Observations on puerperal fever and puerperal mortality : in reply to Dr. Evory Kennedy's paper, entitled Zymotic diseases, as more especially illustrated by puerperal fever : made at the meetings of the Dublin Obstetrical Society, session 1868-69 / by John A. Byrne.

  • Byrne, John August, 1827-
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: Observations on puerperal fever and puerperal mortality : in reply to Dr. Evory Kennedy's paper, entitled Zymotic diseases, as more especially illustrated by puerperal fever : made at the meetings of the Dublin Obstetrical Society, session 1868-69 / by John A. Byrne. 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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    or metroperitonitis, leeches cautiously applied over the affected regions are useful; but where puerperal fever or metria prevails, I would not follow Dr. Kennedy’s advice to leech and leech again coup sur coup until pain is abated or altogether removed, I would much prefer to trust in opium, poultices, removal of the patient to a purer air, and watching the moment to exhibit brandy, wine, quinine, thus endeavour to prevent the tendency to death which is by exhaustion. Those who have witnessed real puerperal cases will call to mind the rapidity with which tympany, diarrhea, effusion into the bronchial tubes, and collapse set in; and no person now-a-days would have the temerity to order from sixty to one hundred leeches to be applied to the abdomen of an unfortunate woman whose whole system is poisoned by this metrial poison, whatever it may be. Yet such was the practice recommended by Campbell, who, not content with one hundred leeches, afterwards encouraged the bleeding by stupes, poultices, &c. Dr. Collins recommends the use of three or four dozen leeches, followed by the warm bath. Can we wonder for a moment that such a fearful mortality attended the disease ? Is it not in fact a matter of surprise that any poor victim ever recovered from such treatment ? I have read in works upon this subject cases in which I have not the slightest doubt in my mind that the patients were—I will not say killed,—but, to use the most charitable phraseology, they were hurried to the grave. The same may be said of calomel, and other preparations of mercury. In simple peritonitis or metritis it may be admissible, but we must be vei’y guarded in its exhibition, even in those cases. Nature never sets up an inflammation of this kind without some object. By our inter- fering with the efforts of nature we may do premature mischief in even mild cases. But what can I say of the treatment recommended by Dr. Kennedy at pages 274, 275 of his paper, He says, “When metria or peri- tonitis were to be anticipated, as when the disease was prevalent, after manual interference in labour, or for the removal of the placenta, my habit was to commence at once after the labour was completed Avith small and frequently repeated doses of mercury—a grain or grain and a half of grey powder every third or fourth hour, and even, in more suspicious cases, applying mercurial ointment to the armpits and groins. By those means, without irritating the patient’s system to any serious extent in the course of forty-eight or fifty-six hours, a slight mer- curialization may be perceptible, often before the time at which the disease could grapple the patient.” And then he goes on to say:— “ Should metria show itself by pressing mercurials a little more freely the system may be speedily brought under its specific influence, and the disease be thus speedily or easily checked, if it had not been prevented. 1 have only,” he says, “ on one or two occasions seen puerperal fever