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insanitary conditions of houses and rooms where in many confinements
have to take place, and personal insanitary conditions of the patients
themselves and their clothing and bedding, &c. Under the Infectious
Disease Notification clauses of the Acts, it is laid down that " Puerperal
Fever " is compulsorily notifiable, but no definition is given as to what
shall constitute " Puerperal Fever." The result has been that, in the
past, only definite cases and serious cases of Puerperal Sepsis have come
to the knowledge of the Sanitary Authority, and generally too late for
treatment or preventive measures, and it has been felt, and practically
known, indeed, that a very large number of other cases, more or less
severe, have also taken place, but have not been notified as "Puerperal
Fever."
From an administrative point of view, the notification of " Puerperal
Fever " has always been unsatisfactory, on account of no precise
definition of the disease having been laid down, thereby leaving it to
the Medical Practitioners concerned to decide the diagnosis in each
individual case, with consequent varying medical standards.
The symptoms which point to Puerperal Fever, as a result of puerperal
infection, are often ill.defined, and the diagnosis is always, more
or less, difficult, and there can be no reasonable doubt but that many
cases of puerperal infection, or sepsis, occur that are not notified as
" Puerperal Fever " to the Medical Officers of Health, and in connection
with which, therefore, no preventive measures, or treatment,
can be taken or given, as required—at least, in time to be of any
value.
It is to avoid this considerable leakage that the Ministry of Health
has decided that in future (from istOotober, 1926) not only shall cases
of puerperal fever (as generally understood by Medical Practitioners at
the present time) be compulsorily notifiable under the Notification of
Infectious Diseases clauses of the Acts, but that also all cases of Puerperal
Pyrexia, which may be due to many different causes This decision
of the Ministry practically means that cases of fever or temperature that
take place during the period of a woman.s confinement (3 weeks), or
that may occur during such period, are to be notified to the Medical
Officers of Health concerned, with a view to preventive measures, and
methods of treatment being adopted in those cases in connection with