fficulty whatever has attended any of my midwifery
cases?"

I am assured, on unquestionable authority, that "About three years
since, a gentleman in extensive midwifery business, in a neighboring
State, lost in the course of a few weeks eight patients in child-bed,
seven of them being undoubted cases of puerperal fever. No other
physician of the town lost a single patient of this disease during the
same period." And from what I have heard in conversation with some of
our most experienced practitioners, I am inclined to think many cases of
the kind might be brought to light by extensive inquiry.

This long catalogue of melancholy histories assumes a still darker
aspect when we remember how kindly nature deals with the parturient
female, when she is 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 r