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at evening sessions and at other suitable times ; the supply by the hospital of Salvarsan or its substitutes
to medical practitioners on an approved list; the supply to practitioners of apparatus for taking samples
of blood, etc., and the furnishing of reports on specimens sent by practitioners ; the supply of statistical
information of work done; the provision of free instruction for practitioners and students; opportunities
for practitioners to act as clinical assistants at approved rates of remuneration ; the employment
of women doctors in clinics for women; and the issue of printed instructions for the guidance of
patients and practitioners.
The Local Government Board signified its approval, of the scheme prepared and it came into
operation on 1st January, 1917. The gross cost of the scheme to the London County Council during
the experimental year is estimated at £49,000, of which sum the Local Government Board will repay
75 per cent.
Mental Deficiency Act, 1913.
Information was received by the Clerk of the Asylums and Mental Deficiency Committee from
various sources of alleged cases of mental defect in 492 cases during 1916, and 418 of these were dealt
with by the local authority. The remainder of the cases were still under consideration at the end of
the year or were otherwise disposed of. Among the 418 cases dealt with, 141 were sent to institutions,
221 were placed under supervision, 3 were placed under guardianship, 53 were sent to places of safety
pending the presentation of a petition, and 43 were referred to the Poor Law. Dr. F. C. Shrubsall, has
made the following analysis of 1,044 cases, which have been ascertained since the Act came into
operation.
Feeble.
minded
Imbecile
Idiot
Total
Feeble.
minded
Imbecile
Idiot
Total
* Primary amentia and cases
of undetermined origin
Epilepsy
Epilepsy and cerebral paralysis
Cerebral paralysis
Following meningitis
Following injury to head
Hydrocephaly
Microcephaly and sub.
microcephaly
155
47
10
13
4
7
5
11
310
88
10
49
8
8
10
56
15
28
18
8
2
IS
486
163
38
70
12
15
17
79
Oxycephaly
Cretin
Mongol
Ateleiosis
Spinal paralysis
Achondroplasia
Blind and partially blind
Deaf
Total
4
6
1
3
1
4
1
2
15
76
10
7
11
2
3
2
6
21
87
1
15
1
7
10
272
655
101
1,028
*Under the heading "Primary Amentia, etc.," are included cases of disseminated sclerosis, cerebral tumour, chorea,
and cerebral syphilis not accompanied by epilepsy or paralysis.
In addition there were 16 moral imbeciles making a grand total of 1,044. During the same period
117 cases were medically examined and deemed to be not defective under the provisions of the Mental
Deficiency Act, 1913.
Midwives Act, 1902.
The number of midwives with London addresses is 5,763, of whom 579 notified their intention
to practise in the county during the year. Of these, 375 were enrolled as a result of examination,
138 held a certificate of training, granted before the passing of the Midwives Act, and 66 were in bona
fide practice for at least a year before the Act was passed. During the year the inspectors of
midwives made 1,069 inspections.
The number of births notified under the Notification of Births Act, 1907, by certified midwives
during the period under review was 43,450, and 3,540 notifications were received by the Council that
medical aid had been advised by certified midwives. The occurrence of 674 stillbirths was reported,
the foetus in 370 cases being macerated and in 254 cases not macerated; in 50 cases no particulars were
given. During the year inquests were held on the bodies of 17 women and 110 children, upon whom
certified midwives had been in attendance.
Under the order made by the Council extending the provisions of Section 55 of the Public Health
(London) Act, 1891, to ophthalmia neonatorum, 773 notifications were received, 277 being in respect of
cases in the practice of certified midwives.
In all, 278 cases of puerperal fever were notified in the county, and the Registrar.General records
153 deaths from puerperal septic disease. Of the notified cases 104 proved fatal, the remaining 49
deaths recorded by the Registrar.General not having been notified. If these 49 cases be added to the
278 notified cases, a total of 327 cases is obtained, 90 of which occurred in the practice of certified
midwives. The Registrar.General also records 237 deaths from other accidents of childbirth, of which
27 were in the practice of midwives.
The establishment of prima facie cases of malpractice, negligence or misconduct on the part of
12 midwives was reported to the Central Midwives Board, the names of 5 being subsequently removed
from the roll of midwives. Of the remainder, 6 were censured, one of whom was at a later date in the
year, struck off the roll, and the remaining midwife succeeded in proving her innocence of the charge
brought against her. Another midwife was convicted of drunkenness, her name being subsequently
removed from the roll. One woman was convicted of having practised midwifery when not certified,
38257 c