Relations of certain bacteria to puerperal inflammations / by E.W. Cushing.

  • Cushing, Ernest W. (Ernest Watson), 1847-1916.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: Relations of certain bacteria to puerperal inflammations / by E.W. Cushing. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    throes of difficult labor. Yet the windows are open ; there is puerperal fever, so-called, always in the city; there is free coming and going in the wards. To my mind the inference is irresistible that puerperal fever does not exist as an endemic or epidemic disease in the sense formerly supposed, but is only a name for the symptoms of an infection of the puerpera by direct carelessness or uncleanliness of somebody, let us say the nurse, as we would gladly suppose that physicians are always thoroughly careful and surgically clean. Moreover, the source of infection is no mysterious aroma or miasma, inseparably connected with the nurse or physician. It is solid and tangible and usually under or around the finger nails, and can be removed by soap and water, by baths and nail brushes, or killed by a I to 1,000 solution of sublimate, or by carbolic acid in two ppc. solution or by permanganate of potash, etc. Clothes can be sterilized by baking them in an oven for an hour or more at a temperature just short of 300° F., where they begin to scorch. The day is at hand when the presence of chains of streptococci in a puerperal woman will be considered a disgrace and dishonor to her accoucheur, and this standard is already attained in surgical operations in the best hospitals. I do not say that at present all such accidents, so- called, can be avoided, but I am sure that there will be a more critical spirit in the public as well as in the profession ; less talk of bowing to the visitations of an inscrutable Providence and more reviling of negli- gent doctors, and I trust more care in selecting properly-trained nurses. Deliveries at home ought to be at least as safe as those in public hospitals. Five or even three years ago they were incomparably safer, now I know that in the best public hospitals, the results are better than in the average home, provided not only death but lighter cases of septic pelvic inflam- mation are included. In the bodies examined were found in all cases, one or several of the three septic bacteria, streptococcus, staphylococcus, or bacillus pyogenes foetidus, alone or in combination. The most constant, and usually occurring alone, was the streptococcus. Less frequent in the puerperal process, but more common in peritonitis after operation, was the staphylococcus. r j • • The B. pyog. foetidus did not occur alone, but was found twice in combination with staphylococci in cases of which I will speak more fully. The cases were not numerous enough, nor do I have sufficiently accu- rate histories to warrant me in drawing any conclusions as to compara-