In connection with the facts which have been stated it seems
proper to allude to the dangerous and often fatal effects which
have followed from wounds received in the post-mortem examination
of patients who have died of puerperal fever. The fact that such
wounds are attended with peculiar risk has been long noticed. I
find that Chaussier was in the habit of cautioning his students
against the danger to which they were exposed in these
dissections. [Footnote: Stein, L'Art d'Accoucher, 1794; Dict. des
Sciences Medicales, art., "Puerperal."] The head pharmacien of
the Hotel Dieu, in his analysis of the fluid effused in puerperal
peritonitis, says that practitioners are convinced of its
deleterious qualities, and that it is very dangerous to apply it
to the denuded skin. [Footnote: Journal de Pharmacie, January
1836.] Sir Benjamin Brodie speaks of it as being well known that
the inoculation of lymph or pus from the peritoneum of a
puerperal patient is often attended with dangerous and even fatal
symptoms. Three cases in confirmation of this statement, two of
them fatal, have been reported to this society within a few
months.
Of about fifty cases of injuries of this kind, of various degrees
of severity, which I have collected from different sources, at
least twelve were instances of infection from puerperal
peritonitis. Some of the others are so stated as to render it
probable that they may have been of the same nature. Five other
cases were of peritoneal inflammation; three in males. Three were
what was called enteritis, in one instance complicated with
erysipelas; but it is well known that this term has been often
used to signify inflammation of the peritoneum covering the
intestines. On the other hand, no case of typhus or typhoid fever
is mentioned as giving rise to dangerous consequences, with the
exception of the single instance of an undertaker mentioned by
Mr. Travers, who seems to have been poisoned by a fluid which
exuded from the body. The other accidents were produced by
dissection, or some other mode of contact with bodies of patients
who had died of various affections. They also differed much in
severity, the cases of puerperal origin being among the most
formidable and fatal. Now a moment's reflection will show that
the number of cases of serious consequences ensuing from the
dissection of the bodies of those who had perished of puerperal
fever is so vastly disproportioned to the relatively small number
of autopsies made in this complaint as compared with typhus or
pneumonia (from which last disease not one case of poisoning
happened), and still more from all diseases put together, that the
conclusion is irresistible that a most fearful morbid poison is
often generated in the course of this disease. Whether or not it
is sui generis confined to this disease, or produced in some
others, as, for instance, erysipelas, I need not stop to inquire.
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