Infections of the Ovum, Embryo and Fetus 513 



The second group, to which the writer belongs, holds that 

 abortion is not a specific contagious or infectious disease 

 like glanders or hog cholera, but that any infection resident 

 in the cervical end of the uterus, or which during pregnancy 

 invades the uterus, may, amongst other results, cause abor- 

 tion. According to this view there are two essential factors 

 in the causation of abortion : the infection must destroy the 

 life of the fetus (asphyxia or inanition due to placentitis, 

 or sepsis due to bacterial invasion of the fetus) , and must 

 arouse such an irritation of the uterus (localized metritis 

 at the cervical end) as to cause it to contract and expel its 

 contents. Any infection capable of bringing about these 

 two conditions may cause abortion, be it the B. abortus, the 

 bacillus of Nocard, the colon organism of Moussu, the vibrio 

 of McFadyean and Stockman, or the spirillum (vibrio) of 

 Theobald Smith. 



Under this conception, there is no limitation upon the 

 number of species of microparasites which may cause abor- 

 tion, no restrictions upon the variety of lesions and results 

 of lesions which the infection may cause, and no obligatory 

 period of invasion or disappearance fixed for the infection. 



This conception offers many analogies to wound infection. 

 In wound infection there is an extended variety of organ- 

 isms, each capable of producing inflammation, suppuration, 

 ulceration, necrosis, wound fever, etc. The microorganisms 

 are normally present upon the body surface and under or- 

 dinary conditions cause no visible harm to the individual. 

 When, however, the protective epithelium is destroyed by 

 physical violence, chemical irritation, or in various ways, 

 the bacteria upon the surface are pushed into, or otherwise 

 enter th^" damaged tissues and wound infection occurs. The 

 lesion which constitutes the avenue of infection may be visi- 

 ble or invisible to the unaided eye. The epithelium may be 

 destroyed or merely so damaged that it wants the power re- 

 quired to resist the attack. 



A knowledge of the identity of the invading organisms is 

 of great interest but not a vital necessity to the surgeon. 

 The measures which will exclude streptococci will serve also 



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