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
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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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    ! se conditions, I think I shall subsequently show that it does not i terially differ from inflammation occurring in the non-puerperal . te. Now, in giving my reasons for believing that puerperal fever ! an essentiality, that it is something entirely distinct from local : egmasise, it will be seen that I adopt a line of argument parallel h that followed by Dr. Stokes in his masterly lectures on typhus er. b'irst, then, puerperal fever has no anatomical character. That re are a great variety of structural lesions found, all will admit. • 2 four principal lesions are, as Dr. Clark has said, those of the itoneum, of the veins of the body of the uterus, of the lymphat- of the inner surface of the uterus. And then we have lesions j the pleura, of the lungs, and pus in the liver, in the muscles, in joints, and pus in the blood. But where we have a group of : iptoms so resembling each other that they are almost identical, j' do not have constant or uniform structural lesion. They are j instant in their seat and their amount. In the same epidemic we i- e the greatest possible variety in their seat and their amount. • >ion of the peritoneum may be present or absent,—so of the ute- so of the lymphatics, and. so of the veins. In those cases, which ander, Gooch, Locock, and Simpson, suppose to be cases of puer- ; al fever without lesion, conceding the correctness of Prof. Clark's ^w, that with a proper examination pus might have been found in veins of the uterus,—that they really were cases of py[emia, what s this prove ? In legal parlance, I should put in a demurrer, mit the fact, will any one claim that all cases of puerperal fever cases of pyaemia, and that inflammation of the inner surface of uterus, or of its veins, is an essential anatomical characteristic of irperal fever ? !!. These lesions are often not sufficient to influence the progress of disease, or to explain the cause of death. The most malignant m of the disease, that in which a fatal result occurs the most eedily, offers the fewest and the least striking structural lesions. ! longer the disease continues, the more prominent and the more lifest are the organic lesions. Does not this prove that the lesions consecutive or secondary,—that there is a primitive source, an ;inal cause of vital depression, which sometimes destroys life so idly that there is no time for the development of the secondary I'bid alteration. The symptoms are not, then, the result of these ons, but the result of some specific agent—some morbid poison, cch subsequently develops the autopsic lesions. Sometimes this