The puerperal diseases : Clinical lectures delivered at Bellevue Hospital / By Fordyce Barker.

  • Barker, Fordyce, 1819-1891.
Date:
1880
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Licence: Public Domain Mark

Credit: The puerperal diseases : Clinical lectures delivered at Bellevue Hospital / By Fordyce Barker. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    LECTURE XIV. PTJEEPEBAL PHLEBITIS. Case—Recovery—Two cases of death—Autopsical lesions—Three forms of puerperal phlebitis : adhesive, circumscribed suppurative, and diffuse suppurative— Ranvier's pathological histology—Uterine phlebitis—Symptoms : rapid pulse, rise in temperature, recurrent chills of moderate severity—Pain, generally not severe, but uterine tenderness—Abdominal tenderness and tympanites not symptoms of phlebitis—Involution not retarded by uterine phlebitis—Typhoid symptoms : rapid depression of the vital powers, delirium, subsultus, diar- rhoea, profuse perspiration, profuse and very offensive lochia—Signs of puru- lent infection—Differential diagnosis of uterine phlebitis from peritonitis and metritis—Terminations of uterine phlebitis—Rapid death from septicaemia or embolism of the pulmonary artery—Recovery by resolution—Slow recovery by eliminative suppuration on the external surface—Death as a result of purulent deposit in serous cavities or in the parenchyma of important organs—Secondary bronchitis or pneumonia—Tendency of this disease to impair assimilation and nutrition, and subsequently to destroy life by marasmus or acute tuberculosis— Treatment Page 280 LECTURE XV. PUEEPEBAL METBITIS. Case—Puerperal metritis very frequently a prominent lesion of puerperal fever, and generally found associated with peritonitis or phlebitis—In this ca<e, compli- cated only with cystitis, which is not uncommon as a puerperal disease—Puer- peral metritis includes endometritis and parenchymatous metritis—Metritis frequently the primary lesion, in the development of phlebitis or peritonitis— Physiological modifications of the mucous membrane of the uterus during the puerperal period—Pathological anatomy of puerperal metritis—Causes—Symp- toms—Duration and terminations—Treatment p. 303 LECTURE XVI. PUERPERAL PEBITOXITI8. Case—Puerperal peritonitis formerly regarded by many as synonymous with puer- peral fever—Very frequently secondary to phlebitis, endometritis, or some other suppurative phlegmasia in the pelvic tissues—Sometimes a primary affec- tion, and general from the beginning—In other cases, becomes general by con- tiguous extension—Most liable to occur early in the puerperal period—Some- times developed before or during labor—Causes—Symptoms—Progress and duration—Time when death occurs—Modes by which recovery takes place— Diagnosis — Treatment — Opiates—Veratrum viride — External application of the oil of turpentine—Blisters—Quinine—Alcoholic stimulants—Vaginal in- jections—Nutrition—Absolute rest—Purgatives dangerous—Mercurials (?) — Venesection (?)—Report of a case appended . p. 324