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33
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 a
confinement or the puerperium, and enquiries are accordingly made and
steps taken to safeguard against this danger.
Puerperal Fever.
Four cases of puerperal fever were notified during the year, one of which
had previously been notified by another doctor as a case of puerperal pyrexia.
Of the thirty-one cases of Puerperal Pyrexia notified, four, including the
case above referred to, were finally diagnosed as suffering from Puerperal
Fever. The total number of cases of which information was received during
the year was accordingly seven.
All cases were removed to hospital.
There were four deaths from Puerperal Fever, one being originally
notified as such, and three being notified in the first instance as puerperal
pyrexia.
Puerperal Fever is a disease associated with child-birth and caused by
infection from the generative tract.
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. 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.