Remarks on puerperal fever : before the New York Academy of Medicine, October 6, 1858 / by Fordyce Barker and A.K. Gardner.

  • Barker, Fordyce, 1819-1891.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on puerperal fever : before the New York Academy of Medicine, October 6, 1858 / by Fordyce Barker and A.K. Gardner. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Disease. Oct. 1857 Not 1857 Dec 1857 Jan. 1858 Feb. 1858 Mar. 1858 Apr. 1858 May 1858 June 1858 July 1858 Aug 1858 Sept IfcoS Puerperal Fever,. Erysipelas, 5 4 9 6 14 16 17 13 26 20 21 14 21 23 19 21 13 8 13 13 9 5 a 3 In Paris there has certainly been afforded an immense field for studying this disease, as in five years, 1852-56, 644 deaths have ocj^. curred, in six of the principal hospitals, from puerperal fever. I may be pardoned for saying, that I have most carefully and con- scientiously read all that has appeared in the French medical journals, and that 1 have observed, with the most earnest desire for truth, in order that I might correct any error in reasoning or deduction, into which I may have previously fallen. Before alluding to some points, in regard to the pathology of this affectiou, I will give a very brief summary of the views of the principal spealiers in the French Academy. The discussion originated with M. Guerard, who stated his belief, that so far as the nature of the disease was concerned, we must look for something beyond the mere local lesions, and that its phenomena cannot be explained by means of puru- lent infection. M. Depaul was the most able advocate of the doctrine of the essentiality of puerperal fever, although, instead of the term puerperal fever, he would prefer calling it puerperal typhus, or puer- pcrai septicasmia. He beheves that its essential character consists in a primary alteration in the blood. In the autopsies which he has made, he has uniformly found the blood in this disease to possess a peculiar fluidity, and to be generally of a violet red color, easily impregnating and coloring the tissues. It often also presents a remarkably oily appearance, and coagulates with difficulty. He quotes from Vogel,(in Virchow's Handbuch,) who states that lactic acid confers an acidity upon the blood in this disease, and that in some cases carbonate of ammonia, in others the hydrosulpbate, is found in it. The fluid loses its aptitude for coagulation, as do the globules to redden on the contact of air, and therefore their fitness for the respiratory act. The globules are in part decomposed and dissolved in the scrum, giving it a reddish or dirty brown color. Scanzoni asserts that in some cases there is an increase of fibrin; in others, a true pva3mia, the constituent elements continuing in their normal pro- portions, and in others, again, a true putrefactive dissolution or septi- csemia. M. Depaul regards the epidemic occurrence of this ^^^'^^^^^^ presumptive proof of its essentiality. He, also, as do several of t e