Septic umbilical arteritis.

During the middle and later part of the last century thousands of infants in this country and on the continent died annually as a result of umbilical infection. Two types were recognized: (a) Moist spreading gangrene of the umbilicus (hospital gangrene) when children died of toxaemia, septicaemia, peritonitis and occasionally rupture of the abdominal wall. (b) Erysipelas of the umbilicus, also called puerperal fever of the newborn, in which septicaemia was the common termination. Both types were much commoner in institutions than in private practice and carried an appalling mortality. Both occurred in epidemic form, often but not always concurrently with epidemics of maternal puerperal infection. Outbreaks of umbilical sepsis were recorded by physicians all over Europe. Trousseau (1844), in describing his cases, noted the occurrence of peritonitis and osteomyelitis,and pointed out that death could result from umbilical infection even when the umbilicus appeared to be normal. Meynet (1857), in Paris, described an epidemic which affected 53 infants, 36 of whom died. Eighteen came to necropsy and of these 10 had peritonitis and in three there was septic umbilical arteritis. He treated umbilical sepsis with Canquoin's paste (zinc chloride in wheaten flour) apparently with some success. He stated that Ambroise Pare regarded the malady (umbilical sepsis) as so grave that he advised the surgeon 'not to raise a hand lest he be accused of having caused the death of the infant'.