ANATOMICAL AND PHYSIOLOGICAL FACTORS 81 



agents are numerous. Abscesses in the region of the rectum do 

 occur and may be exceedingly dangerous. 



Factors in Genitourinary Tract Infections. — The female genito- 

 urinary tract is not uncommonly the seat of infections. These 

 may be exogenous (from without), hematogenous, lymphogenous, 

 or by direct extension. The cervix of the uterus and the vaginal 

 walls are in contact Avith an extensive bacterial flora. The reaction 

 of the secretions from the cervix and vagina may be irritating 

 and the opportunity for fecal contamination is ever present. Dur- 

 ing childbirth the patient becomes exceedingly fatigued, there is 

 always blood loss, the resistance of the tis.sues of the uterine walls 

 and cervix is markedly lowered and the latter frequently lacerated. 

 Thus there are many predisposing factors for infection in such 

 conditions. Infection of the uterus may originate, and frequently 

 does, from some focus within the body carried to the uterus by the 

 blood stream or lymphatics. 



Septic infection that complicates or follows delivery is called 

 puerperal sepsis. Oliver Wendell Plolmes called attention to its 

 spread by the hands of the physician who goes from a case of 

 septic infection to care for a woman in labor. Not infrequently 

 one observes uterine infection in women who have attempted 

 abortion. Such infections lead to pelvic peritonitis, general 

 peritonitis or septicemia. 



Cystitis, or inflammation of the bladder, is said to be more 

 common in girl babies than in males of the same age. Since the 

 colon bacillus is found frequently associated with this condition 

 and since the female urethra is shorter than that of the male and 

 commonly contaminated with fecal material in the diapers, it has 

 been suggested that these factors account for the more frequent 

 occurrence of cystitis in the female babies. The development of 

 cystitis in older age groups is commonly associated with conditions 

 that prevent the normal, free emptying of the bladder. This may 

 be due to a cystoeele in the female or to a hypertropliied prostate 

 in the male or to tumor masses in either. 



Cabot says that the so-called "catheter cystitis^ ^ is always 

 caused by urinary retention with resulting congestion and edema 

 of the bladder mucous membrane and the preparation of a "soiV 

 for bacterial growth and development. In his opinion, proper 

 catheterization prevents infection. 



