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

Date:
1842
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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.

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    most of the cases which I have seen, my later experience warrants me in concluding that the disease would soon have proved fatal had not vigorous means been employed to check its progress. As night was approaching, I feared to wait till the symptoms became more urgent; and, therefore, notwithstanding my reluctance to copious bleeding was not quite overcome, I immediately took from the arm a large basinful (about twenty ounces) of blood, and directed a continuation of the purgative. A cathartic clyster was also injected. The pain was diminished while the blood was flow- ing, and on the following morning it was nearly gone; the fever had also greatly subsided. The bowels had been freely evacuated, yet I thought it advisable to maintain the purging undiminished for another day, and then it was suffered gradually to abate. The patient recovered without further complaint. Thus was an immediate stop put to the disease, which, had the bleeding been omitted, or deferred until morning, would, in all pro- bability, have been irremediable. For, though the first attack was, in some respects, less alarming than in many other cases, yet its early period, the severity of the pain, the consequent soreness of the abdomen, and the rapid increase of the pulse, clearly point it out as a genuine, and not a very slight case of the prevailing epide- mic. Perhaps the previous hemorrhage might, in some degree, have obviated its violence. The next case that occurred was the first of three, which were all that proved unsuccessful in my practice, out of a great num- ber, after the change of treatment adopted in the preceding case. And I trust I shall be able to show that the method of cure which we now employ had not a fair trial in any of them ; and, conse- quently, that they cannot be justly considered as instances of its failure. Case XI. — July 30th, 1810, I was called at midnight to Mrs. , in labour of her sixth child ; but as she lived in the country, at the distance of two miles, and her labour was quick, the child was born before I could arrive at her house. August 2d, at 9i a.m. I was sent for to visit her ; and from the nature of the message I had no doubt she was attacked with the puerperal fever. My father happened to be with me on the road, and we went immediately together. Some sharp after-pains had been excited by several attempts during the night to suckle her child, but she had afterwards got some comfortable sleep. At 6 A.ai. she had been seized with a violent and continued pain in the abdomen, which, as usual, was aggravated by fits. At nine she had a shivering fit, and immedi- ately sent for me. We were with her by ten. The shivering had then ceased, and was not followed by much heat. Pulse 120. The tongue was clean and moist, yet she complained of thirst. The lochial discharge had increased. The uterus was somewhat en- larged, remarkably distinct, and showed much sensibility when touched. As the pain of the abdomen had nearly subsided, and.