Sanitation, intestinal infections, and infant mortality in late Victorian Sydney.

FROM THE viewpoint of community health, the history of the Victorian city in Britain can be regarded as the history of "fever", especially typhoid fever.' The same can properly be said of Victorian Sydney. The introduction of adequate sanitation of the city's environment was an important step in the control of the intestinal infections and the high mortality they produced in infants. Sydney was almost as effective a killer of babies as many other Western cities of the time.2 In Sydney, as overseas, diarrhoeal disease significantly contributed to the high infant mortality of the time: in the period 1875-1900, diarrhoeal mortality was almost always greater than thirty per 1,000 births. It was more than thirty-seven per 1,000 in 1901, but had fallen to just over two per 1,000 in 1933. High death rates from diarrhoeal disease were commonly recorded in other cities of Australia and in Europe and North America. In 1891, Professor H. B. Allen of Melbourne wrote that it was "lamentable that the mortality from these diseases should continue so great" and that the incidence should fall chiefly on children. In 1885 the Health Board of the colony of Victoria had drawn attention to the fact that five-sixths of deaths from diarrhoea were of children under five years of age." In New York City the infant death rate from diarrhoeal disease was over eighty-four per 1,000 in 1885. By 1901 it was down to just under forty-five and was only a little less than eighteen per 1,000 in 1920.4 During the 1880s and 1890s London had an average infant death rate from diarrhoea of 23.3 per 1,000 births. The industrial centre, Leicester, had an average of