The pathology and treatment of childbed : a treatise for physicians and students. ... From the second German edition with many additional notes by the author / by Dr. F. Winckel; translated by James R. Chadwick.

Date:: 1876

Credit: The pathology and treatment of childbed : a treatise for physicians and students. ... From the second German edition with many additional notes by the author / by Dr. F. Winckel; translated by James R. Chadwick. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$in 816 chilclbirths; thus: erysipelas of the face two, of the body two, of the extremities three, of the nates one. All known forms of the malady occur; erysi])das glabrum, as well as vesiculosum and 'pustulosum. Severe rigors, the swelling of the integument, at first circumscribed, the bril- liant hue vanishing upon pressure, the rapid spread of the ex- anthema, all contribute to make the diagnosis on the whole easy. It is not of uncommon occurrence, however, to observe erythema bullosum confounded with scarlatina miliaris. It is, therefore, important at the outset to endeavor to ascertain the point from which the erythema originated. In the primary erysipelas of childbed, the prognosis is, as a rule, less favorable than in the other forms, from the circum- stance that the fever is usually intense, and may attain, espe- cially during the first days of childbed, a very great height (106° F.). The patients are thereby reduced, and recover but slowly; this class of afi’ections, nevertheless, generally termi- nates favorably, unless complicated by other internal affections, such as meningitis, oedema pulmonum, etc. Other cases of erysipelas in lying-in women run a regular course, being by no means more severe than at other times {vide Case 50). The treatment is familiar to all: internally, acidulated drinks, full doses of potash, etc. The employment of emetics and cathartics, which are steadily losing in favor in this malady, and by many are completely discarded (liebra), is still less advisable in the case of puerperal women, whose strength is taxed often enough and severely enough, without resorting to these debilitating agents. The disease cannot be abbreviated by the administration of these remedies. In the vicinity of the genital organs the eruption should be treated with wet compresses, or lead-water fomentations; upon other parts, either by means of dry warmth (cotton batting), meal, pow- dered-chalk, or, if the pain be very severe, there need be no hesitation in trying the efiect of cold, in the form of cold com- presses, or ice-bags. What has been said with regard to erysipelas in puerperal women is, in general, true of the primary form of 'phlegmon^ which, surely, is of more rare occurrence among this class.$