The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells.

  • Wells, Spencer, 1818-1897.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells. 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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    midwife’s finger may act in two ways—the finger may either introduce the streptococcus pyogenes, or it may introduce other micro-organisms which may favour the development of this streptococcus. A few words of explanation are here necessary. Experi- mental observers have lately shown that a comparatively harmless microbe may be rendered exceedingly virulent if introduced into the system with another harmless microbe. Similarly a small quantity of a pathogenic bacillus (such as the bacillus of tetanus) will produce no effect unless it be introduced with some other microbe. A few examples will suffice. The bacillus Chauvoei is harmless to rabbits, but if this bacillus be injected with the micrococcus prodigiosus (which is in itself harmless) the rabbit invariably succumbs to the action of the first-named bacillus. A small quantity of the bacillus of tetanus produces no effect on a guinea-pig; but, if a small quantit}'- of another harmless micro-organism, such as the bacillus proteus, be injected at the same time, the animal dies of tetanus. Moreover, it is not even necessary to inject the harmless microbe itself, for a small dose of its poisons will produce the same effect—it will give the more virulent microbe a chance of starting. Applying this knowledge gained in the laboratory to the case of labour, we see that the introduction of micro-organisms, harmless themselves, is a danger. Even if the streptococcus pyogenes has not already invaded the uterus, the presence of another micro-organism will favour its development, should it find its way in at some future time. Or should the strepto- coccus pyogenes be already present in doses not sufficient to produce any symptoms, the introduction of the other micro- organisms will enable it to make a start. In order that the streptococcus should kill the patient, it is not necessary that it should leave the cavity of the uterus, and infect the whole body. The experiments of Vaillard and others have shown that some micro-organisms produce poisons of so deadly a nature, that an infinitesimal quantity of them will prove fatal even when the micro-organism is still localised in one spot and has not invaded the body. These poisons are chiefly formed in albuminous fluids, and one may well imagine what a quantity of poisons the streptococcus pyogenes and other micro-organisms will produce when thriving in a warm chamber like the uterus, and being cultivated on rich albumi- nous food, such as the lochia of a parturient woman. Even should the disease be localised at first, the absorption of these poisons will favour the dissemination of the micro-organism ; for experiments have shown that micro-organisms spread with