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19
SEPTIC DISEASES.
J. H., m., aetat. 3; admitted Institution lGth July; to Home 30th July; discharged 12th September;
sickened 20th October ; re-admitted Institution 26th idem ; discharged 30th January, 1907.
The above accounfillustrates the danger of "missed cases" as well as the possibility of
direct personal infection in the absence of proper precautions. It should be stated that as
the patients were under treatment for other diseases, nearlv all associated with high
temperatures, the occurrence of enteric fever, the first symptom of which is usually fever,
was obscured by the already prevailing fever. So far as is known, but few of the cases took
a typical course, and the small fatality among the cases connected with the Institution
suggests that the disease was of a mild tvpe.
SEPTIC DISEASES.
These include puerperal fever, erysipelas, and certain other diseases of somewhat
infrequent occurrence. The first two are scheduled for notification.
Puerperal Fever.—In 1905, 7 cases of this disease were reported; last year, 12, a total
which has been exceeded three times onlv since notification was made compulsory, viz., in
1893 (18 cases), in 1896 (13 cases), and in 1902 (14 cases). In each of those three years
scarlet fever was exceptionally prevalent, as was the case last year. It is a common observation
that the two diseases follow the same curve of prevalence. Seven (7) of the 12 cases reported
last year occurred in Queen's Park and Harrow Road Wards, where the incidence of scarlet
fever was heavy in comparison with the other Wards of the Borough. (Table 12.) In
Hampstead only (Table 7) was the morbidity rate, calculated per 1,000 persons, below the
respective mean rate for the preceding five years.
Table 16 gives full information as to the real prevalence, fatality, and mortality from
puerperal fever, the rates being calculated on the numbers-of births and of married women
aged from 15 to 45 years. The morbiditv calculated on the number of births was generally above
the mean, the rates for Marylebone and Hampstead being exceptions to the rule. On the
other hand, the fatality was below the mean, except in Hampstead. Taking the numbers of
deaths recorded in each district, the mortality from puerperal fever was below the mean
except in Kensington and Westminster.
From inquiries made it appeared that six (6) of the patients were primiparae, and that
7 were u nursed " by untrained women. In 3 cases the use of instruments was recorded, and
in 3 other cases the child was born dead (mostly premature). One patient had been pregnant
three times since Februarv, 1905. Her first pregnancv ended in an abortion in that month,
her second had a like ending in the following February, and the third in the succeeding
December, with a fatal ending.
The mortalitv from 44 accidents and diseases of childbirth" was above the mean in
Kensington, Marylebone and Hampstead, below in the other districts, if calculated on the
births registered; but if calculated on the numbers of married women, above the mean in
Kensington and Hampstead, and below in all the others. The "total mortality in childbed,"
including "puerperal fever" and "accidents, &c., of childbirth," was below the mean
except in Kensington, Westminster and Marvlebone, when reckoned on the births; in all
districts except Kensington, when reckoned on the married women. There appear to be
grounds for hoping that the mortalitv in childbed is diminishing.
Erysipelas.—The cases of this disease numbered 138, 2 more than in 1905, the latter
total being 19 in excess of that of 1901. In Church Ward only was there any increase in the