JenniferReiling, Assistant Editor
Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2001American Medical Association
That there is some as yet undiscovered fact or that in the individual case turns the scale for or against infection would appear all too obvious from an abundance of evidence. Of several persons equally exposed, a number will surely be attacked, while another will surely escape. Such susceptibility and immunity are observed not alone in medicine proper, but in surgery as well. The most scrupulous attention to every detail will not in some instances insure against wound infection, while in others the grossest carelessness or even the total want of every precaution will fail to be attended with any undesired result. This latter peculiarity is often strikingly illustrated in the mutilations practiced by the insane, in other self-inflicted injuries and in accidental lesions. A remarkable instance of toleration of this character, bearing the stamp of authenticity, has recently been reported by Dr. Robert Löffler.1 A woman, 42 years old, the wife of a Turkish peasant, had been bedridden for eight months on account of great weakness and pain in the lower extremities. She was at the end of pregnancy, and as she feared that she would die before the child could be born, she concluded to secure relief from her own resources. Taking an ordinary pocket-knife that she had concealed for the purpose for three days, she cut open the abdomen, and became unconscious after seeing the child extruded. When consciousness returned after a time, the woman awakened her 13-year old daughter, sleeping in the same room, and bade her sew up the abdomen. This was done with the aid of a domestic needle and waxed hemp thread. When a physician was called, after an interval of two days, it was learned further that the woman had lost about two quarts of blood, that the daughter had ligated the umbilical cord and had thrown away the placenta.
A CASE OF AUTO-CESAREAN SECTION.. JAMA. 2001;285(17):2173. doi:10.1001/jama.285.17.2173