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erysipelas.
Erysipelas.
General Prevalence.—In 1919 76 cases were reported (males 35, females 41), and in 1920,
81 (males 34, females 47). Those totals compare favourably with the annual averages for
1909-13 (90) and 1914-18 (101). The maximum for any year since 1909 is 141 recorded in
1914, and the minimum, 56 recorded in 1918.
Institutional Treatment.—Twenty-one cases (27.6 per cent. of the total) received
institutional treatment during 1919 and 28 (34.5 per cent.) during 1920, practically all the
cases being treated in Infirmaries.
Secondary Attacks.—Certain individuals appear to be subject to periodical attacks of this
disease. In 1919 4 persons (3 adult females and one boy aged 8) were reported twice, and in
1920, 2 (adult males). The occurrence of two attacks—at four months' interval—in a boy of
8 is believed to be unusual.
Fatality.—Of the 72 persons attacked during 1919, 5 died of the disease, and of the 79
attacked during 1920, 3—showing fatality rates of 6.9 and 3.8 per cent. respectively.
Mortality.—During the two years 8 deaths were ascribed to this disease—5 (all males)
in 1919 and 3 (2 males, 1 female) in 1920. The annual averages (deaths) for the two
quinquennia 1909-13 and 1914-18 were 4 and 5 respectively.
Puerperal Fever.
General Prevalence.— In each of the years 1919 and 1920, 15 cases of this disease—or group
of diseases—were notified, as compared with an annual average of 8 during 1909-13 and
7 during 1914-18. The Index Numbers based on experience of 1909-13, are—1914-18, 87;
1919, 187 and 1920, 187. It has to be borne in mind, however, that during the two
quinquennin, the annual numbers of births were decreasing somewhat rapidly, whereas in
1919 and 1920 the numbers increased very considerably. Calculating morbidity rates on the
births registered within the Borough, it is found that during 1909-13, the rate averaged 2.07
per 1,000, and during 1914-18, 3.02. For 1919 the rate was 7.44, and for 1920, 4.71, the average
for the two years being 5.77—figures which compare unfavourably with those for the preceding
quinquennia.
The cases reported distributed by Wards furnish numbers too small for averaging.
Comparisons of the totals for 1914-18, with the records for the last two years are
given below : —

The occurrence of puerperal fever—as notified cases—is a new phenomenon in the Lancaster
Gate Wards.
Errors of Diagnosis.—Among the 30 cases notified during the two years were three subsequently
diagnosed not puerperal fever and a fourth in which the diagnosis was doubtful.
During 1914-18 the percentage of errors was 88, that for the last two years being exactly
10 per cent.
Institutional Treatment.—Of the 15 cases notified during 1919, 13 were removed to
institutions; and of the 15 reported in 1920, 12. For the two years, the percentage of cases
removed to hospital was 83 3 as compared with an average of 8(3.6 per cent. for 1914-18.
Fatality.—Of the 30 cases reported during the two years, 10 terminated fatally (4 in 1919
and 6 in 1920), equal to a fatality of 33.3 per cent. as compared with an average of 55 per cent.
during 1914-18. Eight of the 10 women dying were primiparæ. There were in addition
2 deaths (one the subject of inquest) of patients whose cases were not notified.