not immersed in the virulent atmosphere of an impure lying-in
hospital, or poisoned in her chamber by the unsuspected breath of
contagion. From all causes together, not more than four deaths in a
thousand births and miscarriages happened in England and Wales during the
period embraced by the first "Report of the Registrar-General." In the
second Report the mortality was shown to be about five in one thousand.
In the Dublin Lying-in Hospital, during the seven years of Dr. 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.

In private practice, leaving out of view the cases that are to be
ascribed to the self-acting system of propagation, it would seem that the
disease must be far from common. Mr. White of Manchester says, "Out of
the whole number of lying-in patients whom I have delivered (and I may
safely call it a great one), I have never lost one, nor to the best of my
recollection has one been greatly endangered, by the puerperal, miliary,
low nervous, putrid malignant, or milk fever." Dr. Joseph Clarke informed
Dr. Collins, that in the course of forty-five years' most extensive
practice he lost but four patients from this disease. One of the most
eminent practitioners of Glasgow, who has been engaged in very extensive
practice for upwards of a quarter of a century, testifies that he never
saw more than twelve cases of real puerperal fever.[Lancet, May 4, 1833]

I have myself been told by two gentlemen practising in this city, and
having for many years a large midwifery business, that they had neither
of them lost a patient from this disease, and by one of them that he had
only seen it in consultation with other physicians. In five hundred
cases of midwifery, of which Dr. Storer has given an abstract in the
first number of this Journal, there was only one instance of fatal
puerperal peritonitis.

In the view of these facts, it does appear a singular coincidence, that
one man or woman should have ten, twenty, thirty, or seventy cases of
this rare disease following his or her footsteps with the keenness of a
beagle, through the streets and lanes of a crowded city, w