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Report of the County Medical Officer—General.
85
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 has endeavoured 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, but only
two institutions have at present sufficient accommodation for this purpose.
In March, 1911, the Council made an order extending the provisions of section 55 of the Public
Health (London) Act, 1891, to ophthalmia neonatorum. Of the 2,013 cases notified from that time until
the end of this year, 507 were in the practice of midwives.
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.
In 1773 an Act (13 Geo. III., cap. 82) was passed requiring the licence, by Justices of the Peace
at Quarter Sessions, of lying-in hospitals and other places appropriated for the charitable reception
of pregnant women, but no power was given in this Act for the supervision of the premises.
As regards premises conducted by certified midwives or at which they are employed, a certain
amount of control is conferred by the provisions of the Midwives Act, 1902.
There are, in the county, over 100 premises in which women are received for delivery, and it
had for some time past been within the knowledge of the Council that some of these houses were
conducted in a manner which called for increased supervision both from a sanitary and a moral
standpoint. During the year representations were made to the Council by certain charitable societies
that, since the National Insurance Act, 1911, came into operation unmarried women of the working
class who formerly obtained admission to poor law infirmaries for confinement were now in a position,
owing to the receipt of maternity benefit, to pay for attention, and in fact many cases entered
lying-in homes of doubtful character.
In these circumstances it seemed to the Council desirable that steps should be taken
to secure additional authority to deal with these premises, and on 21st October, 1913, it decided under
the provisions of section 4 of the Borough Funds Act, 1872, as applied by the County Councils (Bills
in Parliament) Act, 1903, to promote legislation in the session of Parliament of 1914 to confer upon
the Council power to prohibit the use of any premises as lying-in homes or institutions unless they
and the person or persons in charge thereof had been licensed by the Council.
This decision was subsequently modified by the substitution of registration for licen ing.
Work of the chemical and analytical branch of the Public Health Department.
The Council's Chemist and the staff of the late chemical and gas department, with the exception
of those engaged exclusively in connection with gas testing and photography, were transferred to
the Public Health Department as from 1st October, 1913, and formed into a chemical branch of the
department. In addition to the regular work of the branch the following special inquiries were
undertaken in 1913 by the staff.
I. An examination during the months of June, July and August of the water of the River
Thames between Charing Cross and Grays. This work was continued in December, 1913, and during the
present year. It forms part of a series of observations which have been made at intervals since 1893
in the late chemical and gas department in connection with the treatment of sewage at the outfalls.
A report on the results of this work was presented to the Main Drainage Committee. It involved the
collection and examination of samples representing the condition of the river at various localities
between the points indicated on 1,909 occasions.
II. An examination of the solid matter (dust, etc.), deposited from the air in the neighbourhood
of a dust destructor, concerning the working of which complaints had been made. Great variations
in the character of the deposit were found at different distances from the shaft of the destructor.
III. The continuation of an examination of the waters of canals and streams in the county.
In addition to the above-mentioned special inquiries 5,704 samples of all kinds were examined
in the central laboratory and 2,550 samples of sewage, sewage effluent, river water, and chemicals
used in sewage treatment, in the laboratories at the two outfalls.
The samples examined at the central laboratory may be classified as follows:—
(a) Examined in connection with Statutes:—
(1) Fertilisers and Feeding Stuffs Act, 1906.—Most of the samples came from the farms of the
Council's institutions but some were obtained from dealers within the county, as it was desired to ascertain
to what extent, if any, such articles were of inferior quality. The results on the whole show a great
improvement on the conditions which prevailed some years ago, although the general quality of some
materials has altered for the worse. The Chemist is agricultural analyst for the county under the
Fertilisers and Feeding Stuffs Act, and Mr. E. T. Shelbourn is deputy analyst.
(2) Petroleum Acts. The samples examined under these Acts include those taken by inspectors
of the Public Control department at wharves and other places where petroleum is handled or stored
and others found on unlicensed premises or of a suspicious nature. Some samples are also examined
in connection with lamp accidents and other disasters. The question whether a substance is petroleum
to which the Acts apply can be in most cases determined by its flashing point, but not infrequently
an extended chemical examination is necessary before the point can be decided, as many substances
other than ordinary mineral oil are considered to be petroleum for the purposes of these Acts.
Classes for
Midwives
Lying-in
homes