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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 preventing 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 are 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 long as they confine themselves to their proper sphere,
become a grave danger if they attempt to usurp the functions of the midwife.
Enquiries are made with the object of discovering and preventing this abuse.
Under the Maternity and Child Welfare Section of this report particulars will be
given of the Council's scheme for ante-natal care and supervision. Of this scheme,
which includes the provision of sterilized maternity dressings upon the application
of the Doctor or Midwife, it may be said here that everything that is done by way of
caring for the health of the patient and assisting her to make the best possible arrangements
for her confinement lessens the risk of puerperal fever.
Puerperal Pyrexia.
Puerperal pyrexia, as defined in the Public Health (Notification of Puerperal
Fever and Puerperal Pyrexia) Regulations, 1926, means any febrile condition, other
than puerperal fever, occurring in a woman within 21 days after childbirth, or miscarriage,
in which a temperature of 100.4 Fahrenheit, or more, has been sustained
during a period of 24 hours or has recurred during that period.
Provision is made in these Regulations for consultations between the Doctor
notifying and obstetric specialists, and arrangements have been made with five
specialists whose names are included in the list of the staff at the end of this
report, to meet practitioners in consultation on these cases upon request.
During the year 23 cases were notified, of which 16 were removed to hospital.
Consultations with the specialists above referred to were held in three cases.
Ophthalmia Neonatorum.
This disease, the duty of notifying which was, under the Public Health (Ophthalmia
Neonatorum) Regulations, 1926, placed solely upon the medical practitioner in charge
of the case, consists of a purulent discharge from the eye of an infant occurring
within 21 days of birth.
If not properly treated, Ophthalmia Neonatorum may cause blindness or serious
impairment of vision. It is due to a gonorrheal infection of the child's eyes during
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