PUERPERAL FEVER 249 



These were the only cases attended by this physician 

 during the period referred to. " They were all attended 

 by him until their termination, with the exception of the 

 patient No. 6, who fell into the hands of another physician 

 on the 2d of May." (Dr. C. left town for a few days at 

 this time.) Dr. C. attended cases immediately before and 

 after the above-named periods, none of which, however, 

 presented any peculiar symptoms of the disease. 



About the 1st of July he attended another patient in a 

 neighboring village, who died two or three days after 

 delivery. 



The first patient, it is stated, was delivered on the 20th 

 of March. " On the iQth Dr. C. made the autopsy of a 

 man who had died suddenly, sick only forty-eight hours ; had 

 oedema of the thigh and gangrene extending from a little 

 above the ankle into the cavity of the abdomen." Dr. C. 

 wounded himself very slightly in the right hand during the 

 autopsy. The hand was quite painful the night following, 

 during his attendance on the patient No. i. He did not 

 see this patient after the 2oth, being confined to the house, 

 and very sick from the wound just mentioned, from this 

 time until the 3d of April. 



Several cases of erysipdas occurred in the house where 

 the autopsy mentioned above took place, soon after the 

 examination. There were also many cases of erysipelas in 

 town at the time of the fatal puerperal cases which have 

 been mentioned. 



The nurse who laid out the body of the patient No. 3 

 was taken on the evening of the same day with sore 

 throat and erysipelas, and died in ten days from the first 

 attack. 



The nurse who laid out the body of the patient No. 4 

 was taken on the day following with symptoms like those 

 of this patient, and died in a week, without any external 

 marks of erysipelas. 



" No other cases of similar character with those of Dr. 

 C. occurred in the practice of any of the physicians in 

 the town or vicinity at the time. Deaths following con- 

 finement have occurred in the practice of other physicians 

 during the past year, but they were not cases of puerperal 



