Hospitalism and zymotic diseases : as more especially illustrated by puerperal fever, or metria a paper read in the hall of the College of Physicians, on the 13th of March and 10th of April, 1869, before the Obstetrical Society of Dublin also, a reply to the criticisms of seventeen physicians upon this paper delivered on the 10th of July, 1869 / by Evory Kennedy.

  • Kennedy, Evory, 1806-1886
Date:
1869
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Licence: Public Domain Mark

Credit: Hospitalism and zymotic diseases : as more especially illustrated by puerperal fever, or metria a paper read in the hall of the College of Physicians, on the 13th of March and 10th of April, 1869, before the Obstetrical Society of Dublin also, a reply to the criticisms of seventeen physicians upon this paper delivered on the 10th of July, 1869 / by Evory Kennedy. Source: Wellcome Collection.

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    arrived at, better than by transcribing here a question put to me by a Medical Commission, who were engaged in inquiring into the state of the hospitals and sick poor in the year 1840, with my answer:— Query—“ Does puerperal fever appear to have prevailed more extensively when any general epidemic has prevailed in Dublin? ” Answera—“Yes; I have remarked that when continued fever, typhus, or erysipelas were prevalent in the Medical and Surgical Hospitals, puerperal fever appeared to prevail in the Lying-in Hospital, as well as in the city generally. The character of the fever varied also at different times, and occasionally appeared to be influenced in its nature by any prevalent epidemic.” So frequently has metria shown itself afterwards that it is now no longer esteemed an accidental “ post hoc,” but that they stand in relation of cause and effect. This fact alone goes a considerable way in confirming the idea of a common poisonous principle or miasm. Upon this subject I treated so lately in my paper on Pur- puric Puerperal Fever, read before the British Medical Association in 1867, that I shall not dwell upon it further at present. Should the principle of isomerism, which has of late attracted much notice with our chemists and professors of physical science, come to be established, the difficulties in adopting the idea of a common morbific poison would be lessened. As then the poisonous principle, which we might denominate zymotocene, would come to be classed as an original polyatomic molecule or principle, and would fall strictly within Dumas’b definition of what he terms polymor- phism, namely—“ one of those variations in the arrangements of integral molecules of a body which influence its physical properties, either temporarily or permanently.” There is nothing at all unreasonable, therefore, in supposing that, as in the case of polymeric or polymorphous hydrocarbons, we may also have the germs of different disease produced by polymeric combinations in the same elements. To descend, however, from the consideration of these general principles to the special subject with which we are more immediately concerned—puerperal fever. This zymotic disease prevails endemi- cally in crowded hospitals, where it is to be seen in its greatest virulence, and exhibiting its most concentrated fatality; although it is also to be met with in the hovels of the poor and the chambers of the wealthier classes. . When epidemic, showing itself generally a See page 124, infra ; also curvilinear diagram in Appendix E. b Lettre a M. Amphere Ann de Chemie et de Phys. xlviii., p. 208.