The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells.

  • Wells, Spencer, 1818-1897.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    we read, “The deaths attributed to puerperal fever were 1,973, and if to these be added 2,814 other deaths from the various accidents of childbirth, we have a total of 4,787 deaths, giving a mortality of 5‘24 to 1,000 registered births.” But we are left in doubt as to how far the deaths registered as from erysipelas, pyaemia, septicaemia, and puerperal fever have been accurately certified ; and in what proportion others regis- tered as premature births, puerperal mania, puerperal convul- sions, placenta praevia, flooding, phlegmasia dolens, and other accidents of childbirth may or may not have been due to, or complicated by, puerperal fever. In the valuable table where the proportion of deaths to 1,000 births in the different regis- tration counties of England is compared, “ puerpei’al fever and accidents of childbirth ” are grouped together. “ Diseases of parturition” is another general heading which may include a variable proportion of cases of puerperal fever. The lesson from this is, that the registrars are dependent on the practi- tioners who give the certificates; and while more accurate certificates are undoubtedly required by all who desire to improve the national health and ascertain the true causes of disease, it should not be forgotten that the gentlemen who at present perform an important duty to the State have done so for many years past without acknowledgment or reward. This has been made known to the Select Com- mittee of the House of Commons on Death Certification, which is still sitting, which your able and influential member, Dr. Cameron, succeeded in obtaining from the Government, and we may hope that when it becomes known how far accurate registration of the cause of death may lead towards a know- ledge of the best and surest modes of preventing disease— of shortening sickness and prolonging life—such important service to the nation will be recognised and rewarded, either by the state or by some such local authority as a municipality or a County Council. But however desirous anyone of us may be to fill up a death certificate accurately, it may be difficult in many cases to be sure whether puerperal fever, pyaemia, septicaemia, scarlatina, or some accident of childbirth would be the more correct return. Here, again, there crops up the old difficulty on which so many thousands of pages have been published. It is nearly twenty years since I raised a discussion at the Obstetrical Society of London “ On the Relation of Puerperal Fever to the Infective Diseases and Pyaemia.” A full report of my paper, and of the discussion to which it led, and was continued on four nights, may be found in the Obstetrical Transactions for 187-5.