AUTOINFECTION, SO-CALLED, DURING THE 
PUERPERIUM 
By Dr. G. RUSTIA 
Puerperal infection has been known as a morbid entity since 
the early history of medicine. It has been the subject of many 
investigations through all ages. Denmann (1788) was the first 
to observe that the disease was transmitted from cases of puer- 
peral fever to healthy puerperal women by physicians and 
midwives. This view was strongly supported by Alexander 
Gordon, of Aberdeen, in 1795, and by Oliver Wendell Holmes, of 
America, in 1843. Gordon showed the infective nature of the 
disease, and Holmes showed the evidence that it was carried 
from patient. to patient. The last named was confident that 
it could be conveyed in a similar way from a case of erysipelas, 
or from a postmortem, and that it was necessary for the phy- 
sician to disinfect his hands and to change his clothes after 
attending a case of puerperal infection. This work was put 
upon a sound basis by Semmelweiss of the Lying-In Hospital of 
Vienna, who came to the conclusion from his brilliant researches 
that the introduction of ‘‘cadaveric poison” was the main cause 
of puerperal infection. The introduction by him of the use of 
chlorine water and solution of chloride of lime for cleansing the 
hands of the students and nurses attending labor cases reduced 
the mortality rate to 1.27 per cent in 1848. His theories were 
first ridiculed by his colleagues of that time, but were finally 
recognized when Pasteur discovered in 1878-79 the streptococ- 
cus in the uterine discharge, blood, and tissues (postmortem) of 
puerperal fever patients. They thus recognized external in- 
fection. 
Leading obstetricians confirmed the finding of Pasteur, and 
it is a well-known fact to-day that the streptococcus in many 
instances is the sole cause of this disease. But years after the 
discovery of Pasteur, the streptococcus was found to harbor 
normally in the genital canal of healthy parturient women, as 
shown by Doderlein, Bumm, Walton and Medalia, and others. 
The question now arises: Is this organism, found in healthy 
parturient women, the same that causes puerperal infection? 
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