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89
Altogether it seems that it would be a wise policy to arrange for the operations on these cases
on an even greater scale than at present, with the double object of improving the health of the patient
and of diminishing the incidence of infectious ailments amongst them. That surely would come
under the heading of preventive medicine.
Maternity Cases.
Very great pressure was maintained without intermission during the year on this department.
Sixteen beds and 1 labour bed are provided, but as many as twenty-three patients in hospital at
one time was by no means infrequent.
A total of 470 cases as compared with 239 in 1919 was admitted, and as seen in Table No.
97, the complications or ailment associated with the confinement are set out. Of the 470, 30 proved
"not to be in labour. Of the number confined, 429 infants were born alive and 11 dead. Amongst
the former born alive, 26 subsequently died within a few days from general feebleness and immaturity.
Of the infants born alive 223 were males and 217 females. The following table gives the number of
the pregnancy:—

Five mothers were delivered by Caesarean Section, all of them recovering, whilst 31 required
--Torceps delivery. By referring to Table No. 100 under the heading of Obstetrics, other conditions ,
calling for operative interference at the time of confinement are tabulated.
Seven mothers died :—
3 from Septicaemia.
1 „ Pelvic Peritonitis.
1 „ Eclampsia.
1 „ Antepartum Hemorrhage.
1 ,, Pulmonary Embolism.
Gynecological Cases.
Eighty-one as compared with 41 of these cases in 1919 were admitted Two died, one from
Suppurative Salpingitis and one from Pelvic Abscess following abortion.
If there is one department in the Council's hospital more than another, I think it is this which
calls for special support. Evidently there is a large field for helpful work on the part of the Council
with a view to determining the extent to which cases coming under this category exist in the district,
and if considered necessary carrying out the operative treatment already undertaken by the Council
on an even larger scale. From the short experience of 2½ years, there appears to me no doubt but
that there is a large number of women in the district who as the result of pregnancy, and particularly
of the actual confinement itself, suffer from certain grave physical disabilities which must and does
mean to them chronic ill-health. The very nature of the disability makes the patient very diffident
about seeking advice. It is consequently very difficult to get in touch with these, but the increasing
number admitted to the hospital suggests that the Clinic Medical Officers are at least searching some
of these unfortunate cases out. Peculiarly enough, though the condition leads to ill-health, once
operative treatment is carried out, a quick improvement in health is the almost invariable rule :
the patient being once more able to carry out her ordinary household duties. Almost without exception,
these cases are drawn from a class of the community who cannot pay for an operation such as is
entailed. Moreover, the pressure in the. London general hospitals, and the fact too that these patients
require at least 3 weeks or a month's hospital ward treatment, precludes their admission there in a
considerable number of cases. The result of such a condition of affairs necessarily means that,
failing the Council's endeavour, these sad cases will continue with no hope of alleviation.
Operations.
By reference to Table No. 100, it will be seen that 619 operations requiring an anaesthetic,
and of a major or minor character, were performed during the year. This is an average of 50 per