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18 out of the 48 cases notified were traced to sources outside
the Borough, 3 were found not to be suffering from the disease,
and 6 were secondary cases, i.e., derived from previous cases (notified
or unrecognised) as far as could be discovered. No case could be
traced definitely and conclusively to infected ice-creams, water,
milk, fried or shell-fish or watercress, but in 4 cases there was a
history of shell-fish (cray-fish and oysters) having been consumed
by patients 2 to 3 weeks prior to their attacks.
Of the 48 typhoid-infected houses, 20 (i.e., 41.7 per cent.)
showed, on inspection, defective drains, traps, fittings, or appliances,
whilst in 7 (i.e., 14.6 per cent.) the drains themselves were found
to be defective (i.e., gave a result with the test).
In so far as typhoid fever is regarded as a sanitary index of
a district, the statistics for the Borough during 1914 are of a satisfactory
character.
SIMPLE OR CONTINUED, RELAPSING AND TYPHUS
FEVERS.
During 1914, 1 case of continued fever and 1 case of relapsing
fever were notified, but no death from these diseases was registered,
in the Borough. No case was removed to hospital. The annual
averages for the decennia 1901-10 are (1) notified cases 4.3, and
(2) deaths 0.7.
No case of typhus was notified, and no death from the disease
was registered, during 1914 in the Borough. One case of typhus
was notified in the Borough during the decennium 1901-10. i.e.,
an annual average of 0.1.
PUERPERAL FEVER.
During 1914 in the Borough, 10 deaths were registered from
puerperal fever (a disease of child-bed), and 23 cases notified,
giving a case-mortality of 43.5 per cent. 21 of the cases were
removed to hospital, non-pauper as well as pauper patients being
received for treatment and isolation at the Metropolitan Asylums
Board Hospitals under the new Metropolitan Asylums (Puerperal
Fever) Order, 1912 (August 20th).
The annual averages for the two decennia 1891-1900 (Parish)
and 1901-1910 (Borough) are respectively (1) notified cases, 18.9
and 17.0, and (2) deaths 11.5 and 7.8
Puerperal fever is a preventable disease, and is caused through
want of care on the part of the nurse, or the medical practitioner,
attending upon a lying-in woman. 8,188 births were registered in
the Borough during 1914, and in only 23 cases was puerperal fever
notified—a satisfactory fact to be able to report. In each case
of puerperal fever notified, enquiries were made, and the midwives