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.

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    morning, Mrs. H was safely delivered of her sixth child. On the following morning she took the bolus, with twenty- five grains of jalap and three of calomel, which I regularly directed my patients to take on the day after delivery. About ten o'clock the same morning, she was suddenly attacked with a violent pain in the abdomen, which continued without intermission for twenty minutes. She was visited soon after the pain had ceased; and, her pulse being then httle more than seventy, nothing more was done than to order a solution of magnes. sulphas* to be taken at intervals, with the intention of assisting the operation of the bolus. She remained easy for some time; but at seven o'clock in the evening I found that pain and soreness in the abdomen were gradually coming on. The pulse was still no more than between 80 and 90. 9 P.M. The pain and soreness had greatly increased ; and the pulse had got up to nearly 130. The head was slightly affected with pain, and much more so with giddiness and a sense of con- fusion ; so that the patient scarcely knew what was passing around her. The necessity of treating the case as one of puerperal fever being now manifest, I took about thirty ounces of blood; and in addition to the purgatives already taken, prescribed another bolus with a scruple of jalap, and a continuation of the cathartic solution. The disease was immediately alleviated ; and by maintaining a brisk purging for two or three days, it entirely ceased without the recurrence of any bad symptom. This case is similar to the tenth ; but more strongly shows, that the disease may prove severe, though not preceded by rigor, nor accompanied, on its first accession, by continued pain, or a quick pulse. The rapid increase of the pain and soreness, and the re- markable acceleration of the pulse, in the short interval of two hours, sufficiently characterise the nature and violence of the dis- ease. Case XVII. — Mrs. is a lady of a remarkably delicate constitution. In her former lyings-in she had not been able to suckle her children; and the mere attempt to do it, in one instance, so much affected the nervous system, as, for a short period, nearly to destroy vision. She was some time in recovering from the conse- quences of this attempt: and at all times evacuations and reduction of every kind had a great effect upon her. She was brought to bed on the 29th of November; and unfor- tunately a considerable hemorrhage succeeded her labour, which occasioned a great degree of faintness. Under these circumstances I had peculiar fears for the safety of this patient, in case she should be attacked with the puerperal fever, being fully persuaded that she could not bear the evacuations, which, in other cases, were necessary for its cure. But, notwithstanding the great discharge • This solution was in the proportion of one ounce of magnes. sulphas to eight ounces of water; and,to avoid repetition, I shall, in future, call it tlie cathartic solution.