_Inflammation of the Womb_ begins generally between the fourth and ninth day after delivery, and commonly with retention of the lochia: with fever, heat, and pain about the uterine region, elevation and hardness of the abdomen below, with tenderness and acute sensibility on pressure, irritation to urine and stools, colick, intense headach, strong full pulse. The whole, or different parts only, of the womb may be inflamed, whence the contiguous viscera of the pelvis will be differently affected. Where the inflammation is not violent, the crisis is about the fourth or seventh day from the attack; but if severe, may be protracted to the ninth, eleventh, and fourteenth, and be then discussed with some sensible evacuation, by perspiration and sweat, urine, diarrhœa, lochial discharge, or current of milk from the breasts; or may terminate fatally in gangrene, delirium, and convulsions.
The predisposing and occasional _causes_ of irregularity of the lochia, and of uterine inflammation, are, of Excess, grumous clots of blood in the womb; violence done to the womb during parturition; retention of the placenta, or part of it; great weakness; passions of mind; a second child; spasm; repulsion of milk from the breasts; too early and violent motion or walking about; diseased state of the womb; inverted womb; errors in food, drink, passions of mind, excretions, &c. Of Obstruction and Suppression; clots of blood in the vagina; cold admitted to the naked body, either externally or internally; cold rooms, cloaths, and drink; obstructed perspiration; impure air and close heated rooms; passions of mind; hystericks; errors in the non-naturals, diarrhœa. Of inflammation of the womb, suppression of the lochia; external violence; falls; rude extraction of the placenta; morbid adhesion of the placenta; miscarriage; too tight bandages round the belly: its termination is by discussion or gangrene.
_Puerperal Fever_, or Peritonitis, commonly alledged to be peculiar to women after delivery, has been dignified by the moderns, from its danger and fatality, with a generic name: happily for the fair sex, it does not often occur: sometimes it is epidemic, from some unknown quality of the atmosphere; and in such circumstances a considerable number of puerperal women are afflicted at the same time. It generally attacks one or two days, but sometimes a few hours after delivery; and rarely later than the sixth day. The assault is sudden and violent, with shivering, headach, especially in the temples and eyes, giddiness, nausea, sickness of the stomach, and vomiting of bile in large quantity, pains darting through the lower region of the abdomen, and reaching up to the stomach, with extreme sensibility and tenderness, on being pressed with the hand, or by coughing or vomiting: the pain is felt between the stomach and navel, and is higher than in the inflammation of the womb; there is unusual languor and weakness, anxiety, oppression, and load of the spirits, impaired strength, so as not to be able to render themselves any assistance in bed; no refreshing sleep, sometimes delirium; the pulse is always extremely rapid, but various in strength during the revolution of the febrile paroxisms, that is, of the cold and hot fit. When the vomiting abates, it is succeeded by a profuse diarrhœa, accompanied with colick, tormenting gripes, tenesmus. In some, the abdomen begins to swell early. At the beginning the symptoms have an inflammatory appearance; but after a very few days change undisguisedly into the nervous and putrid type, and sometimes with miliary eruption. Often neither the lochial discharge, nor the milk, are interrupted; and it has been observed to ensue even after easy labours.