Part 182

Psychical treatment of hydrophobia, 906

Public sewers, 224

PUERPERAL FEVER, 984 Definition, 984 Frequency, 984 Etiology, 1013 Atmosphere, impure, influence on causation, 1013, 1014 Malaria, nosocomial, influence on causation, 1013 Micro-organisms, influence on causation, 1013-1015 Lochial discharge, influence on causation, 1015 Atmosphere, peculiar states of, on causation, 1016 Direct inoculation, 1016 Contagiousness of, 1017 Contagion, physicians as carriers of, 1017 Dissecting poison, 1018 Self-inoculation, 1019 Morbid anatomy, 985 Spiegelberg's classification of puerperal inflammations, 986 Endocolpitis and endometritis, 986 Diphtheritic ulceration, 986 Metritis and parametritis, 987 Diphtheritic endometritis, 987 Pelvic cellulitis, 988 Cellulitis from specific infection, 988 Peritonitis, pelvic and diffused, 988 exudation in, 989 general, 989 appearance of abdominal cavity, 989 ovaries, 989 Phlebitis and phlebo-thrombosis, 989 Thrombi in uterine and pelvic veins, 989 Abscesses, 989 pulmonary, 989 Veins, inflammation, 989 Thrombi, growth, 990 Septicæmia, 990 Abscesses, metastatic, 990 Endocarditis, ulcerative, 990 Pleuritis, 990 Joints, purulent inflammation, 990 Earlier views concerning nature, 990 Modern view concerning nature, 992 Septic origin, 993-1003 Bacteria, relation to causation, 994 Koch's investigations of, 997 physical characters, 999 modes of entering the circulation, 1000 action of, upon the blood, 1000 Diphtheria of genitalia, characters, 1002 Relation of, to erysipelas, 1002 Inflammatory affections of non-specific origin, 1003 Symptoms, general, 1004 Incubation period, 1004 Chill, significance of, 1005 Of endometritis and endocolpitis, 1005 temperature, 1005 Parametritis and perimetritis, 1005 Incubation, 1006 Temperature, 1006 Pulse, 1006 Relapse, 1006 Headache, 1007 Pains, 1007 Vomiting, 1007 Duration, 1007 Exudation, 1007 Uterus fixity of, 1007 Tumors in iliac fossa, 1008 Abscesses, 1008 location, 1008 pointing of, 1008 Local peritonitis, 1009 Of psoas abscess, 1010 Of peritonitis, general, 1010 Pains, 1010 Abdomen, state, 1010 Respiration, 1010 Vomiting, 1010 Vomit, characters, 1010 Fever, 1010 Skin, 1010 Pulse, 1010 Pyæmic form, 1011 Of septicæmia lymphatica, 1011 Mode of onset, 1011 Temperature in, 1011 Abdomen, state, 1011 Skin, state, 1011 Vomiting, 1011 Tongue, condition, 1011 Pulse, condition, 1011 Respiration, 1012 Pleurisy in, 1012 Endocarditis, 1012 Mental condition, 1012 Joint affections in, 1012 Duration, 1012 Of septicæmia venosa, 1012 Chills in, 1012 Fever in, 1012 Temperature in, 1012 Pulse in, 1012 Abdomen, state of, 1012 Uterus in, 1012 Of pure septicæmia, 1013 Mortality, 1020 Relation of, to zymotic diseases, 1020 Prophylaxis, 1021 Maternity hospitals, advantages, 1021 Necessity of light and air, 1024 Antisepsis, value, 1024 methods, 1025 Sulphurous acid, use, 1025 Corrosive sublimate, use, 1025 Iodoform, use of, intra-uterine, 1025 Vaginal injections, carbolized, use, 1025 Tarnier's maternity pavilions for prevention, 1027 Treatment--indications, 1028 Disinfection, 1028 Local, 1028 Use of hydrochloric acid, 1028 Persulphate of iron, 1028 Intra-uterine injections, use, 1029 dangers of, 1029 methods, 1029 Corrosive sublimate, use, 1025, 1029 Pain, peritoneal, 1031 Use of opium, 1031 in pyæmic variety, 1031 Leeches, 1031 Turpentine stupes, 1032 Hyperpyrexia, 1032 Use of purgatives, 1032 Quinia, 1032 Sodium salicylate, 1032 Veratrum viride, 1033 Digitalis, 1033 Alcohol, 1033 Cold in, 1033 Cold, method of applying, 1034 Cold water, intra-uterine injections, 1034 Baths, cold, use, 1034 Kibbie's fever-cot, use, 1034, 1035 Coil, 1036 Diet, 1036 Encysted peritoneal effusions, 1036 Quinia, use, 1036 Pelvic exudations, 1036 Pelvic abscesses, 1036

Puerperal septicæmia, relations of, to obstetrical scarlatina, 499 women, general sepsis from diphtheria in, 674 symptoms of diphtheria in, 674

Pulmonary abscess in puerperal fever, 989 collapse, complicating influenza, 869 complications of typhus fever, treatment, 367 oedema, complicating rubeola, 572

Pulsation of jugular veins, significance of, in general diagnosis, 156

Pulse and temperature, relation of, in yellow fever, 644 average frequency in health and disease, 154 characters of, in erysipelas, 633 in idiopathic parotitis, 623 in general peritonitis of puerperal fever, 1010 in septicæmia, 977

Pulse, characters of, in septicæmia lymphatica of puerperal fever, 1011 venosa of puerperal fever, 1012 condition of, in acute glanders in man, 921 in beriberi, 1040 in cerebro-spinal meningitis, 815 in cholera, 737 in dengue, 881 in influenza, 866 in pyæmia, 975 in relapsing fever, 382 in typhus fever, 351 significance of, in general diagnosis, 152 in malignant scarlet fever, 507 in typhoid fever, 275 kinds of, 154 methods of examining, 153 relation to respiration, 154 temperature, relation of, in relapsing fever, 382

Pupil, significance of state of, in general diagnosis, 151

Pupils, condition of, in cerebro-spinal meningitis, 810

Pure septicæmia of puerperal fever, 1013

Purgatives, use of, during hot stage of intermittent fever, 596 in cerebro-spinal meningitis, 830 in hemorrhagic form of pernicious malarial fever, 613 in puerperal fever, 1032 in remittent fever, 604

Purity of water, standards of, 184

Purpura, complicating diphtheria, 674

Pus, 48 influence of, in production of pyæmia, 955 in stools, significance in diagnosis, 164

Pustule, malignant, 926

Putrefaction of cadaver, rapidity of, in puerperal fever, 971

Putrified flesh as a means of disseminating typhoid fever, 257

PYÆMIA AND SEPTICÆMIA, 945-955 History, 945-952 Nomenclature, 952 Pyæmia, 953 Definition, 953 Septicæmia, 953 Definition, 954 Etiology of pyæmia, 955 Theories concerning, 955 Pus, influence of, in production, 955 Character of production, 956 Thrombosis, relation of, to causation, 957, 958 Contamination of blood, influence of, in causation, 958 sources, 958 Germs, disease-, influence of, in causation, 958 Wounds, characters of, influence on causation, 958 Etiology of spontaneous pyæmia, 959 Wounds of alimentary canal and genito-urinary apparatus as cause, 959 Air, vitiated, influence of, on causation, 959 Spontaneous origin, 959 Contagiousness, 960 Chemical origin, 960 Living organisms, influence of, on causation, 958-960 Etiology of septicæmia, 960 Septic intoxication, relation of, to, 961 Traumatic fever, relation of, to, 962 Dissecting wounds, relation of, to causation, 962 Putrid substances, maximum toxic action of, on the body, 962 Lymphatics as channel of entrance of poison, 963 Etiology of septo-pyæmia, 963 Pathology, 963 Condition of blood, 963 in pyæmia simplex, 963 multiplex, 963 Metastasis, conditions, 964 Pus, mode of entering the circulation, 964 Metastatic abscesses, production, 964 from primary infection, 964 from secondary infection, 964 Emboli, action of, in production of metastatic abscesses, 964 Thrombi, action of, in production of metastatic abscesses, 965 Seat of pathological changes, 965 Fat emboli, influence of, in production, 966 Morbid anatomy, 966 Of pyæmia, 966 Appearance of body, 966 Rigor mortis, 966 Lesions of cellular tissue, 966 Muscles, 966 Brain and membrane, 966 Retina and choroid, 967 Cornea, 967 Ear, 967 Bones, 967 Joints, 967 Parotid gland, 967 Arteries and veins, 967 Blood, 968 Pericardium, 968 Pleuræ, 968 Lungs, 968 Liver, 969 Spleen, 969 Kidneys, 969 Micro-organism in blood, changes effected by, 970 Pyæmia simplex, 970 Absence of abscesses in, 970 Septicæmia, 971 Putrefaction of bodies, rapidity of, 971 Blood, lesions of, 971 Sepsin, nature, 971 Lesions, nervous system, 972 Endo- and pericardium, 972 Lungs, 972 Pleuræ, 972 Kidneys, 972 Spleen, 972 Uterus, 972 Ovaries, 972 Bladder, 972 Of septo-pyæmia, 972 Symptoms, 972 Of pyæmia, 972 Prodromal stage, 973 Chills, date of appearance, 973 frequency, 973 Temperature, 974 Perspiration, 974 Eruptions, 974 Pulse, 975 Tongue, condition of, 975 Vomiting, 975 Singultus, 975 Diarrhoea, 975 Stools, character of, 976 Heart, condition of, 976 Lungs, condition of, 976 Liver and spleen, enlargement, 976 Urine, 976 Joints, suppuration, 976 Abscesses, frequency, 976 Delirium, 976 Breath, odor of, 976 Wound, changes, 976 Of septicæmia, 976 General, 976 Wound, condition of, 977 Temperature, 977 Abdomen, state of, 977 Pulse, 977 Diarrhoea, 977 Vomiting, 977 Tongue, 977 Singultus, 977 Bronchitis in, 977 Of gangrene foudroyante, 977 Skin, condition, 977 Diagnosis, 978 Of pyæmia from septicæmia, table showing, 978, 979 Treatment, 979 In fully-developed cases unsuccessful, 980 Preventive, 979, 980 Cleanliness, necessity of, in prevention, 980 Atmosphere, pure, necessity of, in prevention, 980 Food and drink, proper, necessity of, in prevention, 980 Cheerful and pleasant surroundings, in prevention, 980 Antiseptics, use of, 980 Local, 981 Of wound, 981 Metastatic abscesses, 981 Constitutional, 982 Sulphites of magnesium, sodium, potassium, and lime, use of, 982 Use of alcohol, 982 Quinia, 982 Ergotine, 982 Diet, 982 Stimulants, 982 Of septicæmia, 982 Indications for, 982 Local, 983 Preventive, 983 Of wound, 983 Diarrhoea, 983 Antisepsis, 983 Sulphites and hyposulphites, use of, 983 Quinia, use of, 983 Of puerperal septicæmia, 983 complicating erysipelas, 634 typhoid fever, 295 typhus fever, 356

Pyæmic form of general peritonitis of puerperal fever, 1010

Quarantine in cholera, 204, 755 in leprosy, 794 in the plague, 783

Quinia, use of, in cerebro-spinal meningitis, 833 in dengue, 885 in diphtheria, 708, 712 in erysipelas, 637 in influenza, 874-876 during cold stage of intermittent fever, 595 hot stage of intermittent fever, 596 sweating stage of intermittent fever, 597 to prevent the return of intermittent fever, paroxysm, 598 in hemorrhagic form of pernicious malarial fever, 612 in pertussis, 847 in puerperal fever, 1032, 1036 in pyæmia, 982 in relapsing fever, 426 in remittent fever, 603 in rubeola, 580 in scarlet fever, 543 in septicæmia, 983 in typhoid fever, 330 in typho-malarial fever, 618 in typhus fever, 365 in yellow fever, 651 and opium, use of, in yellow fever, 651

RABIES AND HYDROPHOBIA, 886 Synonyms, 886 Definition, 886 History, 886 Geographical distribution, 886 Etiology, 887 Climate, relation of, to causation, 887 Season, relation of, to causation, 887 Summer heats, relation of, to causation, 887 Hunger and thirst, relation of, to causation, 888 Improper food, relation of, to causation 888 Sex, relation of, to causation, 888 Liability of special breeds, 889 From skunk-bite, 889 Spontaneous origin, 890 Contagion, 891 Modes of dissemination, 891 Milk, propagation by, 891 Saliva, propagation by, 891 Specific germ, 892 Pasteur's experiments as to infectiousness, 892 Point of election of germ, 892 Antagonism between blood and germ, 892, 893 Localization of the virus in the wound, 893 Relation of successful inoculation to bites, 893 Insusceptibility to, 894 Incubation, 894 Duration of, in lower animals, 894 in man, 894 Condition of cicatrix during, 895 Symptoms, 895 In dogs, 895 Importance of recognizing premonitory, 895 Of prodromal stage, 895 Of furious form, 896 During paroxysms, 896 Between paroxysms, 896 Of paralytic form, 896, 897 Of lethargic form, 897 Popular fallacies regarding, 897 In horse and other animals, 897 In man, 898 Symptoms, 898 Prodromal stage, 898 Appearance of wound, 898, 899 Of paroxysms, 899 Duration, 899 Reflex irritability during, 899 Facies during, 899 Mental condition, 900 Delirium during, 900 Relative severity in men and women, 900 Paralytic stage, 900 duration, 900 Without paroxysms, 900 Diagnosis, 900 Pathognomonic features in, 900 From tetanus, 900 From diphtheria, 900 From pharyngeal anthrax, 900 From acute mania, 900 From epilepsy, 901 From hysteria, 901 From pseudo-hydrophobia, 901 Inoculation in doubtful cases, 902 Morbid anatomy, 902 Post-mortem appearance of body, 902 Changes in mucous membranes, 902 Bronchi and pharynx, 902 Lungs, 902 Heart and blood-vessels, 902 Gastro-intestinal tract, 902 Liver and spleen, 902 Kidneys, 902 Bladder, 902 Brain and spinal cord, 902 Pathognomonic changes in dogs, 903 Treatment, 903 Preventive, 903 Registration of dogs, 904 Modes of preventing diffusion, 904 Inoculation, 904 Pasteur's method, 905 Of bites, 905 Use of caustics, 905 Excision of cicatrix, 906, 908 Futility of eliminating measures, 906 Hygienic, 906 Psychical, importance of, 906 Therapeutic, 907 Use of chloroform, 907 Chloral, 907 Pilocarpine, 907 Curare, 907 Morphia, 907 Atropia and daturia, 907 Vaccine virus, 907 Warm baths, 907 Faradization, 907 Inhalation of oxygen, 907 Importance of rest and quiet, 907 Intravenous injections, 908 Venesection, 908

Race, influence of, in causation of variola, 436 protection as a preventive of small-pox, 130 relation of, as causation of rubeola, 561

Rachialgia in cerebro-spinal meningitis, 808

Rash of variola, date of appearance of, 437 significance of, 437 variolous, 437

Raspberry excrescence in vaccinia, 461

Reaction in cholera, 734 treatment, 763