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trouble taken in the matter by himself and the Royal College over
which he presides. We recommend—
(a) That a letter be addressed to Sir Samuel Wilks, Bart.,
M.D., F.R.S., President of the Royal College of Physicians,
thanking him for the advice afforded to the Council with regard
to the notification of puerperal fever, and for the trouble taken
by himself and the Royal College in the matter.
(ib) That a copy of this report be sent to the Vestry of
Bethnal Green, with an intimation that the Council is advised
that the diseases referred to in their letter are covered by the
term "puerperal fever" in section 55 of the Public Health
(London) Act, 1891, and notifiable as such.
(c) That a copy of this report be forwarded to each of the
other London sanitary authorities for its information.
From this correspondence it will be seen that the Council declines
to help us on the ground that the Royal College of Physicians has
expressed a pious opinion that the diseases we wished to be added
to section 55 are already included in the term "puerperal fever";
but as this opinion is not binding upon the magistrates at the
Worship Street Police Court, we are left just where we were. If
we take another similar case into Court we shall most likely fail to
convince the magistrate that puerperal peritonitis invariably means
puerperal fever.
I propose that the following notice shall for the future be attached
to all books of notification forms issued, this would be a help in
deciding the meaning of the term " puerperal fever."
puerperal fever.
A committee of the Royal College of Physicians of London
has recently endorsed the view that the expression "puerperal
fever "should be taken to include "septicaemia, pyaemia, septic
peritonitis, septic metritis, and other acute septic inflammations
in the pelvis occurring as the direct result of childbirth."
The Council of the Obstetrical Society of London suggests the
following inclusive definition of the term "puerperal fever": that
is, "septicaemia and pyaemia, including peritonitis, and all cases of
acute pelvic inflammation occurring in connection with childbirth."