A new mode of treating puerperal fever / by Charles Bell.

  • Bell, Charles.
Date:
[1872]
Catalogue details

Licence: Public Domain Mark

Credit: A new mode of treating puerperal fever / by Charles Bell. Source: Wellcome Collection.

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    2 the number of wounded persons who were accommodated under the lying-in ward. This was the first appearance of the disease in the epidemic form,,and it was peculiar in its character, as it was pre¬ ceded by haemorrhage, and was attended by numerous internal abscesses. It formed a striking contrast to the next epidemic, which occurred in Paris in 1746, and proved fatal to many women both in the hospital and to those who were delivered in their own houses. According to Montonu, it u commenced with diarrhoea; the uterus became dry, hard, and painful; it was swollen, and the lochia had not their ordinary course; the women experienced pain in the bowels, particularly in the situation of the broad ligaments; the abdomen was tense; and these symptoms were sometimes joined with pain in the head and cough. On the third and fourth day after delivery, the mammas became flaccid. On opening the bodies, matter like curdled milk was found on the surface of the intestines; a milky serous fluid in the hypogastrium; a similar fluid was found in the thorax of certain women; and when the lungs were divided they discharged a milky putrid lymph. The stomach, intestines, and uterus, appear to have been inflamed. It may not be uninteresting to refer to the character of the dis¬ ease as it appeared in the epidemic which occurred in Paris and Lyons in 1750, as illustrating still further the complications which attend the disease, and prove still more its zymotic character. Poteau informs us that the uterus was found enlarged, and its in¬ ternal surface soft and black, and its parietes were livid and gan¬ grenous. While puerperal fever may be complicated in the manner just described, it is not a necessary consequence, as, like smallpox in its most fatal form, it runs its course so rapidly in some cases that there is no time to form any local lesion which can be ascertained during life, or discovered after death. Dr Bigby informs us, that in some of the cases which came under his notice in the general lying-in hospital, there was u neither time nor power sufficient to produce either symptom or trace of inflammation, the powers of life having from the commencement sunk under the deadly in¬ fluence of the disease.” He therefore adds, u that of all the diseases to which the lying-in woman is exposed, puerperal fever is the most to be dreaded, and that there is none in which the accoucheur is frequently more helpless.” In a disease of such virulence, it is of the utmost importance that a remedy should be discovered to moderate its severity. I am convinced of its similarity to erysipelas—a circumstance which has been proved, not only by its appearing epidemically along with that disease, as happened in Barnsley in 1808, and in Leeds in 1809, but there are instances on record,1 in which puerperal fever has been induced by those attending patients suffering from ery¬ sipelas, and then attending women in their confinement; and there