ITS VITAL PROPERTIES, AND RELATIONS TO LIVING ORGANISM. 217 



other zymotic diseases, the liability to which is not thus limited, all extended 

 observation concurs in showing that it is augmented by anything which tends 

 to depress the vital powers of the system, and more particularly by any cause 

 which obstructs the due purification of the blood, by the elimination of the pro- 

 ducts of decomposition. Thus it will be shown hereafter (CHAP, x.), that no 

 antecedent condition has been found so efficacious in augmenting the fatality of 

 Cholera, as overcrowding; which compels those who are subjected to it to be 

 constantly breathing an atmosphere not only charged with carbonic acid, but 

 laden with putrescent emanations ; and which thus favors the accumulation of 

 decomposing matter in the blood, which serves as the most appropriate soil for 

 the seeds of the disease. And what is true of Cholera has been found to be 

 true of Zymotic diseases in general ; the very same fermentable matter in the 

 blood serving for the development of almost any kind of zymotic poison that 

 may be received into the system, whether from the atmosphere, or from the 

 bodies of those who have already been subjects of the disease. Now that what 

 has been here spoken of as "fermentable matter" is not a mere hypothetical 

 entity, but has a real material existence, appears from this consideration ; that 

 in all those conditions of the system in which we know that decomposition is 

 going on to an unusual extent, and in which there is a marked tendency to 

 putrescence in the excreted matters, we witness such a peculiar liability to zymo- 

 tic diseases, as clearly indicates that the state of the blood is peculiarly favor- 

 able to the action of the zymotic poison. This is pre-eminently the case in the 

 puerperal state, in which the tissue of the uterus is undergoing rapid disinte- 

 gration, its vital force having been expended ( 110); for there is now abundant 

 evidence, that the contact of decomposing matters which would be innocuous at 

 other times, is capable of so acting upon the blood of the parturient female, as to 

 induce that most fatal zymosis which is known as " puerperal fever/' 1 And 

 her peculiar liability is in no respect more manifest than in this; that the poison 

 by which she is affected may have lain dormant for weeks or months, for want 

 of an appropriate nidus, and will yet exhibit its full potency on the very first 

 case in which opportunity may be given for its introduction into the system of 

 a puerperal patient. 3 The same kind of liability is displayed in the subjects of 

 severe injuries, among whom, also, there is not only a depression of the vital 

 powers, but also a special source of decomposing matter in the system ; for there 

 is evidence that " surgical fever" may be induced in them by the introduction 

 of a zymotic poison derived from a variety of external sources (amongst others, 

 from patients affected with puerperal fever), such as would have no effect upon 

 a healthy subject; and, moreover, that overcrowding in hospitals has a special 

 tendency to increase this liability. 3 So, again, an excess of muscular exertion, 

 producing an unusual " waste" of tissue, especially when the elimination of the 

 products of this waste is interfered with by imperfect respiration, is well known 

 to engender a peculiar liability to zymotic disease ; and this, too, finds its ex- 



1 For a most marked and convincing example of this kind, see Dr. Routh's paper on 

 "The Causes of the Endemic Puerperal Fever of Vienna," in the " Medico-Chirurgical 

 Transactions," vol. xxxii. p. 27. That the poison which develops puerperal fever, may be 

 conveyed from patients laboring under almost any other form of Zymotic disease tending 

 to putrescence, that is propagable by contact such as scarlatina, smallpox, or erysipelas, 

 is now the general opinion of most practitioners who have paid special attention to the 

 subject. 



2 This is shown by the instances, unhappily of no unfrequent occurrence, in which prac- 

 titioners who have unfortunately become the vehicles of the puerperal poison, and have 

 conveyed it to several patients in succession, have experienced the same direful results 

 immediately on resuming obstetric attendance, after a lengthened interval of suspension 

 from it, and even from professional employment of every kind. 



3 See Prof. Simpson "On the Analogy between Puerperal and Surgical Fever," in the 

 "Edinb. Monthly Journ." vol. xi. p. 414; and vol. xiii. p. 72. 



