London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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Annual Report of the London County Council, 1912.
In 1 of the 6 cases where impairment of vision resulted, the onset of symptoms occurred on
or before the fifth day of life. In three instances there was a history of vaginal discharge in the

The 385 cases of inflammation of the eyes occurred in the practices of 155 midwives.

1 midwife had 20 cases during the year20
1 „ 12 „ „12
2 midwives each had 9 cases during the year18
3 ,, ,,8 ,, ,,24
4 „ „ 7„ „.....28
6 ,, ,, 6 ,, ,,36
2 ,, „ 5 ,, ,,10
9 ,, „ 4 ,, ,,36
15 ,, „ 3 „ ,,45
34 ,, „ 2 „ ,,68
77 „ „ 1 case „ „77

All the midwives who had three or more cases during the year have extensive practices, and it
was found that many of the cases reported were very slight and the eyes were normal in a few days.
So far as could be ascertained there was no evidence that infection was carried from one case to another.
The Council had under consideration the question of hospital treatment for severe cases and
an endeavour was made to secure accommodation for the mother and infant so that while the child
was being treated it would not be deprived of the advantage of being breast-fed.
In March, 1911, the Council made an order extending the provisions of settion 55 of the Public
Health (London) Act, 1891, to opthalmia neonatorum. Of the 1,373 cases notified from that time until
the end of this year. 405 were in the practice of midwives.
Classes for
The Council has arranged classes for the further instruction of midwives at four centres in
London. These classes are attended by midwives who have been in practice for many years, and
also to some extent by pupils to supplement the training they are receiving elsewhere. Midwives showing
lack of knowledge of their Work have been advised by the Council's inspectors to attend these classes.
During the month of September, 1911, there occurred in the practice of a certified midwife a
series of cases of skin disease characterised by superficial blebs and subsequent excoriation. Inquiry was
made into the outbreak by Dr. Wanklyn, assistant medical officer, and Dr. Macrory, woman inspector
under the Midwives Act, who reported jointly upon the matter. As stated in their report, which was
issued by the Council, it would have been desirable to have ascertained whether similar cases were
occurring at the same time and in the same neighbourhood, among infants not attended by this midwife,
with a view to making the point clear as to whether or not cases were exclusively confined to her
practice. The facts only came to light some days after their occurrence, and this lapse of time rendered
it impossible for completely satisfactory control investigations to be made. Such inquiry as was possible
was carried out. The evidence taken as a whole is certainly suggestive, but it cannot be held conclusively
to demonstrate that the association of the midwife with the cases was the factor determining
their occurrence.