CHAPTER V.

PUERPERAL SEPTICEMIA.

Differences of opinion-Confusion from this cause-Modern view of this disease

-History-Its mortality in lying-in hospitals-Numerous theories as to

its nature-Theory of local origin-Theory of an essential zymotic fever—

Theory of its identity with surgical septicemia-Nature of this view—

Channels through which septic matter may be absorbed-Character and

origin of septic matter often obscure-Division into autogenetic and hetero-

genetic cases-Objections to term "autogenetic" -Sources of sapræmia—

Sources of heterogenetic infection—Influence of cadaveric poison-Infec-

tion from erysipelas-Infection from other zymotic diseases-Infection

from sewer-gas-Cases illustrating this mode of infection-Contagion from

other puerperal patients-Mode in which the poison may be conveyed to

the patient-Conduct of the practitioner in relation to the disease-Nature

of the septic poison-Local changes resulting from the absorption of septic

material Channels through which systemic infection is produced-

Pathological phenomena observed after general blood-infection - Four

principal types of pathological change-Intense cases without marked

post-mortem signs-Cases characterized by inflammation of the serous

membranes-Cases characterized by the impaction of infected emboli, and

secondary inflammation and abscess-Description of the disease-Duration

-Varieties of symptoms in different cases-Symptoms of local complica-

tions-Treatment .

-

PAGE

623

CHAPTER VI.

PUERPERAL VENOUS THROMBOSIS AND EMBOLISM.

Puerperal thrombosis and its results-Conditions which favor thrombosis—

Conditions which favor coagulation in the puerperal state-Distinction

between thrombosis and embolism—Is primary thrombosis of the pulmo-

nary arteries possible?-History-Symptoms of pulmonary obstruction—

Is recovery possible?-Causes of death-Post-mortem appearances -Treat-

ment-Puerperal pleuro-pneumonia: its causes and treatment

656

CHAPTER VII.

PUERPERAL ARTERIAL THROMBOSIS AND EMBOLISM.

Causes Symptoms-Treatment .

CHAPTER VIII.

OTHER CAUSES OF SUDDEN DEATH DURING LABOR AND THE

PUERPERAL STATE.

Organic and functional causes-Idiopathic asphyxia-Pulmonary apoplexy—

Cerebral apoplexy-Syncope-Shock and exhaustion-Entrance of air into

the veins

668

. 670

CHAPTER IX.

PERIPHERAL VENOUS THROMBOSIS (SYN.: CRURAL PHLEBITIS-PHLEGMASIA

DOLENS-ANASARCA SEROSA-CEDEMA LACTEUM-WHITE LEG, ETC.)

Nature-Symptoms-History and pathology-[Crural phlebitis after Cæsarean

and Porro operations]-Anatomical form of the thrombi in the veins-

Detachment of emboli-Treatment

PAGE

673

CHAPTER X.

PELVIC CELLULITIS AND PELVIC PERITONITIS.

Two forms of inflammatory disease met with after labor-Variety of nomen-

clature-Importance of differential diagnosis—Etiology-Connection with

septicemia-Seat of inflammation-Relative frequency of the two forms of

disease-Symptomatology-Results of physical examination-Terminations

-Prognosis-Treatment

. 680

INDEX

689

SECTION OF A FROZEN BODY IN THE LAST MONTH OF PREGNANCY (AFTER BRAUNE). ILLUSTRATING THE
RELATIONS OF THE UTERUS TO THE SURROUNDING PARTS, AND THE ATTITUDE OF THE

FOETUS, WHICH IS LYING IN THE SECOND CRANIAL POSITION.

SECTION OF A FROZEN BODY AT THE TERMINATION OF THE FIRST STAGE OF LABOR (AFTER BRAUNE,.
THE BAG OF MEMBRANES IS STILL UNBROKEN, THE CERVIX IS FULLY DILATED, AND
THE HEAD (IN THE SECOND POSITION) IS IN THE PELVIC CAVITY.