Under improved methods of treatment this disease does not terminate fatally as frequently as formerly.
The causes of this disease are:
First. The inflammatory condition of the system before delivery. If the fruit diet has obviated this, there is nothing to fear.
Second. The use of ergot in confinement. Puerperal fever following poisoning by ergot is very rapid in its course, and soon terminates in gangrene. If this drug were banished from practice, child-bed fever would be rare.
Third. Contusions and bruises from instruments not handled dextrously cause inflammation.
Fourth. The use of cathartics, tonics, stimulants and other drugs after delivery.
It is within the power of every woman that she shall not be subject to these causes of puerperal fever.
Some late teachers claim that all child-bed fever is pyæemia, blood-poisoning, and can not be avoided. Why is it, then, that it is notably absent in those who have led a hygienic life? Why is it that those physicians who insist on preparatory treatment seldom meet with it in their practice? Others claim that the disease is contagious, and that the poison can be conveyed by physician and nurse.
Dr. W. S. Playfair, of London, who gives to this disease the name of Puerperal Septicæmia, says: “The whole tendency of recent investigations is daily rendering it more and more certain that obstetricians have been led into error by the special violence and intensity of the disease, and that they have erroneously considered it to be something special to the puerperal state, instead of recognizing in it a form of septic disease, practically identical with that which is familiar to surgeons under the name of pyæmia or septicæmia.
“If this view be correct, the term ‘puerperal fever,’ conveying the idea of a fever such as typhus or typhoid, must be acknowledged to be misleading, and one that should be discarded as only tending to confusion.