The history, pathology, and treatment of puerperal fever and crural phlebitis.

Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: The history, pathology, and treatment of puerperal fever and crural phlebitis. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    disregarded in general practice. The species of inflammatory diathesis which exists throughout the whole period of pregnancy,* together with the throes of parturition, bring the system into a state verging upon febrile excitement, which, no doubt, would be attended with considerable danger, were it not for the secretion of the milk, and the flowing of the lochia. If, therefore, we would lessen the risk of fever in general, and of puerperal fever in par- ticular, the child should not be kept from the breast longer than twelve hours from the time of its birth; we should enjoin the strictest antiphlogistic regimen, and administer purgatives now and then, especially during the first four or five days, as that appears to be the term in which there is the greatest tendency to febrile disorders.! Everything calculated strongly to excite should be withdrawn, such as noise, light, and heat. And at the same time that the room should be kept at a moderate temperature and pro- perly ventilated, we should be particularly careful to prevent cur- rents of cold air from passing over the bed of the patient.J The use of cordials cannot be too positively and repeatedly prohibited ; since it is not uncommon for nurses to give the patients whom they attend a cup of burnt brandy, or caudle after delivery, and to add to the sago or gruel, which ought always to be taken in the simplest form, large portions of strong wine. And it is melan- choly to think that such things are sometimes done expressly against the commands of medical practitioners. The deceptions practised by those persons, commonly called old experienced nurses, are hardly credible; in the presence of the physician they will seem very desirous to carry all his orders into effect, but in his absence either accommodate themselves to the whims of the capricious, or, appealing to their long experience, persuade the timorous patient to take a diet very different from that directed ; and thus, between the hypocrisy of the one, and the weakness of the other, the deceit is successfully carried on, unless danger or accident should reveal it. The lives of many women, and the reputations of many ac- coucheurs have, I am fully confident, been sacrificed in this way. Whenever, therefore, professional men detect anything like dupli- city in the conduct of nurses, they should act in the most authori- tative manner, immediately insisting upon their dismission; for persons who once deliberately commit a dishonourable action can never be trusted with safety a second time. ♦Hunter affirms that the blood is always sizy in breeding women. See a Treatise on the Blood, Inflammation, &c. By the late John Hunter. Phila- delphia, Barring-ton &. Haswell. f The pernicious custom of binding the body too tight ought also to be avoided ; as it will produce difficulty of breathing, headache, and oppression at stomach.—Leake, p. 149. X 'There is nothing so great an enemie to a woman in travail, especially to her whose childe is drawn away by violence, as cold.—And thereof commeth manie grievous accidents, as hysterical suffocation, painful fretting of the guts, fevers, and other mortal diseases.—Johnson's Translation of the Works of Am- brose Pare. Printed in 1G49. See p. 615.