PATHOLOGY AND TREATMENT OF PARTURIENT FEVER. 503 
discussion under the head of parturient fever; it seems to us 
there can be no good reason for continuing to discuss such a 
condition as a fever. True, the condition is the most common 
of all that befalls the parturient female, and yet is just such as 
would follow mechanical injuries to the uterus at its serous in¬ 
vestments from any cause. Such a case, we opine, differs in no way 
from one caused by injuries to those organs from instruments, 
operations, blows, wounds, &c., in the non-parturient female. If 
it be found, however, that the introduction of morbific agents by 
the instruments, or hands of the obstetrician, produce such con¬ 
ditions, if it be found that metro-peritonitis is a link in the chain 
of blood-poisoning, then our premises are untenable; but we do 
not think this can be shown. Thousands of cases of so-called 
parturient fever are cases of septicaemia and pyaemia running their 
well-marked courses, without inflammation of the uterus, or in¬ 
volving either the pelvic connective tissue, peritoneum or abdom¬ 
inal peritoneum; but almost invariably affecting the serous in¬ 
vestment of the lungs. Most authors hold to the doctrine, and 
teach the autogenetic origin of parturient fever. It is said that 
decomposition of retained placenta, secundines, blood clots, &c. ? 
enter the circulation by the lymphatics or blood vessels. If by 
the latter, through the patulous sinuses at the placental site, often 
through wounds or rents in the cervix uteri, or in primipara by 
way of the ruptured fourchette. Even the lochia, we are in¬ 
formed, pouring over the wounded parts, may impart the dreaded 
virus. We accept all this, but we also hold that a primary cause 
may exist, viz., “ a pathological aptitude,” a disposition in the 
blood of the parturient herself. If you ask why, we answer, 
because the cervix is almost invariably lacerated more or less at 
each delivery, and especially is this true of primipara. Portions 
of the membranes are almost always left to decay, and blood-clots 
in a state of decomposition pass over these abraided surfaces 
daily, and yet no blood infection takes place. Again, most of 
you have met with examples of a dead foetus being retained in 
utero for weeks, nay, months perhaps, and yet there was neither 
metritis, or peritonitis, or blood poisoning. It is a common 
practice among country practitioners, and probably some city 
