PARTURITION FEVER. 



397 



fever in their nature, their anatomical alterations, and their symp- 

 toms : 



1. Puerperal fever, puerperal septicemia, or the inflammatory form 

 of vitulary fever of the ancients, which is also looked upon as a 

 phlegmonous or ^'diphtheric'' nephritis, a gangrene of the uterus, 

 or a metro-peritonitis. Produced by septic matters, it is especially 

 characterized by acute inflammation of the vagina and uterus, and 

 it leads to a general septic infection. 



2. Puerperal eclampsia, the " nervous or paralytic form " of the 

 ancients, also designated quite improperly by such expressions as 

 vitulary fever, fever of parturition, milk fever, etc. According to 

 Franck it would essentially consist of a cerebral congestion, accom- 

 panied by œdema and encephalic anemia, a condition occasioned by 

 the too abrupt retraction of the uterus, and made apparent by a 

 deep nervous depression, general paralytic symptoms, and more 

 rarely by convulsions. 



The theory of Franck on the pathology of the paralytic form of 

 parturient fever has been combated by Schmidt and Muhlheim. 



These latter authors consider paralytic vitulary fever as the result 

 of a poisoning produced by the resorption of an agent similar to the 

 sausage or meat poisons ; this agent is said to be the product of a 

 special decomposition (different from putrid decomposition) of the 

 lochia excluded from the air by rapid occlusion of the neck of the 

 uterus (os uteri) ; paralytic vitulary fever would thus be an accident 

 similar to those known in hygiene under the name " botulism." 



The tonic symptoms would consist essentially in paralysis or 

 paresis of the striated muscular fibre of the extremities, of the 

 trunk, the tongue, the covering of the palate, the œsophagus, the 

 larynx, the superior eyelid (ptosis), etc., and of the unstriped mus- 

 cular fibres of the intestine and bloodvessels, while any anatomical 

 macroscopic alteration would be wanting. 



The other theories or hypotheses upon the nature of vitulary 

 fever have merely an historical interest. 



1. The old theory (Bentele, Born, Allemanni, and others) con- 

 sidered milk fever as a lacteal metastasis. Certain authors are 

 believed to have observed this in the kidneys (milky urine), in the 

 abdominal cavity (milky peritoneal contents), in the lung (lactiform 

 nasal discharge), etc. But these lesions and symptoms belong 

 evidently to metastatic nephritis, to peritonitis, or to pneumonia 

 occurring m the course of pyemia. 



