Discussion on puerperal fever.

  • Barker, B. Fordyce.
Date:
[©1858?]
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Licence: Public Domain Mark

Credit: Discussion on puerperal fever. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    in the veins themselves after death. The evidence of this was iu the inflammatory exudation on the inside of the surface of the uterus; the redness of the uterine structure, penetrating a minute distance from within outward; the symptoms of pyeemia and the discovery of pus in distant organs. To present this idea was the chief object of his for- mer remarks, and to give it distinctness he had referred to and recog- nized the then commonly described inflammatory lesions, viz., the per- itonitis, the purulent phlebitis in the uterine sinuses, and the purulent inflammation of the uterine lymphatics. These, together with endo- metritis, he had stated were the primary injlammatory lesions, and that there were other organs subject to inflammation in a subordinate and secondary degree. In another place he asks, wiiether the shortest time (in which the most malignant form of puerperal fever destroys life) is not long enough for endometritis to produce fatal contami- nation of the blood? or, in other words, in what time purulent infec- tion can overwhelm the vital forces ? After giving a condensed sum- mary of the experiments of Sedillot, in injecting laudable and fretid pus into the veins of dogs. Dr. Clark remarks, the import of these experiments, and their relation to the disease we are considering, hardly require comment, especially when it is remembered that the uterine cavity is open to the ready access of air: that when inflamma- tion is recognized on its inner surface, it has often been of a character most likely to furnish a sceptic agent, healthy or degenerated pus, iu an augmented, and consequently accumulated stream. These extracts show the importance with which Dr. Clark regards purulent contami- nation and putrid infection in developing the phenomena of puerperal fever. In the French Academy, M. Yelpeau endeavored to prove tliat it results from purulent infection, and Hervez de Chegoin, that it is due to putrid infection. In my former remarks I expressed a doubt whether pus, the product of simple ordinary inflammation, if absorbed or washed into the circulating blood, will produce the symptoms which we call pytemia, or whether, in fact, another element besides laudable pus is not essential for the production of these phenomena. As to the effects of putrid pus when mingled with the circulation, there is no doubt, for this has been demonstrated by the experiments of numerous competent observers. But with Dubois, I hold that neither purulent contamination nor putrid infection have anything to do with the devel- opment of the disease, but that it results from a special poison of the blood, the essence of which is unknown, but the effects of which are very manifest. I believe this to be true of all that class of cases call- ed pysemia, whether puerperal, traumatic, or idiopathic, and that the