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25
Puerperal Fever.—This fatal malady is most frequently
caused by neglect of cleanly and proper precautions among
women who have very recently been confined. In many cases it
is found to have arisen from the negligence and ignorance of
women who call themselves midwives, but who are untrained,
and whose knowledge of antiseptic precautions is frequently nil.
Too much care cannot be exercised in the selection of a nurse
where ignorance and lack of training may lead to such dire
consequences.
The Deaths (4) from Puerperal Fever furnish a rate of
7.7 per 1,000 registered births—a figure which is well above
that of England and Wales (about 6) for the same period. As
this is essentially a disease which by the exercise of proper care
by those in attendance upon the patient and by the adoption of
proper sanitary precautions in our homes, is so easily prevented,
any mortality, however small, is all the more regrettable.
One midwife was responsible for the spread of 2 cases, both of
which ended fatally within a short period, and I promptly took
such measures as would insure that no further cases should arise
through her agency.
Measles and Whooping Cough.—During the year there
were two distinct outbursts of sickness from Whooping Cough
and, as is frequently the case, the increase in Whooping Cough
was on both occasions concurrent with an outbreak of Measles.
It will be noted by reference to Table A5 that the mortality
from Whooping Cough was exceptionally high,* and I consider
that it calls for the adoption of some preventive measure—in
which it would be well for many reasons to include measles.
There is as you are aware the remedy of including Measles
and Whooping Cough among the Diseases that are compulsorily
notifiable. I am not one of those who consider that such a
step is warranted either by any inherent likehood of success from
such a course, or by the advantages which have been gained in
those Districts where it has already been adopted. The highly
infectious nature of Measles before it can be diagnosed, and
* In the preceding year the rate for Finchley was 0.55, whereas that for
England and Wales was 0.34.