room。Thesameeveningheattendedawomaninlaborwithoutpreviouslychanginghisclothes；thispatientdied。Thenextmorninghedeliveredawomanwiththeforceps；shediedalso，andofmanyotherswhowereseizedwiththediseasewithinafewweeks，threesharedthesamefateinsuccession。
　　InJune，1823，heassistedsomeofhispupilsattheautopsyofacaseofpuerperalfever。Hewasunabletowashhishandswithpropercare，forwantofthenecessaryaccommodations。Ongettinghomehefoundthattwopatientsrequiredhisassistance。Hewentwithoutfurtherablution，orchanginghisclothes；boththesepatientsdiedwithpuerperalfever。ThissameDr。CampbellisoneofDr。
　　Churchill’sauthoritiesagainstcontagion。
　　Mr。Robertonsaysthatinoneinstancewithinhisknowledgeapractitionerpassedthecatheterforapatientwithpuerperalfeverlateintheevening；thesamenightheattendedaladywhohadthesymptomsofthediseaseonthesecondday。Inanotherinstanceasurgeonwascalledwhileintheactofinspectingthebodyofawomanwhohaddiedofthisfever，toattendalabor；withinforty-eighthoursthispatientwasseizedwiththefever。’
　　Onthe16thofMarch，1831，amedicalpractitionerexaminedthebodyofawomanwhohaddiedafewdaysafterdelivery，frompuerperalperitonitis。Ontheeveningofthe17thhedeliveredapatient，whowasseizedwithpuerperalfeveronthe19th，anddiedonthe24th。
　　Betweenthisperiodandthe6thofApril，thesamepractitionerattendedtwootherpatients，bothofwhomwereattackedwiththesamediseaseanddied。
　　Intheautumnof1829aphysicianwaspresentattheexaminationofacaseofpuerperalfever，dissectedouttheorgans，andassistedinsewingupthebody。Hehadscarcelyreachedhomewhenhewassummonedtoattendayoungladyinlabor。Insixteenhoursshewasattackedwiththesymptomsofpuerperalfever，andnarrowlyescapedwithherlife。
　　InDecember，1830，amidwife，whohadattendedtwofatalcasesofpuerperalfeverattheBritishLying-inHospital，examinedapatientwhohadjustbeenadmitted，toascertainiflaborhadcommenced。
　　Thispatientremainedtwodaysintheexpectationthatlaborwouldcomeon，whenshereturnedhomeandwasthensuddenlytakeninlaboranddeliveredbeforeshecouldsetoutforthehospital。Shewentonfavorablyfortwodays，andwasthentakenwithpuerperalfeveranddiedinthirty-sixhours。
　　“Ayoungpractitioner，contrarytoadvice，examinedthebodyofapatientwhohaddiedfrompuerperalfever；therewasnoepidemicatthetime；thecaseappearedtobepurelysporadic。Hedeliveredthreeotherwomenshortlyafterwards；theyalldiedwithpuerperalfever，thesymptomsofwhichbrokeoutverysoonafterlabor。Thepatientsofhiscolleaguedidwell，exceptone，whereheassistedtoremovesomecoagulafromtheuterus；shewasattackedinthesamemannerasthosewhomhehadattended，anddiedalso。“Thewriterinthe“BritishandForeignMedicalReview，“fromwhomIquotethisstatement，——andwhoisnootherthanDr。Rigby，adds，“Wetrustthatthisfactalonewillforeversilencesuchdoubts，andstampthewell-
　　meritedepithetof’criminal，’asabovequoted，uponsuchattempts。“
　　[Brit。andFor。MedicalReviewforJan。1842，p。112。]
　　>FromthecasesgivenbyMr。Ingleby，Iselectthefollowing。Twogentlemen，afterhavingbeenengagedinconductingthepost-mortemexaminationofacaseofpuerperalfever，wentinthesamedress，eachrespectively，toacaseofmidwifery。“Theonepatientwasseizedwiththerigoraboutthirtyhoursafterwards。Theotherpatientwasseizedwitharigorthethirdmorningafterdelivery。
　　Onerecovered，onedied。“[Edin。Med。andSurg。Journal，April，1838。]
　　Oneofthesesamegentlemenattendedanotherwomaninthesameclothestwodaysaftertheautopsyreferredto。“Therigordidnottakeplaceuntiltheeveningofthefifthdayfromthefirstvisit。
　　Resultfatal。“Thesecasesbelongedtoaseriesofseven，thefirstofwhichwasthoughttohaveoriginatedinacaseoferysipelas。
　　“Severalcasesofamildcharacterfollowedtheforegoingseven，andtheirnaturebeingnowmostunequivocal，myfrienddeclinedvisitingallmidwiferycasesforatime，andtherewasnorecurrenceofthedisease。“Thesecasesoccurredin1833。Fiveofthemprovedfatal。
　　Mr。Inglebygivesanotherseriesofseveneaseswhichoccurredtoapractitionerin1836，thefirstofwhichwasalsoattributedtohishavingopenedseveralerysipelatousabscessesashorttimepreviously。
　　IneednotrefertothecaselatelyreadbeforethisSociety，inwhichaphysicianwent，soonafterperforminganautopsyofacaseofpuerperalfever，toawomaninlabor，whowasseizedwiththesamediseaseandperished。Theforfeitofthaterrorhasbeenalreadypaid。
　　AtameetingoftheMedicalandChirurgicalSocietybeforereferredto，Dr。Merrimanrelatedaninstanceoccurringinhisownpractice，whichexcitesareasonablesuspicionthattwolivesweresacrificedtoastilllessdangerousexperiment。Hewasattheexaminationofacaseofpuerperalfeverattwoo’clockintheafternoon。Hetookcarenottotouchthebody。Atnineo’clockthesameeveningheattendedawomaninlabor；shewassonearlydeliveredthathehadscarcelyanythingtodo。Thenextmorningshehadsevererigors，andinforty-eighthoursshewasacorpse。Herinfanthaderysipelasanddiedintwodays。[Lancet，May2，1840。]
　　Inconnectionwiththefactswhichhavebeenstated，itseemspropertoalludetothedangerousandoftenfataleffectswhichhavefollowedfromwoundsreceivedinthepost-mortemexaminationofpatientswhohavediedofpuerperalfever。Thefactthatsuchwoundsareattendedwithpeculiarriskhasbeenlongnoticed。IfindthatChaussierwasinthehabitofcautioninghisstudentsagainstthedangertowhichtheywereexposedinthesedissections。[Stein，L’Artd’Accoucher，1794；Dict。desSciencesMedicales，art。“Puerperal。“]
　　TheheadpharmacienoftheHotelDieu，inhisanalysisofthefluideffusedinpuerperalperitonitis，saysthatpractitionersareconvincedofitsdeleteriousqualities，andthatitisverydangeroustoapplyittothedenudedskin。[JournaldePharmacie，January，1836。]SirBenjaminBrodiespeaksofitasbeingwellknownthattheinoculationoflymphorpusfromtheperitoneumofapuerperalpatientisoftenattendedwithdangerousandevenfatalsymptoms。
　　Threecasesinconfirmationofthisstatement，twoofthemfatal，havebeenreportedtothisSocietywithinafewmonths。
　　Ofaboutfiftycasesofinjuriesofthiskind，ofvariousdegreesofseverity，whichIhavecollectedfromdifferentsources，atleasttwelvewereinstancesofinfectionfrompuerperalperitonitis。Someoftheothersaresostatedastorenderitprobablethattheymayhavebeenofthesamenature。Fiveothercaseswereofperitonealinflammation；threeinmales。Threewerewhatwascalledenteritis，inoneinstancecomplicatedwitherysipelas；butitiswellknownthatthistermhasbeenoftenusedtosignifyinflammationoftheperitoneumcoveringtheintestines。Ontheotherhand，nocaseoftyphusortyphoidfeverismentionedasgivingrisetodangerousconsequences，withtheexceptionofthesingleinstanceofanundertakermentionedbyMr。Travers，whoseemstohavebeenpoisonedbyafluidwhichexudedfromthebody。Theotheraccidentswereproducedbydissection，orsomeothermodeofcontactwithbodiesofpatientswhohaddiedofvariousaffections。Theyalsodifferedmuchinseverity，thecasesofpuerperaloriginbeingamongthemostformidableandfatal。Nowamoment’sreflectionwillshowthatthenumberofcasesofseriousconsequencesensuingfromthedissectionofthebodiesofthosewhohadperishedofpuerperalfeverissovastlydisproportionedtotherelativelysmallnumberofautopsiesmadeinthiscomplaintascomparedwithtyphusorpneumoniafromwhichlastdiseasenotonecaseofpoisoninghappened，andstillmorefromalldiseasesputtogether，thattheconclusionisirresistiblethatamostfearfulmorbidpoisonisoftengeneratedinthecourseofthisdisease。Whetherornotitissuigeneris，confinedtothisdisease，orproducedinsomeothers，as，forinstance，erysipelas，Ineed，notstoptoinquire。
　　InconnectionwiththismaybetakenthefollowingstatementofDr。
　　Rigby。“Thatthedischargesfromapatientunderpuerperalfeverareinthehighestdegreecontagiouswehaveabundantevidenceinthehistoryoflying-inhospitals。Thepuerperalabscessesarealsocontagious，andmaybecommunicatedtohealthylying-inwomenbywashingwiththesamesponge；thisfacthasbeenrepeatedlyprovedintheViennaHospital；buttheyareequallycommunicabletowomennotpregnant；onmorethanoneoccasionthewomenengagedinwashingthesoiledbed-linenoftheGeneralLying-inHospitalhavebeenattackedwithabscessinthefingersorhands，attendedwithrapidlyspreadinginflammationofthecellulartissue。“
　　Nowaddtoallthistheundisputedfact，thatwithinthewallsoflying-inhospitalsthereisoftengeneratedamiasm，palpableasthechlorineusedtodestroyit，tenacioussoasinsomecasesalmosttodefyextirpation，deadlyinsomeinstitutionsastheplague；whichhaskilledwomeninaprivatehospitalofLondonsofastthattheywereburiedtwoinonecoffintoconcealitshorrors；whichenabledTonnelletorecordtwohundredandtwenty-twoautopsiesattheMaterniteofParis；whichhasledDr。Leetoexpresshisdeliberateconvictionthatthelossoflifeoccasionedbytheseinstitutionscompletelydefeatstheobjectsoftheirfounders；andoutofthistrainofcumulativeevidence，themultipliedgroupsofcasesclusteringaboutindividuals，thedeadlyresultsofautopsies，theinoculationbyfluidsfromthelivingpatient，themurderouspoisonofhospitals，-doestherenotresultaconclusionthatlaughsallsophistrytoscorn，andrendersallargumentaninsult？
　　Ihavehadoccasiontomentionsomeinstancesinwhichtherewasanapparentrelationbetweenpuerperalfeveranderysipelas。Thelengthtowhichthispaperhasextendeddoesnotallowmetoenterintotheconsiderationofthismostimportantsubject。Iwillonlysay，thattheevidenceappearstomealtogethersatisfactorythatsomemostfatalseriesofpuerperalfeverhavebeenproducedbyaninfectionoriginatinginthematteroreffluviaoferysipelas。Inevidenceofsomeconnectionbetweenthetwodiseases，Ineednotgobacktotheolderauthors，asPouteauorGordon，butwillcontentmyselfwithgivingthefollowingreferences，withtheirdates；fromwhichitwillbeseenthatthetestimonyhasbeenconstantlycomingbeforetheprofessionforthelastfewyears。
　　“LondonCyclopaediaofPracticalMedicine，“articlePuerperalFever，1833。
　　Mr。Ceeley’sAccountofthePuerperalFeveratAylesbury。“Lancet，“
　　1835。
　　Dr。Ramsbotham’sLecture。“LondonMedicalGazette，“1835。
　　Mr。YatesAckerly’sLetterinthesameJournal，1838。
　　Mr。InglebyonEpidemicPuerperalFever。“EdinburghMedicalandSurgicalJournal，“1838。
　　Mr。Paley’sLetter。“LondonMedicalGazette，“1839。
　　RemarksattheMedicalandChirurgicalSociety。“Lancet，“1840。
　　Dr。Rigby’s“SystemofMidwifery。“1841。
　　“NunneleyonErysipelas，“——aworkwhichcontainsalargenumberofreferencesonthesubject。1841。
　　“BritishandForeignQuarterlyReview，“1842。
　　Dr。S。JacksonofNorthumberland，asalreadyquotedfromtheSummaryoftheCollegeofPhysicians，1842。
　　Andlastly，astartlingseriesofcasesbyMr。StorrsofDoncaster，tobe，foundinthe“AmericanJournaloftheMedicalSciences“forJanuary，1843。
　　Therelationofpuerperalfeverwithothercontinuedfeverswouldseemtoberemoteandrarelyobvious。HeyreferstotwocasesofsynochusoccurringintheRoyalInfirmaryofEdinburgh，inwomenwhohadattendeduponpuerperalpatients。Dr。Collinsreferstoseveralinstancesinwhichpuerperalfeverhasappearedtooriginatefromacontinuedproximitytopatientssufferingwithtyphus。
　　Suchoccurrencesasthosejustmentioned，thoughmostimportanttoberememberedandguardedagainst，hardlyattractournoticeinthemidstofthegloomyfactsbywhichtheyaresurrounded。Ofthesefacts，attheriskoffatiguingrepetitions，Ihavesummonedasufficientnumber，asIbelieve，toconvincethemostincredulousthateveryattempttodisguisethetruthwhichunderliesthemallisuseless。
　　Itistruethatsomeofthehistoriansofthedisease，especiallyHulme，Hull，andLeake，inEngland；Tonnelle，Duges，andBaudelocque，inFrance，professnottohavefoundpuerperalfevercontagious。Atthemosttheygiveusmerenegativefacts，worthlessagainstanextentofevidencewhichnowoverlapsthewidestrangeofdoubt，anddoublesuponitselfintheredundancyofsuperfluousdemonstration。
　　Examinedindetail，thisandmuchoftheshowoftestimonybroughtuptostarethedaylightofconvictionoutofcountenance，provestobeinagreatmeasureunmeaningandinapplicable，asmightbeeasilyshownwereitnecessary。NordoIfeelthenecessityofenforcingtheconclusionwhicharisesspontaneouslyfromthefactswhichhavebeenenumerated，byformallycitingtheopinionsofthosegraveauthoritieswhohaveforthelasthalf-centurybeensoundingtheunwelcometruthithascostsomanylivestoestablish。