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The same evening he attended a woman in labor without previously changing his clothes; this patient died. The next morning he delivered a woman with the forceps; she died also, and of many others who were seized with the disease within a few weeks, three shared the same fate in succession. In June, 1823, he assisted some of his pupils at the autopsy of a case of puerperal fever.
"It is customary among the lower and middle ranks of people to make frequent personal visits to puerperal women resident in the same neighborhood, and I have ample evidence for affirming that the infection of the disease was often carried about in that manner; and, however painful to my feelings, I must in candor declare, that it is very probable the contagion was conveyed, in some instances, by myself, though I took every possible care to prevent such a thing from happening, the moment that I ascertained that the distemper was infectious."
He did not see this patient after the 20th, being confined to the house, and very sick from the wound just mentioned, from this time until the 3d of April. Several cases of erysipelas occurred in the house where the autopsy mentioned above took place, soon after the examination. There were also many cases of erysipelas in town at the time of the fatal puerperal cases which have been mentioned.
Collins's mastership, there was one case of puerperal fever to 178 deliveries, or less than six to the thousand, and one death from this disease in 278 cases, or between three and four to the thousand a yet during this period the disease was endemic in the hospital, and might have gone on to rival the horrors of the pestilence of the Maternite, had not the poison been destroyed by a thorough purification.
Certainly nothing can be more open and explicit than the account given by Dr. Peirson of Salem, of the cases seen by him. In the first nineteen days of January, 1829, he had five consecutive cases of puerperal fever, every patient he attended being attacked, and the three first cases proving fatal.
Three cases in confirmation of this statement, two of them fatal, have been reported to this Society within a few months. Of about fifty cases of injuries of this kind, of various degrees of severity, which I have collected from different sources, at least twelve were instances of infection from puerperal peritonitis.
III. "My Dear Sir: I received a note from you last evening requesting me to answer certain questions therein proposed, touching the cases of puerperal fever which came under my observation the past summer.
Gregson, in which that gentleman says, in reference to the great number of cases occurring in his practice, "The cause of this I cannot pretend fully to explain, but I should be wanting in common liberality if I were to make any hesitation in asserting that the disease which appeared in my practice was highly contagious, and communicable from one puerperal woman to another."
Have I not as much right to draw a positive inference from "Dr. A.'s" seventy exclusive cases as he from the three cases in the ward of the Dublin Hospital? All practical medicine, and all action in common affairs, is founded on inferences. How does Dr. Meigs know that the patients he bled in puerperal fever would not have all got well if he had not bled them?
Chir. Review, April, 1850. Hill, of Leuchars. A Series of Cases Illustrating the Contagious Nature of Erysipelas and Puerperal Fever, and their Intimate Pathological Connection. Jour. Med. Sc., July, 1850. Skoda on the Causes of Puerperal Fever. Jour. Med. Sc., October, 1850. Arneth. Paper read before the National Academy of Medicine. Annales d'Hygiene, Tome LXV. 2e Partie. Moir.
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