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and which was thought to be the result of war conditions ; but it was
never decided what the conditions were that did in fact produce these
results. But what was much more disturbing was that after the war,
although the numbers of deaths from disease fell year by year, there was
no corresponding fall in the numbers of notifications. For the country
as a whole they are not rising, but they are certainly not falling. Even in a
district such as this where the general housing conditions can be considered
to be satisfactory, where there must be as little statutory overcrowding as in
any other district of its size and where the general standard of living of the
population as a whole must be considered satisfactory, in spite of all these
favourable factors new cases are being learned of at the rate of 5, 6 and 7
a week as contrasted with the figures of before the war of 3, 4 and 5.
Not so many years ago ophthalmia neonatorum caused much blindness
amongst children. The cases which are now being notified in diminishing
numbers have been of mild character ; in all, recovery has been
complete with no resulting scarring of the cornea or blindness.
The variations in the numbers of persons notified as suffering from
puerperal pyrexia cannot be accepted as an indication of the variation
of the incidence of this complaint. Because puerperal fever which was
notifiable under the Public Health Act was not satisfactorily being notified,
puerperal pyrexia was made notifiable by regulation. This called for
notification whenever a certain temperature was reached in a puerperal
woman, whatever the cause of the rise in temperature. Whereas the cases
notified as puerperal fever were mostly those in which there had been
infection of the genital tract, the raised temperature in persons notified as
suffering from puerperal pyrexia might be, or would be, due to conditions
not associated in any way with the recent confinement. But as the
condition which was notifiable was the raised temperature, when this
temperature was kept down by drugs, notification was not called for. The
definition of the condition which was notifiable was therefore altered by
the 1951 regulations. The fall in the numbers of cases notified in the
nineteen-forties, then, might reflect not a fall in the incidence of illness in
puerperal women, but a fall in the numbers of cases i n which the temperature
reached the specified point, or remained high for the specified period as set
out in the previous regulations. Chemotherapy might then account for these
altered figures, just as it has undoubtedly had its effect in saving the
lives of some who have suffered from puerperal infection.