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47
Puerperal Fever.
The deaths attributed to puerperal fever in 1897 numbered 215 in the registration County of
London, the corrected annual aver age of the preceding ten years being 272.

There is therefore in 1897, as compared with 1896, a decrease in the case rate and death rate
calculated on the births. Comparison of the rates of puerperal fever and those of erysipelas during the
last seven years show a correspondence between the two diseases which is suggestive.
As in previous years the number of cases notified only slightly exceeded the number of deaths.
The medical officer of health of Bethnal-green gives account of two cases in which the first
intimation he received was the entry of the death in the weekly return of the district registrar. He
thus writes—
In the first of these two cases the death was certified to be caused by "peritonitis after labour,
12 days." I felt sure that this must be a case of puerperal fever as the medical practitioner who signed
the certificate had a few weeks previously notified to me a similar case on the day the patient died;
accordingly I wrote to this gentleman to ask why he had failed to report the case; he answered apologising
for his neglect, which he sought to excuse on the ground that the illness and death of his patient so
upset him that he had forgotten to send the certificate.
The medical attendant was summoned before the magistrate. He was not present at the hearing
but sent a representative who was prepared to admit the offence and pay such penalty as might be
inflicted. The medical officer of health was unable to give evidence that peritonitis following labour
was invariably due to puerperal fever, and the defendant's letter was not received as evidence as to his
signature. The prosecution was not sustained.
Influenza, Bronchitis and Pneumonia.
The deaths from influenza, which in 1896 numbered 496, rose in 1897 to 671, the corrected
annual average for the preceding ten years being 1,069. The deaths attributed to bronchitis and also
to pneumonia were below the corrected average for the preceding ten years.

Phthisis.
The deaths from phthisis in the Administrative County of London during 1897 numbered 7,645.

See footnote (2), page 7.