eal 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, while the
scores that cross the same paths on the same errands know it only
by name. It is a series of similar coincidences which has led us to
consider the dagger, the musket, and certain innocent-looking white
powders as having some little claim to be regarded as dangerous. It is
the practical inattention to similar coincidences which has given rise
to the unpleasant but often necessary documents called indictments,
which has sharpened a form of the cephalotome sometimes employed in
the case of adults, and adjusted that modification of the fillet which
delivers the world of those who happen to be too much in the way while
such striking coincidences are taking place.

I shall now mention a few instances in which the disease appears to have
been conveyed by the process of direct inoculation.

Dr. Campbell of Edinburgh states that in October, 1821, he assisted at
the post-mortem examination of a patient who died with puerperal fever.
He carried the pelvic viscera in his pocket to the class-room. 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. He was unable to wash his hands with proper care,
for want of the necessary accommodations. On getting home he found that
two patients required his assistance. He went without further ablution,
or changing his clothes; both these patients died with puerperal fever.
This same Dr. Campbell is one of Dr. Churc