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75
Continued Fever.—No case was reported as due to Continued
Fever, against no case in the previous year.
PUERPERAL FEVER AND PUERPERAL PYREXIA.
In August the Minister of Health forwarded copies of the
Public Health (Notification of Puerperal Fever and Puerperal
Pyrexia) Regulations, 1926, which came into operation on
the 1st October, 1926.
NOTIFICATION.
Puerperal Fever has been notifiable throughout the country
since the Infectious Disease (Notification) Extension Act,
1899, came into force. Experience has shown, however, that
for a variety of reasons notification of this disease has been
far from complete, with the result that not only are the
statistics relating to the disease inaccurate and misleading
(particularly as regards incidence and fatality rate), but
measures for the prevention and effective treatment of the
condition have been seriously hampered.
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 Diph-.
theria. There is frequently, therefore, a genuine doubt as to
the correct diagnosis. The term moreover bears a connotation
which may be thought to imply some slur upon the patient or
medical attendant, and this may possibly act as a deterrent
to notification of a doubtful case. In any event, it is certain
that many cases are not notified at all and that severe cases
are often notified only when it is too late for effective action
to be taken; and it is therefore important to modify the
existing arrangements for the notification of Puerperal Fever
by requiring the prompt notification of this morbid process
as soon as symptoms suggestive of septic infection become
manifest, in order that adequate nursing and treatment can
be ensured and the spread of infection to others prevented.
The Minister consulted the Section of Obstetrics and Gynaecology
of the Royal Society of Medicine in this matter, and a
representative committee appointed by the Section submitted
a report in February, 1925, upon which the enclosed Regulations
are based.
The Minister is advised that it will ultimately be desirable
to replace the term "Puerperal Fever" by the term " Puerperal
Pyrexia, " the latter being defined in terms which
involve no theory as to causation, but without legislation
amending the Infectious Disease (Notification) Acts it is not
practicable to substitute "Puerperal Pyrexia" for