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 1911
[Report of the Medical Officer of Health for London County Council]
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78
Annual Report of the London County Council, 1911.
notified cases, 97 proved fatal, a case mortality of 32 per cent. Of the remaining deaths recorded,
3 were deaths in London institutions of women confined outside London, and probably notified as
puerperal fever in the district where the confinement took place. The other deaths were those of cases
which were not notified.
Early information of notification of cases of puerperal fever is received from the Metropolitan
Asylums Board or from the borough medical officers, and I am indebted to the latter for information as
to by whom the patient was delivered.
The following table gives the results of these inquiries which relate to the 302 notified cases and 48 deaths of cases not notified in London:—
| Delivery conducted by | Cases. | Deaths. | |
|---|---|---|---|
| (a) Medical practitioners (including cases attended by medical students and also cases in which a medical practitioner was in charge of the case, but the birth took place before his arrival) | 219 | 92 | |
| (b) Certified midwives (including cases in which birth took place before her arrival) | 68 | 16 | |
| (c) Medical practitioner and certified midwife, i.e., cases in which a midwife was unable to deliver and called in a medical practitioner | 8 | 4 | |
| (d) Hospitals and poor law institutions | 24 | 14 | |
| (e) Uncertified women | 4 | 2 | |
| (f) Cases of miscarriage or abortion where no attendant was engaged | 24 | 14 | |
| (g) Cases where patient died in London, but was confined elsewhere | 3 | 3 | |
| 350 | 145 | ||
The cause of death as stated in the death certificates in the 142 fatal cases where the deceased was confined in London is shown in the following table :—
| Cause of death. | Notified cases. | Unnotified cases. | Total. |
|---|---|---|---|
| Puerperal septicaemia, toxaemia, and septic absorption | 71 | 19 | 90 (15) |
| Puerperal peritonitis | 6 | 13 | 19 (3) |
| Pyaemia | 5 | - | 5(2) |
| Saprsæmia | 1 | 2 | 3(1) |
| Puerperal fever (not defined) | 8 | 3 | 11 |
| Metritis, perimetritis, parametritis and endometritis | 1 | 2 | 3 |
| Toxsemia of pregnancy | - | 1 | 1 |
| Infective endocarditis | - | 1 | 1 |
| Phlegmasia alba dolens | - | 1 | 1 |
| Post partum eclampsia | 2 | - | 2 |
| Pelvic cellulitis | 2 | - | 2 |
| Phlebitis after parturition | - | 1 | 1 |
| Erysipelas after parturition | - | 1 | 1 |
| Pyonephrosis and toxæmia | - | 1 | 1 |
| Salpingitis | 1 | - | 1 |
| 97 | 45 | 142 |
The number of fatal cases of puerperal fever which followed abortion or miscarriage was 21. The classification of these cases is shown by the figures in brackets in the last column of the above table.
| Total. | 15-20 | 20-25 | 25-30 | 30-35 | 35-40 | 40-15 | Over 45 | Age not given. | |
|---|---|---|---|---|---|---|---|---|---|
| Recovery cases | 205 | 10 | 39 | 61 | 53 | 26 | 7 | - | 9 |
| Fatal cases | 145 | 4 | 25 | 41 | 28 | 23 | 22 | 2 | - |
In cases where a midwife was concerned the Council's inspector visited the midwife, learnt particulars
of the case from her, made enquiries as to any other patients recently attended, and took steps to
ensure that the rules as to disinfection were fully carried out before the midwife resumed her work.