Much confusion has arisen in recent discussions of puerperal fever from ambiguity of terms. An illustration of this fact is furnished in the various use of the words, auto-infection and hetero-infection. It is evident, however, upon critical examination, that the difference of opinion is only apparent, not real, and is largely dependent upon the fallacy just mentioned.
Thus, Ahlfeld1 urges that the puerperia of the cases of precipitate labor—street labors — collected by Winckel, and the labors experimentally conducted by himself to settle the question, demonstrate that self-infection does occur. Under self-infection Ahlfeld includes those cases in which "the poisoning substances were on or in the parturient passages during labor, or are formed there during labor and the puerperium, and are introduced into the body of the woman in consequence of the manipulations of physician and nurse, or without these manipulations. " This is the original conception of auto-infection by Semmelweiss
SPONTANEOUS AND CONTACT INFECTION IN PUERPERAL FEVER.. JAMA. 1888;X(20):621–622. doi:10.1001/jama.1888.02400460017004
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