A manual of obstetrics : theoretical and practical / by W. Tyler Smith.

  • Smith, W. Tyler (William Tyler), 1815-1873.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: A manual of obstetrics : theoretical and practical / by W. Tyler Smith. Source: Wellcome Collection.

    552/656 (page 532)
    A fatal result is almost invariable when pus is formed in any considerable quantity upon the peritoneal surface. The pathological changes consist of effusions of pus or of lymph, rarely so highly organized as after ordinary peritonitis ; sero-purulent effusions ancl abscesses of the surface of the uterus or its appendages, or of the omentum. In many cases, the uterus is found diseased, the inflammatory disorder having extended from the uterus to the peritoneum, or, pro- bably, in some cases, from the peritoneum to the uterus. Softening of the parietes, patches of gangrene, abscesses in the walls, and collections of pus in the veins of the uterus, are often met with. One of the greatest, if not the greatest, advances ever made in the pathology of puerperal fever consists in the Knowledge we have obtained, in recent years, of the existence of Uterine! Phlebitis as a very common and destructive form of puerperal disease. The occurrence of uterine phlebitis and suppurationj of the veins in isolated cases had long been known, but no| other inquiries have at all equalled the researches of Dr.i Robert Lee in this particular department, and it is to his| exteuded investigations of the subject that we chiefly owi the establishment of the doctrine of uterine phlebitis as occurs after parturition. Others have, as I believe, with truth, controverted Dr. Lee’s views of the entire dependent of puerperal fever upon uterine inflammation and phlebitis, and it may, I think, be shown, that where phlebitis exists, is, in almost all eases, an expression of constitutional disorder] and especially of a poisoned or diseased state of the blood] rather than an idiopathic disease. The researches of Dr. Perl guson and others prove that puerperal fever may destroy patients before there has been sufficient time for the occur rence of phlebitic inflammation, and that in such cases nj pathological changes beyond a diseased state of the blood arj met with. Many facls in the history of puerperal fever provi that before the purulent infection of the blood, believed b; Scanzoni and others to constitute the essence of the disease has taken place, changes have occurred in the circulating fluid, which may in some cases destroy the patient longbcforl the suppurating stage lias been reached. The experiments Dr. Mackenzie, and the cases lie lias collected, show that th| healthy obstructive inflammation of the veins, the result simple traumatic injury, docs not result in purulent infectiol ol the blood, but that a morbid state of the circulating fluid i