260 O. W. HOLMES 



in labor; she was so nearly delivered that he had scarcely 

 anything to do. The next morning she had severe rigors, 

 and in forty-eight hours she was a corpse. Her infant had 

 erysipelas and died in two days. 29 



In connection with the facts which have been stated it 

 seems proper to allude to the dangerous and often fatal ef- 

 fects 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. 80 The head pharma- 

 cien 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. 81 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. Trav- 

 ers, who seems to have been poisoned by a fluid which exuded 

 from the body. The other accidents were produced by dis- 

 section, or some other mode of contact with bodies of patients 

 who had died of various affections. They also differed much 



29 Lancet, May 2, 1840. 



30 Stein, L'Art d'Accoucher, 1794; Diet, des Sciences Mfdicalts, art.. 

 * Puerperal." 31 Journal de Pharmacie, January, 1836. 



