Apparently there is no puerperal parasite, properly speaking.  I have not encountered true septicemia in my experiments; but it ought to be among the puerperal affections.

Fourth observation.—­On June fourteenth, at the Lariboisiere, a woman was very ill following a recent confinement; she was at the point of death; in fact she did die on the fourteenth at midnight.  Some hours before death pus was taken from an abscess on the arm, and blood from a puncture in a finger.  Both were sowed.  On the next day (the fifteenth) the flask containing the pus from the abscess was filled with long chains of granules.  The flask containing the blood was sterile.  The autopsy was at ten o’clock on the morning of the sixteenth.  Blood from a vein of the arm, pus from the uterine walls and that from a collection in the synovial sac of the knee were all placed in culture media.  All showed growth, even the blood, and they all contained the long strings of granules.  The peritoneum contained no pus.

Interpretation of the disease and of the death.—­The injury of the uterus during confinement as usual furnished pus, which gave a lodging place for the germs of the long chains of granules.  These, probably through the lymphatics, passed to the joints and to some other places, thus being the origin of the metastic abscesses which produced death.

Fifth observation.—­On June seventeenth, M. Doleris, a well-known hospital interne, brought to me some blood, removed with the necessary precautions, from a child dead immediately after birth, whose mother, before confinement had had febrile symptoms with chills.  This blood, upon cultivation, gave an abundance of the pyogenic vibrio.  On the other hand, blood taken from the mother on the morning of the eighteenth (she had died at one o’clock that morning) showed no development whatever, on the nineteenth nor on following days.  The autopsy on the mother took place on the nineteenth.  It is certainly worthy of note that the uterus, peritoneum and intestines showed nothing special, but the liver was full of metastatic abscesses.  At the exit of the hepatic vein from the liver there was pus, and its walls were ulcerated at this place.  The pus from the liver abscesses was filled with the pyogenic vibrio.  Even the liver tissues, at a distance from the visible abscesses, gave abundant cultures of the same organism.

Interpretation of the disease and of the death.—­The pyogenic vibrio, found in the uterus, or which was perhaps already in the body of the mother, since she suffered from chills before confinement, produced metastatic abscesses in the liver and, carried to the blood of the child, there induced one of the forms of infection called purulent, which caused its death.