PUERPERAL FEVER, an infectious dis ease of women occurring shortly after child birth, or following a miscarriage, accidental or induced. It is caused by a micro-organism, usually a bacterium (Streptococcus), and is communicated by contact with unclean hands, instruments or clothing which may have brought the infection, just before, during or after the birth of the foetus. Only in the rarest of in stances does it occur when due precautions as to absolute surgical cleanliness have been ob served. It usually begins within a week after the termination of pregnancy, ordinarily from the third to the fifth day, and is attended with acute inflammation of the reproductive organs and with septic infection of the blood and body at large. It is always an infection from with out, and is preventable by rigid aseptic mid wifery. The symptoms will vary very widely according to the infecting organism and the severity of the infection. A slight amount of
fever and some local extension of tenderness may be the only symptoms present in mild cases. In septicamic cases there is usually a decided chill about the third or fourth day, and is attendant with acute inflammation of 103°, 105° F. with general depression and rapid pulse. The temperature usually remains high and then suddenly drops as the patient re covers. In the severest cases, the pyaemic infections, the blood-current becomes infected; chills, temperature, sweats occur and recur, and the patient usually dies. The treatment is purely medical, sometimes surgical, and needs the skilled physician and nurse. Prevention is the demand of the modern woman, and she is entitled to it. Unskilled and dirty midwives, unclean doctors and abortionists are responsible for practically all of the deaths due to childbed fever.