f my patients had puerperal fever, one very
badly, the other not so badly. Both recovered. One other had swelled
leg, or phlegmasia dolens, and one or two others did not recover as well
as usual.

"In the summer of 1835 another disastrous period occurred in my
practice. July 1st, I attended a lady in labor, who was afterwards quite
ill and feverish; but at the time I did not consider her case a decided
puerperal fever. On the 8th, I attended one who did well. On the 12th,
one who was seriously sick. This was also an equivocal case, apparently
arising from constipation and irritation of the rectum. These women were
ten miles apart and five from my residence. On 15th and 20th, two who
did well. On 25th, I attended another. This was a severe labor, and
followed by unequivocal puerperal fever, or peritonitis. She recovered.
August 2d and 3d, in about twenty-four hours I attended four persons.
Two of them did very well; one was attacked with some of the common
symptoms, which however subsided in a day or two, and the other had
decided puerperal fever, but recovered. This woman resided five miles
from me. Up to this time I wore the same coat. All my other clothes had
frequently been changed. On 6th, I attended two women, one of whom was
not sick at all; but the other, Mrs. L., was afterwards taken ill. On
10th, I attended a lady, who did very well. I had previously changed all
my clothes, and had no garment on which had been in a puerperal room. On
12th, I was called to Mrs. S., in labor. While she was ill, I left her
to visit Mrs. L., one of the ladies who was confined on 6th. Mrs. L. had
been more unwell than usual, but I had not considered her case anything
more than common till this visit. I had on a surtout at this visit,
which, on my return to Mrs. S., I left in another room. Mrs. S. was
delivered on 13th with forceps. These women both died of decided
puerperal fever.

"While I attended these women in their fevers, I changed my clothes, and
washed my hands in a solution of chloride of lime after each visit. I
attended seven women in labor during this period, all of whom recovered
without sickness.

"In my practice I have had several single cases of puerperal fever, some
of whom have died and some have recovered. Until the year 1830 I had
no suspicion that the disease could be communicated from one patient
to another by a nurse or midwife; but I now think the foregoing facts
strongly favor that idea. I was so much con