Transactions of the American Association of Obstetricians and Gynecologists for the year ... . mon problem is to continue in our collab-oration with the bacteriologist. We feel that great assistance hasbeen given in the management of puerperal infection by the hos-pital laboratory in the details of culture and spread slide is true that the isolation of the offending bacterium is often oflittle apparent value. Streptococci in uterus cases get welland sterile culture cases die. Investigators argue that we arenot justified in classing a case as streptococcic toxemia just be-cause a few
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . mon problem is to continue in our collab-oration with the bacteriologist. We feel that great assistance hasbeen given in the management of puerperal infection by the hos-pital laboratory in the details of culture and spread slide is true that the isolation of the offending bacterium is often oflittle apparent value. Streptococci in uterus cases get welland sterile culture cases die. Investigators argue that we arenot justified in classing a case as streptococcic toxemia just be-cause a few non-virulent streptococci are found on cervical smear 438 PUERPERAL INFECTION. 439 or uterine culture. The quality and quantity of the particularwomans resistance, however, must be taken into account as wellas the acquired virulence of the same non-virulent bacteria asthey penetrate into wounded and devitalized tissues. When theattending physician knows what organism is at work he always ^ow deli very SOCIETY OF THE LYING-IN HOSPITAL OP THE CITY OF NEW YORK Conococcus infection .. Chart I.—Temperature curve of gonorrheal infection of the early up without sequelae in the first week of the puerperium. feels in better command of the situation. It helps him to judgewhen to be radical and when to be conservative in his attack ifhe is acqainted with the identity of the enemy. Certainly withour present knowledge of the subject the most exact index of thevariety of the infection is the result of cervical and uterine smear 440 JAMES A. H A R R A R. and culture. On the other hand, the clinical picture of pulse,temperature and general condition is the correct index of the bal-ance between the virulence of the particular strain of that organ-ism and the resistance of the patient. There were 225 women in which either the streptococcus, thegonococcus, the staphylococcus or the colon bacillus were found,and the discussion will be confined chiefly to these and to a
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