Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West.

  • West, Charles, 1816-1898.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1844-5 / by C. West. Source: Wellcome Collection.

    19/50 (page 17)
    of puerperal fever with that of erysipelas, and to show that the treatment ap¬ plicable to it is not such as would be suitable in cases of sthenic inflammation. Mr. Storr,* of Doncaster, relates several cases in illustration of the fact that the contagion of puerperal fever may produce in persons not in the puerperal state, either peritonitis, or inflammation of some of the serous membranes attended with lovv fever; or local or general erysipelas, or various forms of typhus fever. A re¬ markable illustration of the affinity between puerperal fever, and other diseases the result of morbid poisons is contained in Dr. Murphy’s Report of the Obste¬ tric Practice of University College.f Having had occasion to remove the pla¬ centa of a patient who died soon afterwards from puerperal fever, several pus¬ tules appeared two days afterwards on the arm which he had introduced into the uterus. The appearance of these pustules was attended with considerable constitutional disturbance, and one of them assumed much of the character of malignant pustule. Mr. FarrJ has made some observations on the rate of mortality in childbed, and on the share which puerperal fever has in its pro¬ duction. He has likewise published in his report an interesting document furnished by Mr. Bossey of Woolwich, which shows by facts occurring in his own practice, the highly contagious nature of puerperal fever. M. Botrel§ describes two epidemics of puerperal fever which prevailed in the city and hospital of Rennes, in 1842 and 1844. He proposes for the disease as he ob¬ served it, the name of angioleucite uterine, since it was characterized by in¬ flammation of the uterine lymphatics without any affection of the veins. The blood presented various deviations from a healthy condition, and purulent de¬ posits in the lungs were by no means unusual. He believes that it depended on atmospheric causes, especially on dampness and highly electric conditions of the air, but rejects, though scarcely on adequate grounds, the influence of deficient ventilation in its production as well as the notion of its being propar gated by contagion. Its attacks usually commenced with violent febrile symp¬ toms, soon followed by a condition of stupor. The abdominal pain, at first confined to the uterine region, extended speedily over the whole abdomen, and for a short period was very excruciating, but ceased almost entirely as the state of depression increased. The prostration of all the powers, and the af¬ fection of almost all the functions of the body when this typhoid state super¬ vened were very remarkable, and terminated after a short period in death. Some patients died in 36, others in 40 hours, but the 5th day was the period of the greatest mortality. Very few of those who were attacked survived ; in 1842, only 4 recovered out of 24 who were attacked, and in 1844 only 2 out of 22. In those cases in which recovery took place local and general bleeding', purgatives, and mercurials were employed, and when these remedies failed to do good, all other means proved perfectly useless. M. Marelial de Calvi|] has published a very elaborate essay on intra-pelvic abscess. He treats of the disease in both sexes, but of the 75 cases he records 52 have reference to puerperal women. Of these 52 cases, 44 have already appeared in print, 8 have been communicated to M. Marchal by M. Bouchut, but none have fallen under his own observation. The chief value of his pam¬ phlet consists therefore, in the care with which he has collected almost all re¬ corded cases of this affection. Dr Lever^T has written a paper on the same affection, containing the account of several cases that came under his own notice. He proposes for it the name of pelvic inflammation, in preference to any more definite designation, in consideration of the difficulty that there is in the way of determining what partis primarily affected, whether the cellular tissue of the pelvis or the uterine appendages. A case of this kind is likewise de- * Prov. Med. and Surg. Journal, May 7. 1845. t Op. cit. p. 47. J Fifth Report of the Registrar-general, pp. 380-96. § Arch. Gen. de Med., Avril, Mai, Juin, 1845. || Reprinted from the Annales de la Chirurgie, for 1844. Guy’s Hospital Reports, 1844.