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which such preventive measures, or treatment, are necessary, and
which, are set out on the notifications forms, as follows
(i) to have a second opinion on the case ;
(ii) to have a bacteriological examination of (a) lochia, and
(6) blood ;
(iii) to have the patient admitted to hospital ;
(iv) to provide trained nurses.
It is well.known medically that, during confinement, the nervous
system is liable to periods of irritability, or high tension, and that, as
the result, the slightest shock may cause the temperature to rise. Thus,
on the third day, when the milk appears in the breasts, the temperature
of the mother always rises, whilst any indiscretion (very slight indiscretion)
in diet, moving, or otherwise, may also cause the temperature
to rise. All cases, however, of pyrexia, or fever, or temperature,
during the puerperium, are to be notified, apparently, irrespective of
the cause or causes, to which such Pyrexia, or fever, or temperature,
may be attributed.
There may be many notificatons of puerperal pyrexia sent in
officially under the Regulations, especially as miscarriages have to be
dealt with as well as child births. No estimate is possible.
The Regulations lay down that all Medical Practitioners residing,
or practising, within the Borough of Lambeth must be communicated
with, and informed of their new duties, and that new books of notification
forms must be issued, as set out in the schedules to the Regulations.
This has been done. The notification fees attached to these
notifications are the same as for other infectious diseases, viz., 2s. 6d.
(private) and is. public) for each notification certificate sent in, and are
repayable by the Metropolitan Asylums Board.
Typhoid and " Enteric " Fever.
In the " enteric " group are included typhus, typhoid (and paratyphoid)
fever, and continued or relapsing fever. These diseases are
practically non.existent within the Borough but may be, sporadically,
introduced from outside or from abroad.
Typhus fever has been stamped out for many years, and typhoid
(and paratyphoid) fever and continued (and relapsing) fever are rapidly
becoming diseases of the past.