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
London County Council 1907
[Report of the Medical Officer of Health for London County Council]
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The following table shows the number of cases, and by whom delivered:—
| Delivery conducted by | Cases. | Deaths. |
|---|---|---|
| (a) Certified midwives | 77 | 21 |
| (b) Medical practitioners | 112 | 51 |
| (c) Uncertified women | 7 | 3 |
| (d) No attendant present | 12 | 4 |
| (e) Confined in hospital or infirmary | 15 | 12 |
| (f)Medical man called in by midwife at delivery | 9 | 5 |
| (g) No midwife present | 78 | 48 |
| (h) Deaths in London of patients confined elsewhere | 8 | 8 |
| 318 | 152 |
The causes of death in the 152 fatal cases, as stated on the death certificates, were as follows:—
| Cause of death. | Total deaths. | Delivered by certified midwives. | Attended by certified midwives but delivered by medical practitioners. | Not attended by certified midwives. |
|---|---|---|---|---|
| Septicæmia | 66 | 13 | 3 | 50 |
| Pyæmia | 11 | 2 | - | 9 |
| Sapræmia | 5 | - | - | 5 |
| Puerperal peritonitis | 25 | 1 | - | 24 |
| Pelvic cellulitis | 5 | - | - | 5 |
| Puerperal fever and toxæia | 21 | 4 | 1 | 16 |
| Eclampsia | 2 | - | 1 | 1 |
| •• Puerperal mania | 2 | 1 | - | 1 |
| Phlegmasia dolens | 2 | - | - | 2 |
| Septic phlebitis | 2 | — | —' | 2 |
| Septic pneumonia | 2 | - | - | 2 |
| Parametritis | 1 | — | - | 1 |
| Erysipelas after parturition | 1 | — | - | 1 |
| Septic absorption | 3 | — | - | 3 |
| Enteritis after parturition | 2 | — | - | 2 |
| Gangrene of vulva | 1 | — | - | 1 |
| Peritoneal abscess | 1 | — | - | 1 |
| Total | 152 | 21 | 5 | 126 |
During the latter part of the year, enquiries were made from each medical practitioner who was called in by a midwife to a case subsequently notified as puerperal fever with the object of obtaining more precise information with regard to the nature of the case notified, and the following table is based upon the information thus supplied:—
| Disease. | Recovery. | Fatal. | Total. |
|---|---|---|---|
| Septicaemia | 10 | 6 | 16 |
| Sapræmia | 11 | 1 | 12 |
| Pyæmia | 1 | 1 | 2 |
| Parametritis | 1 | - | 1 |
| Phlegmasia dolens | 1 | - | 1 |
| Pelvic cellulitis | 2 | - | 2 |
| Peritonitis | - | 1 | 1 |
| Endocarditis | - | 1 | 1 |
| Erysipelas | 1 | - | 1 |
| Rheumatism | 1 | - | 1 |
| Sub-involution | 1 | - | 1 |
| Mammary abscess | 1 | - | 1 |
| Mistaken diagnosis | 2 | - | 2 |
| Total | 32 | 10 | 42 |
With regard to the 77 cases delivered by certified midwives, it was found that the symptoms of
fever were not observed in 13 instances during the 10 days of the midwife's attendance and that, con-
*The 78 cases under (g) occurred in the early part of the year. 146 similar cases in the latter part of the year
are classed under (b), (c), (d) or (e).