London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1909
[Report of the Medical Officer of Health for London County Council]
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Causes of death in the 172 fatal cases confined in London:—
| Cause of death. | Notified cases. | Unnotified, cases. |
|---|---|---|
| Puerperal septicaemia and toxcemia | 88 | 13 |
| Puerperal peritonitis | 12 | 12 |
| Puerperal fever (not defined) | 15 | — |
| Puerperal pycemia | 5 | 3 |
| Parametritis | — | 1 |
| Sapraemia | 1 | 1 |
| Continued fever after miscarriage | 1 | — |
| Pelvic cellulitis and cellulitis of leg | 2 | 1 |
| Pelvic abscess | — | 1 |
| Septic pneumonia | 1 | — |
| Puerperal metritis | 3 | — |
| Phlebitis | — | 1 |
| Phlegmasia alba dolens | — | 4 |
| Perimetritis | — | 1 |
| Meningitis and blood poisoning | — | 1 |
| Puerperal eclampsia and mania | 1 | 1 |
| Collapse after child-birth and fever | 1 | — |
| Puerperal endometritis | 1 | — |
| Post partum haemorrhage and fever | 1 | — |
| Total | 132 | 40 |
The age incidence of the 337 cases of puerperal fever was as follows:—
| Total. | Age 15-20. | 20-25. | 25-30. | 30-35. | 35-40. | 40-45. | Over 45. | Age not known. | |
|---|---|---|---|---|---|---|---|---|---|
| Recovery cases | 155 | 10 | 31 | 52 | 33 | 18 | 4 | 2 | 5 |
| Fatal cases.. | 182 | 1 | 32 | 54 | 53 | 29 | 10 | 2 | 1 |
called in was also seen by the inspector and his views of the case were ascertained. The 83 cases attended by midwives were diagnosed as follows:—
| Diagnosis. | Recovery cases. | Fatal cases. |
|---|---|---|
| Septicaemia | 8 | 24 |
| Sapraemia | 24 | 2 |
| Pycemia | — | 2 |
| Peritonitis | 2 | 6 |
| Perimetritis | — | 1 |
| Septic pneumonia | — | 1 |
| Puerperal mania | 2 | 1 |
| Phlebitis | — | 1 |
| Cellulitis of the leg | — | 1 |
| No information obtained | 8 | — |
| Total | 44 | 39 |
The rule which requires that medical help shall be sought when a patient's temperature rises
to 100.4° and remains above that figure for 24 hours, has proved useful in affording information
concerning cases in which there is danger of the development of puerperal fever; 173 notices were
received stating that medical assistance had been advised for this reason. The midwife was visited,
and in 105 of these cases the inspectors learnt that the temperature had fallen and no further
symptoms of puerperal fever presented themselves. In 64 cases the rise of temperature proved to
be the first indication of septic trouble, and the inspector was thus able in some instances without
awaiting notification to take steps to prevent the midwife from attending other women in childbirth
until she had been thoroughly disinfected. The rise of temperature occurred most frequently
on the third and fourth days of lying-in; 36 cases had a rise of temperature on one of