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105
and then passed, with the School Inspection Medical Card, to
the Head-Teacher of the particular school to which the child
has been admitted and is produced at the next medical inspection
of the scholars by the Assistant School Medical Officer.
There were eight deaths during 1925 from Puerperal
Fever amongst 7,017 births. Considering the condition of the
homes in which many of the women are confined, I consider
that this is a remarkably low percentage of deaths, and that
it redounds to the credit as to the care taken by the General
Practitioner and Midwife. The fact remains, though, that
there should not be any deaths from Puerperal Fever which,
under proper circumstances, is a preventable disease.
Pemphigus Neonatorum.—During the year, a very
considerable number of cases of Pemphigus Neonatorum has
occurred: the first case was brought to my notice during
August of last year, and up to January, 1926, 15 such cases
have been notified, though there have occurred a number of
other cases which were not notified, but which have come to
my knowledge through the Health Visitors. Of the 15
notified cases, 6 were born in Queen Mary's Hospital, 7 were
attended by the Plaistow Maternity Charity, and the
remaining 2 occurred in the practice of a private midwife, in
September last. (There has been no further case in the
practice of this midwife since.) In the series of cases under
review the complaint began between the 5th and 10th day
after birth, with the occurrence of an inflamed lozengeshaped
area, with no definite site: this inflamed area within
the space of a few hours resolved itself into a raised blister
containing clear watery serum. In some cases only one
blister occurred, in others a large number occurred, but with
no uniform distribution. Most of the infants were in fair
general health during the attack and able to take their feeds
well. In two of the 15 cases death occurred, the rash having
spread rapidly over the whole body, becoming confluent and
then postulate, death supervening within a few days. Every
case has been, as far as practicable, carefully investigated,
but in no instance has any definite source of infection been
established. I am strongly of opinion that this complaint
should be made compulsorily notifiable. No case occurred
amongst either the mothers or any other adults. All the
babies were breast fed. I am still further investigating
this outbreak with a view to obtaining, if possible, some
scientific data.