240 O. W. HOLMES 



fcction to a great number of women." He then enumerates 

 a number of instances in which the disease was conveyed 

 by midwives and others to the neighboring villages, and 

 declares that " these facts fully prove that the cause of the 

 puerperal fever, of which I treat, was a specific contagion, 

 or infection, altogether unconnected with a noxious con- 

 stitution of the atmosphere." 



But his most terrible evidence is given in these words: 



" I ARRIVED AT THAT CERTAINTY IN THE MATTER THAT I 

 COULD VENTURE TO FORETELL WHAT WOMEN WOULD BE AF- 

 FECTED WITH THE DISEASE, UPON HEARING BY WHAT MID- 

 WIFE THEY WERE TO BE DELIVERED, OR BY WHAT NURSE THEY 

 WERE TO BE ATTENDED, DURING THEIR LYING-IN: AND ALMOST 

 IN EVERY INSTANCE MY PREDICTION WAS VERIFIED." 



Even previously to Gordon, Mr. White, of Manchester, 

 had said: "I am acquainted with two gentlemen in another 

 town, where the whole business of midwifery is divided 

 betwixt them, and it is very remarkable that one of them 

 loses several patients every year of the puerperal fever, 

 and the other never so much as meets with the disorder " 

 a difference which he seems to attribute to their various 

 modes of treatment. 1 



Dr. Armstrong has given a number of instances in his 

 Essay on Puerperal Fever of the prevalence of the disease 

 among the patients of a single practitioner. At Sunder- 

 land, " in all, forty-three cases occurred from the ist of 

 January to the ist of October, when the disease ceased; and 

 of this number, forty were witnessed by Mr. Gregson and 

 his assistant, Mr. Gregory, the remainder having been 

 separately seen by three accoucheurs." There is appended 

 to the London edition of this Essay a letter from Mr. 

 Gregson, in which that gentleman says, in reference to the 

 great number of cases occurring in his practice, " The cause 

 of this I cannot pretend fully to explain, but I should be 

 wanting in common liberality if I were to make any hesitation 

 in asserting that the disease which appeared in my practice 

 was highly contagious, and communicable from one puer- 

 peral woman to another." " It is customary among the lower 

 and middle ranks of people to make frequent personal visits 



1 On the Management of Lying-in Women, p. 120. 



