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greater. In view of its dangerous character, prompt recognition
and treatment of the disease is essential, and it is the duty
of every Sanitary Authority to facilitate early diagnosis and
provide the means for proper treatment. For many years past
the Council has provided for bacteriological examination, and
a supply of anti-toxin serum has also been maintained for
gratuitous injection in necessitous cases. I regret, however,
that the facilities offered for free bacteriological examination
have not been taken advantage of to the extent that one would
have reasonably expected or hoped.
Typhoid or Enteric Fever.—Three persons were notified as
suffering from this disease, two in South Park and one in
Trinity Wards, representing an attack rate of .05 per 1,000.
The decline in the number of Typhoid cases notified has
been very marked in recent years, and it is worthy of note that
not only is this the smallest number of cases occurring in any
one year since the Notification of Infectious Diseases Act
came into force in January, 1890, but they represent the
lowest attack rate recorded during the thirty-eight or more
years I have held office.
Puerperal Fever.—One case only was notified; inquiries
were promptly made, and from facts ascertained I suggested
to the Midwife in attendance that she should, on account of
her age, in future, only attend cases of Midwifery under a
medical man's supervision and discontinue attending in the
absence of a doctor.
Midwives Act, 1902.—Since the coming into force of this
Act, I have acted as Local Supervising Officer for the Surrey
County Council. the Local Authority under the Act, and I
venture to give a brief epitome of my last report presented to
the County Council on the working of the Act in Wimbledon.
In the district some sixteen women sent in Notices of
intention to practise during 1909, and in the course of the year
I paid two surprise visits to every midwife with a view to
thoroughly examining her kit bag, appliances, books, etc.; in
addition, when occasion required, special visits were made in
order to keep up a high standard of efficiency so necessary in
such an important work.
Midwives may be divided into two classes, the first containing
those who only act after passing through a course of
training at hospital and obtaining a Certificate as to their
qualifications for such work, the second being those whose
names are on the Midwives Roll by virtue of having been in
practise before July, 1901.
In the former class the women are hospital trained, welleducated
and most capable, and ample proof of this is given
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