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39
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 pueperal 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.
Consultations were held in four cases notified under these regulations.
The number of cases of Puerperal Pyrexia notified was twenty-nine. It
is the practice to follow up these notifications with a request for a final