London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Shoreditch 1928
[Report of the Medical Officer of Health for Shoreditch]
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Administrative measures have for their object the securing of adequate treatment,
the discovery of the source and the prevention of the spread of infection
A case of erysipelas in the house is a source of danger during the puerperium and
enquiries are accordingly made and steps are taken to safeguard against this dan-. r
PUERPERAL FEVER.
Seven cases were certified, all of which were removed to Hospital. There were
three deaths.
A comparison between London and Shoreditch during the last 10 years is contained in the following table:—
| London. | Shoreditch. | |||||||
|---|---|---|---|---|---|---|---|---|
| Year. | Cases. | Cases per 1,000 births. | Deaths. | Deaths per 1,000 births. | Cases. | Cases per 1,000 births. | Deaths | Deaths per 1,000 births. |
| 1919 | 313 | 3.7 | 155 | 1.8 | 3 | 1.3 | 3 | 1.3 |
| 1920 | 451 | 3.7 | 215 | 1.7 | 11 | 2.9 | 5 | 1.3 |
| 1921 | 353 | 3.5 | 142 | 1.4 | 12 | 4.0 | 4 | 2.0 |
| 1922 | 311 | 3.3 | 129 | 1.3 | 9 | 3.1 | 3 | 1.0 |
| 1923 | 352 | 3.9 | 126 | 1.3 | 7 | 2.5 | ... | ... |
| 1924 | 298 | 3.5 | 106 | 1.2 | 10 | 3.9 | 1 | 0.4 |
| 1925 | 324 | 3.9 | 117 | 1.4 | 13 | 49 | 2 | 0.8 |
| 1926 | 341 | 4.3 | 127 | 1.6 | 10 | 3.9 | 3 | 1.2 |
| 1927 | 265 | 3.5 | 96 | 1.3 | 11 | 5.0 | 2 | 0.91 |
| 1928 | 295 | 3.5 | 115 | 1.5 | 7 | 3.4 | 3 | 1.4 |
Puerperal fever is a disease caused by the infection of the generative tract after
labour. It may be stated as a general rule that the actual source of the infecting
agent lies in the patient herself or in the hands, instruments and appliances of the
Doctor or Midwife.
On receipt of a notification steps are taken to secure the best treatment for the
patient, to ascertain the source of infection and to carry out such disinfection as
may be necessary. The majority of cases are removed to Hospital and the earlier
this is done the better. Search for the source of infection is undertaken primarily
with a view to making sure that its activity is not allowed to continue with the risk
of further infections. All cases occurring in the practice of midwives are further
investigated by the London County Council, who are the authority responsible
for the supervision of midwives practising in the Metropolis. Midwives in whose
practice a case of puerperal fever has occurred are required to carry out a complete
disinfection of their persons, clothes and instruments before taking fresh cases. It
sometimes happens that improper examinations and manipulations arc made by
unqualified women who are engaged ostensibly to give general assistance to the
patient. These women, known as " handy women," who are most useful so