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19
SEPTIC DISEASES.
Of the 9 definite cases, 3 were believed to have been imported. Two of the patients were
ill when they landed in this country from abroad.
There were 4 deaths among persons reported to have the disease, but in 2 of the fatal cases
(one each of enteric fever and continued fever) the illness had been erroneously diagnosed.
The fatality (Table 16) among definite cases was 22.2 last year, as compared with 31.5 in 1913,
and an average of 16.4 for the five years.
The Widal test was known to have been used in three instances before notification, in each
of which a positive reaction was obtained. In one case, however, the diagnosis based on the
result of the test was subsequently rejected.
The mortality from enteric fever last year was at the rate of 0.02 per 1,000 persons, as compared
with 0.04 in 1913, and an average of 0.03. Lower rates were recorded in Kensington
(0.00) and Willesden (0.01). (See Table 11.) The Ward mortalities will be found in Table 17.
SEPTIC DISEASES.
Puerperal Fever.— Ten cases of this disease were reported during the past year, the total for
1913 being 8, and the average for the five years 1909-13, 7.6. The numbers of cases reported
from each of the Wards during the past six years are given in Table 7.
The morbidity rate was 3.44 per 1,000 births last year (Table 4), as compared with a rate
of 2.80 in 1913, and an average for the preceding five years of 2.65. According to the data
used in the preparation of Table 5, the local rate was 337 last year. Higher rates were recorded
in Westminster (4.64), St. Marylebone (4.22), and Hampstead (5.49), and lower in Kensington
(1.87) and Willesden (2.91). In Extra-Metropolitan England and Wales (Table 6) last year's
rate was 2.53 per 1,000 births, as compared with 2.13 in 1913 and 2.36 in 1912. The morbidity
rates in the different Wards of the Borough are shown below.

Eight of the confinements were attended by medical practitioners and 2 by midwives. The
patients were all delivered of living children. Four cases were removed to the Paddington
Infirmary, 1 to St. Mary's Hospital, and 1 to the North-Western Hospital, the remaining 4 being
kept at home.
Three of the notified cases terminated fatally. In one of these it was found that the
patient's permanent address was not in the Borough, consequently the death does not appear in
the local "corrected" statistics. There were also 3 deaths of patients who had not been notified,
making a nett total of 5 deaths belonging to the Borough. (See Tables III. and IV., Appendix.)
Inquests were held touching 3 deaths (1 notified case and 2 non-notified cases), the findings of
the Juries being: (1) "Puerperal septicaemia and erysipelas of the face, such erysipelas following
injury to the nose. Although the Jury are unable to say the exact nature of such injury, they
are satisfied it was accidental." (2) "Miscarriage. Septicaemia brought about by accidental
infection." And (3) "Syncope when suffering from general peritonitis (pneumococcal) after a
miscarriage attended by an untrained woman."
The mortality per 1,000 births in the Borough last year was the same as the rate for the
County (1.68). Lower rates were recorded in Kensington (1.24) and Marylebone (1.40). (See
Table 18.)