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39
of the regulations, was sent to all Fulham doctors
before the regulations came into force :—
25th September, 1926.
The Public Health (Notification of Puerperal Fever
and Puerperal Pyrexia) Regulations, 1926.
Under the above Regulations the Local Authority is
required to give notice to all medical practitioners resident
or practising in its area of the duties imposed upon them by
the Regulations, which come into operation on the 1st October
next.
Circular 722 of the Ministry of Health states that for a
variety of reasons notification of cases of puerperal fever has
been far from complete, with the result that not only are
statistics relating to the disease misleading, but measures for
the prevention and effective treatment of the condition have
been seriously impaired. The main reason for the comparative
failure to notify is to be found in the fact that puerperal fever
is ill-defined and is not a specific disease comparable with scarlet
fever or diphtheria. There is frequently a genuine doubt as to
the correct diagnosis. The Ministry is advised that it will ultimately
be desirable to replace the term " Puerperal Fever "
by the term " Puerperal Pyrexia," but this is not practicable
without further legislation. The Regulations therefore require
the notification of cases of puerperal pyrexia irrespective of
the cause, in addition to notification of cases of puerperal fever.
Puerperal pyrexia is defined in the Regulations as " any febrile
condition (other than a condition which is required to be notified
as puerperal fever under the Infectious Disease (Notification)
Acts) occurring in a woman within twenty-one days after childbirth
or miscarriage in which a temperature of 100-40 Fahrenheit
(38° Centigrade) or more has been sustained during a
period of twenty-four hours or has recurred during that period."
It is recognised by the Ministry of Health that the notification
of cases of puerperal pyrexia, in addition to cases of
puerperal fever, will lead to a great increase in the number of
notifications, and that many cases so reported will be relatively
trivial in degree, but the great importance of securing adequate
treatment in the early stages of puerperal infection is regarded
as outweighing any objection to the notification of a certain
amount of minor illness. Unfortunately, the ordinary notification
form in use for notifiable infectious disease does not meet
the requirements of the Regulations, and two new notification
forms are prescribed by the Ministry.
Facilities for Diagnosis and Treatment.
It will be seen that the notification forms enable medical
practitioners to indicate whether assistance in dealing with
the case is desired. Facilities for a second opinion and for