PUERPERAL INFECTIONS. 



During the puerperal state,' the great vascularity of the entire 

 genital system, combined with the denudation of all that portion 

 of the uterus occupied by the placenta, and the almost inevitable 

 abrasions and lacerations of some of the parts, tends very strongly 

 to lead to infections of a more or less serious character. The de- 

 tachment of the fetal from the maternal placenta leaves a vast 

 denuded surface, which, in relation to infection, is somewhat 

 comparable to a wound. If to this is added wounds, contusions 

 and abrasions, of a more or less extensive character, the tend- 

 ency to infection is still more increased. 



In the separation qf the placenta there is inevitably some escape 

 of blood and other fluids into the uterine cavity, which, if not 

 promptly expelled, act as foreign bodies and invite infection in 

 the part. If the placenta for any reason fails to become detached 

 and expelled at the proper time, it inevitably undergoes decom- 

 position and leads with certainty to a greater or less degree of in- 

 fection of the uterus and vagina, with possible involvement of 

 distant parts and the general system. Added to all this, when 

 dystokia occurs and the animal is weakened , the genital organs 

 are debilitated, do not contract and close as they should, and 

 infection is directly carried into the uterus by the ignorant or 

 careless operator, upon the hands, instruments or apparatus. 



It is consequently not so much to be wondered that infection 

 frequently occurs during the puerperal state, but rather that such 

 infection does not occur with greater frequency. Infections re- 

 ferable to the puerperal state are consequently of the greatest 

 possible variety in intensity, location, character and symptoms. 

 It is difl&cult to draw definite lines between the various forms, 

 nor is it possible to describe all forms of infection. We shall 

 endeavor to describe only those of leading importance, which 

 offer some special train of symptoms, and permit of classification. 

 They all trace to the one common source — the entrance of infec- 

 tion into some part of the genital tract during the highly sus- 

 ceptible puerperal state. From the genital tract the infection 

 may extend to neighboring or distant parts, or involve the entire 

 system in more or less grave disease. 



871 



