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are taken, and hospital treatment is advised ; and if the case is not removed to a hospital or infirmary
arrangements are made to supplement out-patient hospital treatment by obtaining the services of a
district nurse.
Midwives Act, 1902.
The number of midwives with London addresses whose names appear on the roll of midwives
for 1914 is 5,972, of whom 591 notified their intention to practise in the county during the whole year
or for shorter periods. Of these practising midwives 373 were enrolled as a result of examination by
the Central Midwives Board, 144 held a certificate of training granted before the passing of the Midwives
Act, and 74 were in bona fide practice for at least a year before the Act was passed. During the year
the midwives inspectors paid 1,278 visits. In 95 cases the reports were unsatisfactory or presented some
unusual feature, and in 374 cases the midwife was absent from home when the inspector visited.
Bitths notified
The number of births notified under the Notification of Births Act, 1907, by certified midwives
. during the period under review was 46,442, and 3,002 notifications were received by the Council that
medical aid had been advised by certified midwives. The occurrence of 676 stillbirths was reported,
the foetus in 364 cases being macerated and in 265 not macerated; in 47 cases no particulars were
given ; 374 were males, 300 females, and in two instances the sex was not stated.
Puerperal fever
During the year 57 notices of the deaths of children were received, and 119 inquests were held,
15 on the bodies of women and 104 on the bodies of children, upon whom certified midwives had
been in attendance. In all 276 cases of puerperal fever were notified in the county, and the RegistrarGeneral
records 126 deaths from puerperal septic disease ; two of these, however, refer to cases notified
during 1914. Of the notified cases, 71 proved fatal, the remaining 55 deaths recorded by the
Registrar-General not having been notified as due to puerperal fever. Of these 331 cases, both notified
and unnotified, 95 occurred in the practice of certified midwives, 20 having a fatal termination,
Ophthalmia neonatorum
Under the order made by the Council extending the provisions of section 55 of the Public Health
(London) Act, 1891, to ophthalmia neonatorum, 760 notifications were received, 165 being in respect
of cases in the practice of certified midwives.
Negligence.and misconduct
Two certified midwives were temporarily suspended from practice in order to prevent the spread
of infection. Four women were convicted of having practised midwiferv when not certified. Penalties
amounting to £15 in one case, and £1 Is. in another were inflicted, and two women were bound over.
Seven certified midwives were reported to the Central Midwives Board for negligence and misconduct.
Lying -in-homes
As stated in last year's annual report the Council decided on October 21st, 1913, to promote
legislation to obtain power to register lying-in homes. Section IV. of the London County Council (General
Powers) Act, 1915, now prohibits, after 1st February, 1916, the use of any premises as a lying-in home
unless both the premises and the person carrying on the business are registered by the Council. The
Council is empowered to refuse registration or to cancel the registration of persons of bad character, and
of premises unsuitable or not suitably equipped for the purpose of a lying-in home, or connected with any
other premises used for an immoral purpose. Right of appeal to a police court magistrate is given
against the Council's decision as to registration. Certain hospitals and institutions, and homes kept by
duly qualified medical practitioners are exempt from the operations of the section.
Work of the Chemical and Analytical Branch of the Public Health Department
The work conducted at the Council's laboratory, Savoy Hill, includes the examination of samples
received under the Fertilisers and Feeding Stuffs Acts, 1906, the Petroleum Acts, London County
Council (General Powers) Act, 1912, and the London Building Acts.
A considerable proportion of the work consists of the examinations of materials used in connection
with works or contracts undertaken by or for the Council, and samples of stores supplied to
the Council. Examinations are also made in connection with complaints concerning materials in use.
The analytical work may be classified as follows:—Of 318 samples examined in connection
with Statutes, 4 were unsatisfactory ; under the heading of works or contracts, 494 samples were
examined and 49 were unsatisfactory ; of 3,269 samples of stores, 123 were found to be unsatisfactory.
In addition to the work done at the central laboratory, systematic analyses of sewage effluent
and sludge have been made at the sewage outfall laboratories. The special examination of the River
Thames, investigations in connection with the bacterial treatment of sewage, and other questions arising
in connection with sewage treatment have been conducted at these laboratories.