666 PATHOLOGY OF PARTURITION. 



after-biith or lochia : it was more dry than moist, and the cervix was covered by a small 

 quantity of mucus. The color of the uterus contrasted strongly with that of the vagina, 

 the posterior part of which was congested, and towards the vulva was a wide patch of 

 ecchymosis. The upper surface of the lining membrane was dry. In the udder was 

 plenty of milk of good quality. The kidneys and bladder were normal ; the latter was 

 filled with reddish urine. The blood in the vessels was dark-colored and inclined to 

 coagulate. There were a few ecchymosed spots on the surface of the heart, which was 

 otherwise healthy. The lungs were normal, though full of dark blood, and emphyse- 

 matous at the left anterior border ; the bronchial mucous membrane was of a livid-red 

 hue, and without mucus ; out of the trachea, as well as from the nostrils, flowed a quan- 

 tity of fluid mixed with food. When the head was cut off no fluid escaped. The dura 

 mater of the brain was normal ; no fluid in the sub-arac^noideal space, but the arachnoi- 

 deal membrane and pia mater appeared somewhat infiltrated and opaque. The brain- 

 substance had a natural hue without blood-points {punda vasculosa) on section. There 

 was no trace of fluid in the ventricles. The other organs were healthy. 



Nature. 



With regard to the nature or efficient cause of the disease, there has 

 been, and is even now, much divergence of opinion, as already stated. 

 With some authorities it is a fever — a nervous or paralytic form of par- 

 turient fever, closely allied to the puerperal fever of woman, and due to 

 a blood-poisoning : the two forms only differing in degree. But we have 

 shown that there is no fever ; that the temperature is rarely above, but 

 is generally below, the normal standard ; and that sometimes the animal 

 recovers — all the symptoms disappear in a remarkably brief space of 

 time, and leave not the slightest trace of either fever or inflammation.^ 

 This theory is opposed to the most careful and exact observations, and 

 is evidently based upon erroneous notions, or through mistaking metritis 

 or metro-peritonitis, with its septic fever, for this disease. 



With other writers the disease is considered to be a grave form of 

 gastric fever — this opinion being based on the circumstance that there is 

 constipation, and impaction of the digestive organs with hard dry food. 

 But impaction does not produce the symptoms of parturient apoplexy, 

 neither does it cause death in such a brief period. Again, it is supposed 

 that mephitic gases, generated in the digestive apparatus, enter the blood, 

 alter it, and so produce disturbance and stupefaction in all the organs. 

 But no proof of the existence of such a gas i^ given us. 



The increase in the proportion of white corpuscles in the blood to- 

 wards the end of pregnancy and after parturition, has led some writers 

 to imagine that the disease might be a kind of leucocythaemia. But it is 

 evident that this cannot be so. 



Again, the disease has been considered as in its essence a cerebral or 

 spinal congestion, encephalitis, myelitis, a meningo-cephalitis, or a cere- 

 bral or medullary apoplexy, according to the nature or the scr.t of the 

 lesions found after death. But some of these opinions are opposed by 

 the fact, that many of the lesions on which they are based are not found 

 in all cases of death, and that recovery is often quite rapid. With re- 

 gard to cerebral congestion and apoplexy we shall have to refer hereafter. 



Many high authorities — such as Kohne, Carsten-Harms, Wannovius, 

 Fusch, Roll, Baumeister-Rueff, Barlow, and others — have maintained that 

 the disease is primarily a derangement or paralysis of the ganglionic 

 nervous system, which affects, or is extended to, the spinal cord and 

 brain during the course of the disease. The following explanation is 

 offered in support of this opinion. A too easy birth throws out of play 

 a certain amount of the nervous force destined to the accomplishment of 

 this act. Hence, there is a disproportion between the polar tension of the 



