ON PUERPERAL EEVEli. 
43 
a time, be retarded in our progress by difference in opinion, arising 
from the misconception and the mistaking the cause for the effect ; 
but in the end the facts which will be adduced, and the force of 
truth, like merit, will rise above every opposing obstacle. 
I, for one, infer that the universal appearance of peculiar abnormal 
lesions, and the deranged state of certain viscera, stamp the cha- 
racter of the disease ; and it is this, aided by the manifestations of 
morbid actions and appearances during and after life, that have in- 
duced me to consider the general 
Predisposing cause to be a depressed or weak state of vital power, 
especially as it stands related to the organic nervous system ; im- 
pairing the digestive and assimilating powers, and which is gene- 
rally consequent upon the influence of certain physical agents, as 
inactivity, plethora, &c. and conducing to enfeeble the powers of 
volition. It may occasionally be dependent upon pathological 
causes, as a pre-existing abnormal state of some portion of the spinal 
track. All of these concurring to produce debility in some of its 
various forms, the excitory nerves become depressed, and being no 
longer able to issue their mandates with energy, the servants of this 
principle of organic life — the voluntary nerves — become indolent and 
enfeebled, and then accrues the operation of the exciting causes 
which I have arranged into, first, mechanical ; second, physical ; 
and, thirdly, pathological. 
Under the first of these may be considered that state of collapse 
which is induced by the contraction, alteration, and displacement 
of structure, consequent upon the expulsion of the foetus. The 
physical causes may be the excitement attendant upon parturition, 
premature exposure to cold, or to cold and humidity conjoined ; 
and also high ranges of temperature, which may have been a pre- 
disposing cause as tending to enfeeble the vital energies, hut now, 
from continued action, becomes an exciting one. The pathological 
cause I assign to be a sudden or imperfect division of nervous and 
vascular action or power, and, what is more than probable, a mor- 
bid state of the circulating fluids. 
I cannot do better than close this part of my thesis in the lan- 
guage of one whose name will be cherished as long as the science 
of medicine is known. “ Although diminished energy of the powers 
of life has a marked influence in favouring the operation of the 
exciting causes, yet something more is required; and this must be 
referred to a certain constitution of frame, which is influenced 
sometimes in a relative manner only by relative causes, and at 
other times only by positive causes ; and which often either resists 
the operation of the usual causes altogether, or yields merely to 
the combined action of a greater or less number*.” 
* Dr. Copland. 
