Child Bed Fever. Puerperal Fever. Septicemia.
Few complaints more justly excite the dread of the practitioner than this. It cuts down woman at a time when she can least of all be spared by her young offspring, and at a moment when she most excites the love and sympathy of her whole family. It is a terrible disease.
Until after the discovery of the germ character of many diseases, this fearful scourge was only suspected by medical men to be contagious. It has, however, long since been found to be highly contagious and propagated by the ordinary routes of travel by physician, nurse, friend, etc., who come in contact with women about to be confined or with people who have open wounds.
We know that when a woman is confined the germs which naturally belong on the skin and in the vagina, if introduced into the little lacerations and wounds which are liable to ensue during labor, set up a violent form of blood poisoning,, which, for its severity, rapidity of development, and direful consequences, surpasses all other infectious diseases. Child bed fever is purely and simply a germ disease, caused by unclean hands, unclean instruments, unclean napkins, or, in fact, anything which contains germs, being brought in contact with the mother. For a further understanding of this causation, see articles on Asepsis, Antisepsis, etc.
It becomes quite necessary for a woman to regard herself as about to undergo a surgical operation when she is to be confined, for the simple reason that she should be prepared for the labor just as the patient is for the operation, that she may have all the advantages of skilled nursing and the many little antiseptic precautions which render not only operations but labor itself safe.
Symptoms. The train of symptoms belonging to this dreadful malady are too well known to many to repeat them in much detail. The first that one carefully observant of the sick one notices, is a slight rise of temperature, then perhaps follows a chill, sweating and headache; discharges begin to smell badly, the bowels enlarge from the formation of gas; the stomach is upset, and finally, if the disease is not checked, the infection spreads to the tubes and ovaries and into the general abdominal cavity, when death soon steps in to end the frightful scene.
Treatment. The nurse should always be on the alert to discover the least rise in temperature or any beginning odor; it is just here that valuable time is often lost. The womb has become infected, but as yet the septic inflammation is only on the inside of the organ. At this point vigorous measures must be at once inaugurated and the womb thoroughly irrigated with some disinfectant solution, like the, corrosive sublimate solution, with carbolic acid solution or sulpho naphthol solution. If this measure, repeated every eight to twelve hours, does not speedily correct the odor, lower the temperature and improve affairs at once, a thorough curetting of the entire lining of the womb must be made, as described under womb diseases (page 435) and the organ daily irrigated or packed with iodoform gauze.
In many cases the womb and its belongings may have to be removed entirely. Blood tonics must be employed from the first, and the infection thoroughly removed lest subsequent womb troubles ensue.
It is a well known medical fact that in blood poisoning the use of alcohol may be pushed to a degree that would be thought unwise in other troubles. Enough whiskey or brandy should be given to a patient to keep him stimulated until such time as the temperature and the pulse are in normal condition.
The chief preventive of this disease is extreme cleanliness and care in warding off its causes.
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