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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$hours later, the red eolor became black, and sloughing of the integument followed. The affected extremities became cold, oedematous, and dejirived of sensation. The pain ceased; sopor and speedy death ensued. The lochial secretion was very offensive during the whole course of the disease, and so corro- sive as to produce excoriations of the vagina and external genitals ; there was, however, no sloughing of these parts. , When incisions were made into the affected limb a quantity of reddish serum exuded from the infiltrated cellular tissue. The muscles were soft and flabby almost to their insertion into the bones, though not affected b}' fatty degeneration. The inner surface of the uterus was of an ashy-gray color, and covered with a thin layer of an offensive yellowish fluid with red streaks; the parenchyma being soft and pulpy to the do])th of two lines. In two instances only was there a small amount of a thin, grayish-yellow, sero-purulent fluid, dis- covered in the peritoneum. The liver was soft and anemic, the spleen larger than normal, the kidneys pale and flabby. In the spermatic vein, purulent deposits were found, as well as oedema and congestion of the lung. The whole description leaves no doubt that the affection referred to was a puerperal Bcptico-pyemia originating in the uterus. * {(j) Scarlatina miliaris is much less common as a septic dis- ease of the skin in Ijdng-in women. Mayr says, in Ilebra’s Skin Diseases ([>. 120), that the so-called puerperal scarlet fever has nothinc: in common with the true scarlatina except the color, and falls, therefore, under the head of erythema ; but this statement is, at the most, intended to be applied to simple scarlet fever, since, with reference to scarlatina miliaris, it is pointed out later (p. 142) “that it is not infrequently a S3unp- tom of p3’emia,” and it is not easy to see, a priori^ wh}^ a scarlatina miliaris might not also occur in puerperal septice- mia. Yet it has been previously shown (p. 466) that this statement will not bear critical examination even in case of scarlatina Isevis. There are developed in lying-in women inflammations of the skin, which bear a very marked resem- blance to scarlatina miliaris, beginning, as in case of simple scarlatina, with an eruption upon the neck and breast, and characterized by the extreme rapidity with which this erup-$