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It will be seen, therefore, that there has been a
gradual decline in the amount of money expended
in this way during the past three years, the greatest
drop being between 1921 and 1922. Very careful
enquiries are made into the financial circumstances
of applicants for free or reduced price milk, and the
Maternity and Child Welfare Committee have been
much helped in these enquiries by the assistance of the
Charity Organisation Society. In addition to the
milk given free or at reduced price, 15,079 lbs. of dried
milk, value £1,339 2s. 4d., were sold at cost price to
persons recommended by the Health Visitors or Infant
Welfare Centres. During 1922 the amount of dried
milk distributed was 25,764 lbs., value £2,556 19s. 1 1d.
There has, therefore, been a considerable falling off
in the amount of dried milk sold at cost price.
Incidence of Infections Disease among Parturient Women
and Infants.
Puerperal Fever.
Thirty-two cases of puerperal fever, equal to 10
per thousand births, were notified during 1923, compared
with 31 during the previous year. There were
nine deaths from this disease against eight during
1922. All the cases except three were removed to
hospital. In my annual report for 1922 I outlined
the arrangements which had been entered into with
the Fulham Guardians whereby medical practitioners
can now send into the Fulham Infirmary suspected
cases of puerperal fever without waiting until the
diagnosis is absolutely certain. This enables such
cases to be brought under effective treatment at the
earliest possible moment. On making an analysis
of the cases of this disease during 1923, I find that no
less than thirteen occurred subsequent to mis-carriages,
many of them in the early months of pregnancy.
When considering the high incidence of this disease
in Fulham, viz. : 10 per thousand births, the fact
should be borne in mind that the rate following actual
labours (when the thirteen cases of mis-carriage are
deducted) is only 6 per thousand births. It is