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50
Puerperal Fever.
The deaths attributed to puerperal fever in 1896 amounted to 225 in the registration county of
London, the corrected annual average of the preceding ten years being 283.

There is therefore in 1896, as compared with 1895, increase in the case rate and in the death
rate, calculated on the births. Comparison of the fluctuations of the rates of puerperal fever with
those of erysipelas during these six years show close correspondence between the two diseases, that
is to say, in each year they rise or fall together.
The following references to puerperal fever are contained in the reports of the medical officers
of health of Poplar (Bow) and Plumstead—
Poplar (Bow)—
Two fatal cases of puerperal fever occurred in the practice of one of the midwives to the Royal
Maternity Society, residing in Old Ford. -As soon as he (the medical officer of health) received the
notification of the first case he wrote both the midwife and the nurse, requesting them to retire for a
time. The midwife had already given notice to her society, and was suspended; but before she became
aware of the nature of the case she had attended another patient and infected her. Both women died.
Through disobedience to the secretary's order to permit the Board's officials to disinfect her working
clothes the midwife was dismissed from the society's service. Then, and then only, she gave up her
clothes for disinfection.
Plumstead—
Three cases of puerperal fever having occurred in the practice of one midwife at the close of 1895, I
requested her, at the beginning of 1896, besides taking the usual measures of disinfection, to abstain
from attending any further cases for a month. This she agreed to do, and no more cases occurred in her
practice.
I have found that puerperal fever most often occurs in the practice of midwives. Accordingly I
have, by the authorisation of the health committee, issued to the midwives practising in Plumstead a
printed bill of recommendations for antiseptic measures, and other precautions, likely to tend to the
avoidance of infection.
Influenza, Bronchitis and Pneumonia.
The deaths from influenza, which in 1895 numbered 2,156, fell in 1896 to 496, the corrected
annual average for the preceding ten years being 1,039. The deaths attributed to bronchitis were
considerably below the corrected average, while the deaths attributed to pneumonia were but slightly
below the corrected average for the preceding ten years.

* See footnote (2), page 8.