The Attempt to Understand Puerperal Fever in the Eighteenth and Early Nineteenth Centuries: The Influence of Inflammation Theory

Puerperal fever was a devastating disease. It affected women within the first three days after childbirth and progressed rapidly, causing acute symptoms of severe abdominal pain, fever and debility. Although it had been recognized from as early as the time of the Hippocratic corpus that women in childbed were prone to fevers, the distinct name, ‘‘puerperal fever’’ appears in the historical record only in the early eighteenth century. The purpose of this paper is to trace some of the ideas within those medical treatises on puerperal fever which were published during the period from 1760 to 1850. Previous historical writing, with the exception of Margaret DeLacy’s overview of puerperal fever in eighteenth-century Britain, and George Lowis’s paper considering the work of Alexander Gordon, has either focused on the innovations of the later nineteenth century or offered a broad overview of the subject which has tended to pass over the eighteenth and early nineteenth centuries with little comment, moving rapidly to the contributions of a later generation of physicians in the later nineteenth and twentieth centuries. Those contributions appeared to cast light on the infectious nature of puerperal fever. The disease is currently believed to be caused by a bacterial infection of the upper genital tract, in which the most common causative organism is the Beta haemolytic streptococcus, Lancefield Group A. Death and disease caused by childbirth were a commonplace of early modern life. Pre-eclampsia, ante-partum and post-partum haemorrhage and cephalopelvic disproportion were only a few of the complications which could affect women and children at this most