PUERPERAL SEPTICAEMIA. 
341 
was generally accepted throughout Europe. It has, however, 
recently been successfully combatted by Schmidt and Muhl- 
heim, who in place of Franck’s theory believe that the para¬ 
lytic form of vitulary fever is due to a poisoning by an absorp¬ 
tion into the system of various ptomaines similar to the poison¬ 
ing which sometimes occurs in man through the consumption 
of certain meats and sausages—a condition known as botulism. 
It is the assumption of these authorities that septic intoxication 
takes places through the uterus, and that the ptomaines result¬ 
ing from the rapid multiplication of the septic microbes in the 
lochia of the occluded uterus, is the exciting cause of this fatal 
disease. 
This I believe to be the true etiology of the so-called milk- 
fever, parturient apoplexy, puerperal paresis, parturient eclamp¬ 
sia or whatever name may be employed to express the conditions 
under consideration. It is evident, however, that if this hypo¬ 
thesis as to its etiology is correct, that the more correct and ex¬ 
pressive term is puerperal septicaemia and I believe that as its 
pathology becomes better understood this term will commend 
itself to all. 
Septicaemia is defined in a general way as the pathological 
condition which follows the penetration of putrid matters into 
the system. Now, as putrefaction is a complex fermentation 
which takes place only through the intervention of microbes, 
it is evident that septicaemia cannot exist, unless artificially 
produced, without the presence in the system of microbes pro¬ 
ducing ptomaines or toxines resulting from their proliferation. 
The microbes which give rise to septicaemia are various, 
and, according to the work on microbiology by Mosselmann and 
Lienaux, the pyogenic germs can also give rise to septicaemia. 
According to the above authority, the streptococcus pyogenes 
aureus is the cause of puerperal fever, also the stapliylocoocus 
pyogenes aureus has been found in the blood in several cases of 
septicaemia. In such cases the virulence of these germs is 
very great and death follows too quickly to allow the forma¬ 
tion of pus. - - 
