Cases illustrative of the contagious nature of puerperal fever, and its intimate connection with erysipelatous and phlebitic inflammation / by Alexander Peddie.

  • Peddie, Alexander, 1810-1907.
Date:
[1846?]
Catalogue details

Licence: Public Domain Mark

Credit: Cases illustrative of the contagious nature of puerperal fever, and its intimate connection with erysipelatous and phlebitic inflammation / by Alexander Peddie. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the convulsion occurred, of a timely diaphoresis bringing with it relief and recovery. A post mortem examination of this singular case was very de- sirable, but could not be obtained, in consequence of the peculiar ideas and feelings of the relatives. With regard to inspections of the other cases, I may here state that for several reasons I made no applications toobtain such,—la?, because, from the reportof nu- merous cases, it seems well established that such examinations are extremely dangerous for the propagation of the disease ;* 9.d, be- cause all the cases occurred in that station ofsociety, where an autopsy is almost invariably refused, unless death has been very sudden, or unless there has been some dispute or mystery about the cause ; and, 3^/, because there have unfortunately been a sufficient number of post mortem inspections in cases of puerperal fever to exhibit all that dissection can discover. In many hundreds of autopsies, conducted by the most able men of past and present times,! it has been abundantly ascertained, that in those cases partaking of the purely inflammatory type of the disease, the structural changes are, various decrees of softeninof and disorf^anization of the sub- stance of the uterus, purulent matter found in the veins in some instances, and as often not ;'l thickenings and depositions of lymph on the peritoneal covering of the uterus and that of its append- * Dr R. l^ce, in tlie Midical (Gazette, August liJ43, relates the case of a practi- tioner in F^ondon in 18.'}I, who h.id three cases of puerperal fi ver, shortly after open- ing the body of a person who died of the disease ; that he himself in !{}.'i5 had two ca!-es immediately after an autopsy, notwithstanding the j^rc.itest precautions ; again in MVSi'u he had one case, and another in 1839. Dr Merriman had one case of ])u- erperal fever on the morning following an inspection in a similar case, even although he did not touch the body, (vide Provincial Journal, No. l(>(i.) Many like instances are well authtnlicatcd, and several have been stated to me by medical friends,— among the nidst singular of which was the occurrence of three cases to Dr l'ater.>on of l-eith from simply touching a portion of the uterus in the possession of Professor Simpson, of a person who hud died of puerperal fever ; aiid the danger ot such au- topsies is made yet more apparent by the fact that, wliile Dr Simpson obtained this prc])aration at an examination of one of the five latal cases recorded by iMr Sidey in this Journal for 1839, Dr Simpson himself had four cases of puerperal fever im- mediately following. ■j- Leake, llulme. Hunter, Hey, Armstrong, Gooch, I.ee, Toniielle, Clarke, Meckel, llibe.s, Dance, Arnott, Collins, Lee, Mackintosh, Campbell, Hall, Fergus- son, Locock, &c. &c. + Mr Moore, who has perhaps written the be!.t monograph on puerperal fever, says, when alluding to the relations of French and German patliologists regarding the detection of purulent matter in the veins, In tliis country, \v)\ie\tr. post iiiurtcvi examinations, not excepting those conducted by our best anatomists, have generally failed to detect purulent matter in the veins.—linquiry into tlie Pathology, &c. of Puerperal Fever, p. G'.K Phlebitis or any other local inflammation cannot be considered the cause of that maliijnancy which puerperal fever evinces, since that character is exhibited with nearly equal |)recision when associated wiih either of the various conditions before- mentioned, (effusion into the peritoneum, &c.), proving that structural derangement is lilt an accident of Us course.''''—Ibid, p 79- To believers in the identity of peritonitis and puerperal fever, we can show pu- erperal fever with a perfei tly healthy peritoneum. To those who insist on inflam- mation of the uterine veins as constituting puerperal fever, we can show the genuine disease without this condition.—Dr Ferguson on Important Diseases of Women, p. 81.