Page:A dissertation on the puerperal fever (1789).djvu/12

 by an obtrusion of the secretion of the milk, while many others imagine it arises from a suppression of the lochia merely.

It commonly begins, like other fevers, with rigour on the 1st, 2d, and 3d day after delivery, which is followed by great pain and soreness over the whole hypogastric region; there is a sense of heat and throbbing about the region of the uterus. There is much thirst, pain in the head, chiefly in the parts about the eye-brows, a flushing in the face, anxiety, a hot, dry skin, quick and weak pulse, though sometimes it will resist the finger strongly, accompanied with other signs of inflammation; a shortness in breathing, high coloured urine, and a suppression of the lochia.

A change in the quality of the lochia takes place, together with a tenesmus. Sometimes the patient vomits, from the beginning, a matter resembling what is discharged in the cholera morbus.

When the fever has continued a few days, the symptoms of inflammation usually subside, and the disease takes a putrid form; a bilious or putrid diarrhœa supervenes, the stools become involuntary, and the patient dies.

Although this disorder begins sometimes like a regular fever, and at others shows symptoms of genuine inflammation; yet it seems to differ from both, and exhibits those symptoms of irritation, with sudden depression of strength, quick and low pulse, dizziness, glazy eyes, and that species of delirium which denote a diminished energy of the brain; the symptoms are such as commonly arise when the mucous