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The following extract from a communication which was
circularised to all the medical practitioners in the Borough will
explain more fully the object of the Regulations, and in this
connection I may say that the Minister's assumption that the
Regulations would result in a great increase in the number of
notifications has not been borne out by the facts, as only five
cases of Puerperal Pyrexia were notified between the commencement
of the Regulations and the end of the year. In one case
the assistance of the specialist was sought.
The Public Health (Notification of Puerperal Fever
and Puerperal Pyrexia) Regulations, 1926.
In the Circular accompanying these Regulation, the Minister of
Health states that Puerperal Fever has been notifiable throughout the
country since the Infectious Disease (Notification) Extension Act, 1890,
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 have
been seriously hampered.
The Circular goes on to state that 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, 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 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 "Puerperal Fever" as a disease notifiable under these
Acts. The Regulations, therefore, while prescribing new forms for the
notification of cases of Puerperal Fever, also require the notification
of cases of Puerperal Pyrexia (as defined in the Regulations) in
addition to the present notification of Puerperal Fever under the
Infectious Diseases (Notification) Acts, thus placing an obligation upon
medical practitioners to notify all cases of Pyrexia during the puer-