PARTURITION FEVER. 



403 



also from a dead and decomposed foetus, etc. (auto-infection), or 

 introduced by the obstetrician's hand, or by instruments, sutures, 

 etc.; at other times an infection by neighboring animals which are 

 affected by vitulary fever, non-delivery, or abortion. The infectious 

 agents enter through wounds on the mucous membrane produced 

 through brutal or ignorant interference in difficult or complicated 

 parturition (foetal dystocia, embryotomy, premature violent me- 

 chanical separation of the foetal envelopes). 



The infectious process requires a certain time for its accomplish- 

 ment ; ordinarily the disease appears on the third day following 

 parturition. 



Pathological anatomy. Except in some rare cases of subacute 

 evolution in which no local inflammatory alteration has had time 

 to be produced, we find upon the mucous membrane of the vagina, 

 the OS uteri, and the womb so-called puerperal ulcerations ; they 

 occupy the place of primitive wounds, and are also covered by a 

 necrotic or " diphtheric^' exudate of bad aspect, or by granulations. 

 These ulcerations are surrounded by an œdematous tumefaction, 

 which sometimes extend to the vagina or the internal side of the 

 thighs. The other regions of the utero-vaginal mucous membrane 

 are invaded by a phlegmonous inflammation, which, in carnivorous 

 animals, often ends in a '^diphtheric" eschar (colpitis or vaginitis 

 and phlegmonous or croupous endometritis); in this variety the 

 mucous membrane is of a dirty-brown or greenish-black color, 

 covered with ulcerations and coated with an ichorous and fetid 

 muco-pus ; in certain places it is transformed into a pultaceous, 

 necrotic matter, immediately upon the mucous membrane, which is 

 laid bare by the elimination of gangrenous spots. 



The uterus is not contracted, its walls are friable, softened, and 

 infiltrated by a serous or purulent liquid ; the lymphatic vessels 

 and the thrombosed veins are filled with pus. Under the micro- 

 scope we find the lymphatic interstices of the muscles filled with 

 colonies of micrococci (Letzerich) ; the muscular fibres are affected 

 with turbid tumefaction or with fatty degeneration. There are at 

 times abscesses formed in the muscular tissue (phlegmonous metritis). 

 The connective tissue is also œdematous, infiltrated with pus, filled 

 with small abscesses (phlegmonous parametritis). 



Later, the peritoneal coating of the uterus, the pelvis, and at 

 times the whole peritoneum, show lesions of serous, purulent, or 

 putrid inflammation (perimetritis, pelvi-metritis, diff*use peritonitis). 



