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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    deemed inexcusable who undertakes the management of them without a due, nay, an unusually careful preparation for the enter- prise. He ought not to confide alone in his own keen perceptions at the clinic, nor in the results of his own most imperfect ex- perience. He is obliged by his vocation to take up a position which he ought fully to examine and render secure before he enters into the conflict with so dangerous an enemy. I refer to the statements in the volume of Robert Lee for accounts of the mortality produced in some parts of Great Britain, and on the Continent,by puerperal fever. Those gentlemen who, in our own country, have had occasion to observe it either as an epide- mic or sporadic disease, will require no further incitement to a perusal of the volumes now published. They will see Gordon's success, who, by the antiphlogistic treatment, was able to save forty-nine out of seventy-seven cases ; or rather, forty-five out of fifty ; Hey, who met with a most encouraging success by the same method ; and Lee, who lost fifty-nine only out of seventy-two cases ; while Armstrong saved all but five of his patients. In bespeaking so great a share of attention to these writers, I do not mean to disparage the opinions of others who act upon the same practical principles. I would refer, with especial satisfaction, to the opinions and experience of Dr. Legonais, of David D. Davies, of Dr. Mackintosh, and the younger Baudelocque, for confirmation of the views of the gentle- men whose works are now republished. Let us briefly consider the nature of the disorders usually com- prised under the term childbed fever, after taking a view of the organs and tissues known to be afl:ected in its different varieties and complications. In the first place, the gravid womb is a hollow muscle, supplied with a vast profusion of veins, arteries, absorbents, and nerves. It would hardly be deemed the stretch of a prurient imagination, to compare it, on account of its great vascularity, to an enor- mous aneurism by anastomosis, furnished with a suflicient quan- tity of muscular fibres to reduce back and compress within safe and natural limits the luxuriant production of sanguine tissues, of which it is chiefly constituted, and which afibrd a proper nidus for the germ, which derives from so abundant a source the mate- rials of its new development. Its nerves, abundantly distributed through its substance, and having the most intimate and complex connexion with the hypogastric, sacral, and renal plexuses, and indeed, the whole sympathetic system, endow it with a normal and pathological sympathy,coextensive with the body, and a keen sensibility to both intrinsic and extrinsic causes of excitement. Under the circumstances of such a physical constitution we need feel no surprise at observing the extent of disturbing force which it exerts, when diseased, upon the whole economy; nor, indeed, at the rapid destruction it brings upon the living system, whenever it happens to become the scat of disorganizing inflammation. The violent exertions of its contractile power, in labour, are often