The Tragedy of Childbed Fever

The bicentenary of James Young Simpson (1811–1870)

“…From 1840, being aware of Alexander Gordon's work on preventing puerperal fever (Aberdeen, 1795), Simpson claimed that the infection could be transmitted through the hands of midwives [16] and taught his students so; he used a solution of potassium cyanide to wash his hands before operating [17]. This preceded the 1847 publication by Semmelweis on the efficacy of washing hands with chlorine water.…”

General practitioners and obstetrics: a brief history

“…The defeat of puerperal fever by the sulphonamides -the most important advance in the whole history of obstetrics -began in 1937. 9 In addition, antenatal and postnatal care were becoming routine in the late 1930s, the concept of the obstetric flying squad was introduced, and ergometrine played a large part in the treatment of postpartum haemorrhage.…”

“…By the 1950s there were about 400 such hospitals scattered widely through England and Wales. 9 They tended to be friendly institutions in which GPs and groupattached midwives worked closely together providing continuity of care and delivering the patients close to their home. 11 These GP community hospitals give us a glimpse of a way in which an NHS obstetric service based on GPs and midwives attached to practices might have evolved.…”

An early Medical Research Council controlled trial of vitamins for preventing infection

“…A large majority of the seriously ill and fatal cases were due to Streptococcus pyogenes, but a few were due to Staphylococcus aureus and some milder cases were due to Bacterium coli. 4 In the early years of the nineteenth century, when nosography and nosology were based on postmortem appearances, there were numerous synonyms for puerperal fever. We can forget these, except to say that the original term 'puerperal fever' managed to survive until the 1890s as the title of first choice.…”

“…For this reason, the published notifications of puerperal fever between 1899 and the 1930s are so flawed as to be valueless. 4 Now the title of this paper-'Diet as a Prophylactic Agent against Puerperal Sepsis'-states clearly that it has measured the incidence of 'sepsis' in a group of 550 postnatal women. 1 Yet the list of diseases included under this definition (Table 1 on page 596) included cystitis (nine cases), mastitis (seven cases), influenza (one case), gonorrhoea (one case), cervicitis (one case) and septic perineum (two cases).…”