the death rate and the sanitary circumstance* of a town, it is usual to pay particular attention to the mortality in Infant Life and also to the mortality from Phthisis, Diarrhoea, and Enteric Fever.
The Infantile death rate in Dublin, while somewhat higher than that of London, it but little in excess of the average rate from this cause in the thirty-three large townitf England and Wales, and, is, indeed considerably less than the Infantile death rate of njtint of these towns.
This comparatively satisfactory state of matters may, as suggested it evidence to the Committee, be attributable in part to climatic conditions being leaf favourable to Summer Diarrhoea in Dublin than in some other places.
This malady k apt to be a prominent cause of death among infants.
In part also it may be re¬ ferred to the practice among Dublin mothers ot the poorer class of suckling their chil¬ dren throughout the early months of infancy instead of having recourse to the feedinf Lottie.
This practice not only provides infants with the nourishment best suite!
to them, but also tends to lessen the risk of their contracting Diarrhoea.
The Diarrhoea death rate in Dublin also stands in much the same relation to that k London and in the thirty-three large towns of England and Wales as does the Infant* death rate in Dublin to that in these places, and the comments made under the lattif head concerning Diarrhoea afford some explanation of the reason why, with a lugs general death rate, the death rate from Diarrhoea is nevertheless not relatively nig* in Dublin.
r.
The death rate from Enteric Fever in Dublin is, as already noted, very high V\ if our present lack of accurate knowledge regarding the manner of propagation of Lnters Fever it is not possible on the evidence submitted to the Committee to account for this.
The suggestion made in evidence that the continued excessive prevalence m Enteric Fever in Dublin is intimately associated with certain conditions of thes sou may be accepted as probably correct, but it is by no means clear what these condition m Of recent years organic pollution of the soil has come to be looked upon as *a^ri* the life and growth of the specific organism of Enteric Fever in that medium; am m doubtedly in Dublin the liability of the soil to pollution is great.
The soil on wt Dublin stands is polluted by leakage from defective drains and by plentiful soaKag foul matters from the surfaces of filthy house-yards and ill-cleansed lanes and aiiep.
* although there is agreement that the influence of such conditions is for evil ana wi^ j> endeavour should be made to lessen or remove them, it is clear that even .£
tQ ^ soil favour the spread of Enteric Fever, it is far from being the only soil concm
rf thought of in this way.
For in Dublin it is not in the districts where P0^^ k soil pollution are greatest that Enteric Fever most abounds.
It was a ^ ^^ evidence before the Committee that those parts of Dublin where» toe ao"^ce astotl^ more from Enteric Fever than those where the soil is clay.
But the e
^ aet fo ^ disposition of the gravel and the clay underlying Dublin is not su.mc^
^ evidence, i* mit definite conclusion on this point; a comment which also applies
^ ^^ ^Q^ this connection, regarding the level of the sub-soil water m Dublin.
^^ toward ever, as were submitted to the Committee regarding the latter P '
^ surface* showing that the fever is less prevalent where the sub-soil water is ne
