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1900] 88
erysipelas under treatment in the same house; or it may arise from putrefactive
changes occurring in the genital organs themselves, or by the retention of a part or
parts of the placenta.
From these remarks it can at once be seen that to a large extent the disease is
preventable, and that a great responsibility rests on persons in attendance on
women during their confinement; for as they are careful or negligent in matters of
cleanliness, whether of personal clothing, hands, sponges, instruments, or of
bedding, diapers and patients' clothing, will there be a probability or an improbability
of their patient being attacked. Indeed, it should be laid down as a rule
by everyone in attendance on a patient that they should not touch her without first
carefully disinfecting their hands. Medical men understand the necessity of such
a practice and adopt it; but, it is regrettable to think that midwives or nurses
either through their ignorance or carelessnessdo not; and that consequently puerperal
fever arises more frequently when the patients are under their care than when in
charge of a medical practitioner. There is no question also that many cases
arise through the failure or neglect of nurses to freely use disinfectants (carbolic
acid 1 to 40 or corrosive sublimate 1 to 2,000) in all the necessary washings or
syringings.
The habits of the patient, too, both as regards her personal clothing, her
bedding, her house or rooms have a powerful influence in promoting the disease.
The woman, knowing she is about to be confined, who wilfully or negligently fails
to make her surroundings thoroughly clean and wholesome is undoubtedly going
a long distance on the road to meet this serious disease which so often ends, as
already pointed out, in death.