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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    condition of the air of the hospital, and that the blood thus poisoned exhibited those manifestations. The laws of zymosis are so little under- stood, however, that up to the present we cannot, as I have said, acknowledge that we are certain of the precise means by which blood poisons are developed, and it would be like building a house upon a foundation of sand to found a theory of such importance upon a mere hypothesis. No. 3. Not agreeing exactly in the view which Dr. Kennedy enter- tains as to the mode of generation of metria, and which he seeks to impress upon the Society, and also because I think that the very statistics upon which he relies are opposed to his ideas. I must withhold my con- sent to this proposition. If we take the statistics of the Rotunda Hospital, and divide the years into groups or series, we find that the reverse of this proposition is true, for it is a fact that the mortality was less when a large number were admitted into the hospital than in similar groups of years when the number of patients was less. The very group of years upon which Dr. Kennedy relies so strongly, viz., the last fifteen years, shows the highest mortality, whereas those groups of years in which the greatest number of females were admitted shows the smallest death-rate. This part of the question has been so recently and so satisfactorily made evident by Dr. M‘Clintock in his able and argumentative observations, that it would be a waste of time to repeat now what he has placed in such a clear light before us ; but I may be permitted to say, that the statistics which I have copied from another source, viz., the mortality from puerperal fever occurring in six of the French hospitals, and to which I shall again refer, amply corroborate this important fact, viz., that the death-rate does not seem to bear a direct ratio to the numbers admitted. No. 4. This proposition, in my opinion, involves a paradox, for it affirms that where a large number of patients are delivered under the same roof the disease finds its habitat, appearing and reappearing at uncertain intervals. By the habitat of a disease we mean, in fact, the place of dwelling of it; and we must believe, if this hypothesis is true, that metria is con- stantly in the wards of a lying-in hospital. If it be, therefore, constantly present, or lurking in the atmosphere, how do we reconcile this with the well-known fact, that the disease only makes its appearance now and then, appeal’s and reappears at uncertain intervals, as Dr. Kennedy states. If this supposition were true, every patient entering a lying-in hos- pital would be almost certain to be attacked. But is such the case? No. Intervals longer or shorter generally elapse between the occurrence of outbreaks of this disease, and sometimes it will remain in abeyance