In conclusion it should be remarked, that the tendency to miscarry, like many female diseases, is undoubtedly owing, in great part, to the general debility and weakness which characterizes so many women at the present day, and which is brought on chiefly by neglect of their physical education when girls, and by their artificial mode of life afterwards.
SECTION X.
THE DISEASES OF WOMEN IN CHILDBED, AFTER LYING IN.
CHAPTER XXVIII.
DISEASES OF CHILDBED.
PUERPERAL FEVER, OR CHILDBED FEVER.
This is undoubtedly the most serious of all those maladies that so often follow labor. It appears from medical records that puerperal fever has been known from very remote times, and that it has frequently become epidemic, or has spread from one to another, like the Cholera. In hospitals this has often been observed, and also in cities, sometimes almost every female delivered in the place having been attacked while it prevailed. There is also no doubt but that it is contagious, or capable of being transmitted from one person to another, like small pox. Numerous instances have been known where nurses and physicians have conveyed it to all whom they attended, during a long period after having been with a single case. One physician, after attending a case of puerperal fever, lost nine patients successively from the same disease, before he suspected the cause, and an old nurse assured me, that when she was a young woman, she was the unfortunate means of conveying it to two females whom she visited, by merely having been in the room a short time with one who was suffering from it. It is therefore highly important that all persons who may happen to be with a female so affected should not attend another case of childbirth for some time, and particularly that they should not wear any portion of the same clothing they had then on, and that they should bathe the whole body several times. If a case occurs in a hospital or other public institution, the female must be carefully isolated from all the others, and none of her attendants must be permitted on any account, to visit other puerperal patients, till after a sufficient time has elapsed, and every precaution has been taken.
The causes that produce this terrible disorder are not very well understood; some of them probably predispose to it before delivery, or even before pregnancy, while others are connected with labor and its consequences. Among the former may be mentioned, improper diet, an inactive life, anxiety of mind, bad air, a damp situation, a full habit, or great weakness, the frequent use of stimulants, and certain excesses! The principal causes operating immediately are difficult labors, violent treatment, the use of instruments, tearing away the placenta too soon, retention of the lochia, cold, rising from the bed too soon, depression or excitement of the mind, over exertion in talking to and seeing company, and neglect of cleanliness. The most frequent cause probably is cold or damp, which checks the lochia and the perspiration, and leads directly to inflammation. It is on this account that the complaint is nearly always worse in winter than in summer, and prevails most in low damp situations, and in badly ventilated apartments, or in those insufficiently warmed. In most warm countries, and in those of an equable temperature, where the females remain much in the open air, and use regular exercise, puerperal fever appears to be but little known.