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58
Spinster (22).—Admitted to Hospital suffering from effects of a
recent abortion with evidence of septic metritis. Condition gradually
deteriorated with severe toxaemia. Died 48 days after admission
to Hospital. She had not sought any ante-natal care and in
fact the evidence rather pointed to procured abortion.
It is very satisfactory to report only one case of maternal death in the
City during the year.
The problem of maternal illness and mortality is not one that concerns
a community so much as individuals, as each case presents its own
peculiar features. As an illustration of the difficulties which beset local
authorities in dealing with the problem the following case of a woman
who became dangerously ill with puerperal fever after the birth of a
still-born child may be mentioned. She was removed to a special
hospital in a very grave condition. After two or three days, however,
both patient and her husband became insistent that she should return to
her home. Conditions at the home were such that she would have been
without proper treatment or nursing. This most probably would have
caused her death. After some fruitless discussion with the husband it
was reluctantly decided to put in motion the provisions of Section 67 of
the Public Health (London) Act, 1891, for her compulsory detention in
hospital. Fortunately, however, it did not prove necessary to enforce
those powers as the husband and wife were finally persuaded to accept the
advice of the doctors to remain in hospital. The patient, after some six
weeks' treatment, returned home restored to health and resumed her
domestic duties. The woman, on recovery spoke in terms of warmest
appreciation and gratitude of her treatment in hospital and attributed
her earlier and somewhat peculiar attitude to her condition of acute illness
at that time; a state of mind not uncommon in cases of serious illness
after confinement.
Another case was that of a woman removed to one of the London
County Council's special Hospitals suffering from puerperal pyrexia following
miscarriage, who insisted against medical advice on being discharged
from the Hospital. On the health visitor calling at the home the
patient stated that she felt all right, and the husband intimated that
further visits from the health visitor were not desired. Steps were therefore
taken for the medical practitioner who had secured the patient's
removal into hospital to attend the case and thus secure for her adequate
medical attention and nursing.