244 O. W. HOLMES 



are the channels by which, as I suspect, the infection is 

 principally conveyed." 7 



At a meeting of the Royal Medical and Chirurgical 

 Society Dr. King mentioned that some years since a prac- 

 titioner at Woolwich lost sixteen patients from puerperal 

 fever in the same year. He was compelled to give up 

 practice for one or two years, his business being divided 

 among the neighboring practitioners. No case of puerperal 

 fever occurred afterwards, neither had any of the neigh- 

 boring surgeons any cases of this disease. 



At the same meeting Mr. Hutchinson mentioned th.e 

 occurrence of three consecutive cases of puerperal fever, 

 followed subsequently by two others, all in the practice 

 of one accoucheur. 8 



Dr. Lee makes the following statement: "In the last two 

 weeks of September. 1827, five fatal cases of uterine in- 

 flammation came under our observation. All the individuals 

 so attacked had been attended in labor by the same mid- 

 wife, and no example of a febrile or inflammatory disease 

 of a serious nature occurred during that period among the 

 other patients of the Westminster General Dispensary, who 

 had been attended by the other midwives belonging to 

 that institution." 8 



The recurrence of long series of cases like those I have 

 cited, reported by those most interested to disbelieve in 

 contagion, scattered along through an interval of half a 

 century, might have been thought sufficient to satisfy the 

 minds of all inquirers that here was something more than 

 a singular coincidence. But if, on a more extended ob- 

 servation, it should be found that the same ominous groups 

 of cases clustering about individual practitioners were ob- 

 served in a remote country, at different times, and in widely 

 separated regions, it would seem incredible that any should 

 be found too prejudiced or indolent to accept the solemn 

 truth knelled into their ears by the funeral bells from 

 both sides of the ocean the plain conclusion that the phy- 

 sician and the disease entered, hand in hand, into the cham- 

 ber of the unsuspecting patient. 



7 Lect. on Midwifery, p. 395. 8 Lancet, May 2, 1840. 

 9 Lond. Cyc. of Pract. Med., art., " Fever, Puerperal. 



