Buhl Disease

Buhl Disease (Buhl), which was formerly considered a distinct form, now has only historical interest. It was described by Buhl and Hecker in 1861 under the name 'acute fatty degeneration of newborns.' It is characterized by multiple hemorrhages and acute fatty degeneration of internal organs, resembling the picture in phosphorus poisoning. The etiology of this disease was considered unclear; now, however, the view of it as a variety of general sepsis is increasingly being substantiated and confirmed. This is supported by the extraordinary similarity in clinical picture, bacteriological examination of the blood, and severe course of both diseases. The absence of portals of entry, which sometimes served as a basis for the differential diagnosis of Buhl's disease, is not proven, since the digestive tract and airways can also serve as portals, especially in the presence of asphyxia. With more careful bacteriological examination, it was possible to detect the presence of microbes in the blood: staphylococcus (Finkelstein, Rothler) and B. coli (Lucksch). Veterinarians have described a similar disease in newborn foals, pigs, and calves under the name paralysis ('Lahme'). Autopsy of dead animals revealed a picture of fatty degeneration of internal organs. As can be seen, both clinical and pathological-anatomical pictures are very close to the picture of sepsis; Reis is rightly pointing out that the name 'Buhl Disease' should be replaced by the name 'acute hemorrhagic sepsis.' The prognosis is always severe, while cases of recovery are rare. Prevention, in the current state of the question, comes down to protecting both the child and the mother from infection (during and after childbirth, as well as in the last months of pregnancy), to the strictest asepsis in the care of the umbilical cord, etc. Treatment also follows from the above: careful and reasonable fight against asphyxia, against bleeding, general strengthening of the body's strength, breastfeeding, as well as hemotherapy, which undoubtedly gives encouraging results. Maternal blood is injected into the child's sinus or subscapular region in an amount of 15-20 cubic cm; injections are repeated daily or every other day (depending on the course of the disease).