The history, pathology, and treatment of puerperal fever and crural phlebitis.

Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: The history, pathology, and treatment of puerperal fever and crural phlebitis. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

    112/378 (page 110)
    This case appears to me an instance of a remarkable metastasis of the puerperal fever; and had the disease been transferred to a less vital organ than the brain, a more happy crisis would proba- bly have been the result. I have before mentioned, that at Aber- deen, the disease was not unfrequently transferred to the surface of the body, producing an erysipelas on the extremities, which proved a certain sign of a salutary crisis. And the transition of inflammatory afiections of various kinds from one part of the body to another, is a fact well known in the practice of physic. In. the case just related, it is observable that, while the inflammation of the abdomen subsisted, the head was free from all complaint; and that as soon as the inflammation was completely removed from the abdomen, to which it never in any degree returned, the head became aflected with symptoms of inflammation, accompanied with evident marks of compression of the brain.* Whatever other conclusions may be drawn from this case, the entire removal of the abdominal atfection, and the appearance of the blood, which was of a firmer texture than any I had ever seen, both tended to confirm me in the propriety of bleeding in the dis- ease under consideration. I was anxious to be more particularly acquainted with Dr. Gordon's mode of practice; but before I could procure his treatise I was called to the following case of puerperal fever. Case X. — Mrs. S was brought to bed on the 5th of July, 1810, about 9 o'clock in the morning. In her former labours she had been subject to a relaxation of the uterus after delivery, which usually occasioned a considerable flooding. Her discharge, at this time, was copious •, but, being aware of the tendency to hemor- rhage, I was able, by suitable means, to keep it within moderate bounds. On the following day, at 3 o'clock in the afternoon, I was called lo her in haste, on account of an excruciating pain which had suddenly seized the abdomen. It continued for half an hour without intermission ; but before my arrival it had ceased. As the pain was not preceded by rigor, and the pulse was not acceler- ated, I could not conclude the case to be one of puerperal fever; and therefore satisfied myself with prescribing an opening medi- cine, and requesting to be sent for immediately if the pain should return. Having heard no more from the patient, I visited her late in the evening ; and then found that the pain had returned, but with a less degree of severity ; and, having had regular remissions, it had been mistaken for the common after-pain, and had therefore created little alarm. The abdomen had become very tender, and the pulse frequent. No doubt now remained oti my mind of tlie nature of the dis- ease ; and though the attack was less distinctly marked than in ♦ Metastasis proprie dicitur, quando, alio morbo quicscente, translata alio ma- teria novum morbum excitat.