London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Islington 1900
Forty-fifth annual report on the health and sanitary condition of the Borough of Islington
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87 [1900
The preceding returns have been as follows:—
| 1891 | 33 cases | 3.67 per 1,000 registered births. |
| 1892 | 51 „ | 5.34 „ „ |
| 1893 | 38 „ | 3.90 „ „ |
| 1894 | 23 „ | 2.42 „ „ |
| 1895 | 22 „ | 2.23 „ „ |
| 1896 | 30 „ | 3.02 „ „ |
| 1897 | 27 „ | 2.74 „ „ |
| 1898 | 19 „ | 2.86 „ „ |
| 1899 | 33 „ | 3.42 „ „ |
| Mean | 33 „ | 3.78 „ „ |
| 1900 | 16 „ | 1.73 „ „ |
This return is exceedingly gratifying, as Puerperal Fever is possibly the most
fatal disease with which woman are afflicted. This may be well understood from
the fact that out of the 16 cases notified 6 died, or 37.5 per cent.
In every instance the most careful enquiries were made as to the cause of the
disease, and in several instances it was very evident that it arose from dirty
surroundings, or want of care as to cleanliness on the part of the attendants or
nurses, who were often unskilled persons. In at least five instances it became
necessary to request midwives, in large practice, to suspend their occupation for a
lengthened period, lest they should convey the disease to other parturient women;
and it is pleasing to record that compliance was at once and readily made with the
requirement. It cannot be said from the evidence that was obtainable that these
nurses were the cause of the disease, indeed, in some of the cases it was clearly
evident that they could not have been; but still, in the interest of the public, it
became necessary that they should forego their practice until such time as it might
be fairly assumed that they, having been thoroughly disinfected, might safely resume
their business.
Cause of the Disease.—It is generally caused by septic matter—i.e.,
matter that promotes putrefaction—coming into contact with the wounded inner
surface of the womb after child birth, or with the dilated veins and lymph channels
which are at that time abundant, or with some part in the genital tract where
lesions or injuries exist, all of which things are of common occurrence during
labour.
The septic poison may be introduced from without during labour by persons
coming into contact with the patient conveying the infection through their clothes,
their hands, by sponges or even by surgical instruments; also by the bedding,
sheets, diapers, or by the air conveying the infection from such a disease as