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* See text.
25 cases of Puerperal Fever occurred in the Borough. Three of these cases died as
indicated in the above table. The Registrar General, however, has allocated one of these
deaths to another Borough. Strictly speaking, we should, therefore, only report 2 deaths
and consequently a mortality rate of 8 instead of 12 per 1,000, and a death rate of .7 instead
of 1.0. Without doubt the above table reflects the true result of the infection for it relates
the end result of the 25 cases.
About 8 per cent. of all confinements in the Borough were of unmarried women.
Thirty-five per cent. of the confinements which resulted in Puerperal Pyrexia and 24 per cent.
of those which ended with Puerperal Fever were among unmarried women. This points to
the higher risks of illegitimate pregnancies. They result in a greater incidence of such
morbid, and sometimes fatal, conditions as the "Pyrexia" and "Fever" under discussion and
also of Ophthalmia Neonatorum.
Nearly three-quarters of all the cases of Puerperal Pyrexia were among primiparæ,
that is women in their first confinement. Among the Puerperal Fever cases 44 per cent.
were primiparae.
Abortion plays an important part. Its share cannot be expressed in figures. The
reason is obvious. Even in accidental abortions the cause of the Pyrexia is often missed.
In many cases the incident is missed or even deliberately concealed. It has been suggested
by many authorities that the harmful effects often manifest themselves only at subsequent
pregnancies and confinements, with serious results.
A distinction between these two conditions is sometimes difficult and often a matter
of opinion. Puerperal Fever is more particularly the result of inflammation, acute or chronic,
of the female organs of reproduction. Puerperal Pyrexia is a rise of temperature due to
inflammation or disease elsewhere.
ERYSIPELAS.
96 cases were notified and 8 deaths occurred, as compared with 120 cases and 9
deaths during the previous year.
CEREBRO-SPINAL MENINGITIS.
(Cerebro-Spinal Fever, Meningococcal Meningitis, "Spotted Fever.")
There were 12 notifications of this disease during the year. Nine of these cases died
and two additional cases were brought to notice on special death reports. There were, therefore,
14 cases and 11 deaths.