View report page

9
TUBERCULOSIS.
Accidents and Diseases of Parturition.—There were 18 casualties from these causes
during the five years, viz., 1914, 7; 1916, 8; and 1915, 1917 and 1918, one each.
The deaths from puerperal fever and accidents and disease of parturition numbered 41
during 1914-18, or 4 less than the total (55) for 1909-13. The Index Numbers for 1914-18
(averages for 1909-13=100) are —
Puerperal fever, 144. Accidents and Diseases of Parturition, 46. Combined, 74.
In dealing with this group of diseases, it is possible to present reliable statistics as
fatality rates should be calculated on the numbers of births, rather than the numbers of
women of any age-group. One reservation is necessary, however. There being no record
of still-births, the rates now to be submitted somewhat overstate the fatalities being based
on the births of children registered as born alive. According to the Department's records
there were 15,040 births (corrected total) during 1909-13, and 41 deaths from this group of
diseases, giving a fatality of 3.6 per thousand. During 1914-18 the figures were births,
12,444 and deaths, 41, and the fatality 3.2 per thousand From puerperal fever alone the
fatality was IT in the first period and 1.8 in the second. The following comparison is based
on data extracted from the Quarterly Reports of the Registrar-General.

The risks of parturition to the mothers appear to have increased slightly during the
second period.
Accommodation for cases of puerperal fever has been provided for some years in the
hospitals of the Metropolitan Asylums Board. In 1918 a small special hospital (12 beds) was
opened for parturient women suffering from venereal diseases. Admission to this hospital
is authorised under Sec. 80 of the Public Health (London) Act, 1891.
Ophthalmia Neonatorum.—This disease has been notified since 1911. (See Table III.,
Appendix.) During 1914-18 the notifications totalled 151, averaging 30 per annum. In
the three years 1911-13 the average was 25 per annum. The attack-rate per 1,000 children
born was 12.1 per 1,000 during 1914-18, compared with one of 8.2 during the preceding
three years. Forty-two of the patients (27.8 per cent.) received institutional treatment, 30
in the Infirmary, 9 in Queen Charlotte's Hospital, 1 in St. Mary's Hospital, and 2 in St.
Margaret's (M.A.B.) Hospital—opened in 1918 only.
Tuberculosis.
Notification.—Informal notification of pulmonary tuberculosis was initiated in the
Borough in 1903, but up to 1909, when the Paddington Tuberculosis Dispensary was founded,
the numbers of cases reported remained very low. Compulsory notification, limited to cases
of pulmonary disease among persons under the care of the Poor Law, was brought into force by
the Tuberculosis Regulations, 1909, and the universal notification of all forms of tuberculosis
by those of 1912.
During the five years, 1914-18,(5,241 certificates were received by the I)epartment, of
which 2,832 (45.3 per cent.) referred to patients already on the Department's Registers and
834 (13'3 per cent.) to patients not residing in the Borough. A further 39 certificates were
received from outlying areas relating to patients living in the Borough, so that the corrected
total of new cases reported during the period amounted to 2,614.
A Register of "suspect" cases* is also kept by the Department, to which 744 new
names were added during the five vears.
At the end of 1918 the Registers contained entries relating to 1,674 "definite" and £541
"suspect" cases. Table 8 shows the numbers of cases reported annually since 1903 and the
"wastage" (by death, removal, &c.) in each year. It will be observed that the number
reported annually since 1911, i.e., since complete compulsory notification was established, rose
to a maximum of 812 in 1913, and that, save for an increase in 1915, the numbers have progressively
decreased since that year. Taking the numbers for 1914 as 100 in each case, the
following Index Numbers for the last four years are obtained.
* These are cases under observation as possibly tuberculous. Cases medically certified are referred to as
" definite."
c