254 O. W. HOLMES 



"All the cases that occurred in my practice took place be- 

 tween the 7th of May and the i/th of June, 1842. 



"They were not confined to any particular part of the 

 city. The first two cases were patients residing at the South 

 End, the next was at the extreme North End, one living in 

 Sea Street and the other in Roxbury. The following is the 

 order in which they occurred : 



"CASE I. Mrs. was confined on the 7th of May, at 



5 o'clock, P. M., after a natural labor of six hours. At 12 

 o'clock at night, on the gth (thirty-one hours after confine- 

 ment), she was taken with severe chill, previous to which 

 she was as comfortable as women usually are under the 

 circumstances. She died on the loth. 



"CASE 2. Mrs. was confined on the loth of June 



(four weeks after Mrs. C), at n A. M., after a natural, 

 but somewhat severe, labor of five hours. At 7 o'clock, 

 on the morning of the nth, she had a chill. Died on 

 the I2th. 



"CASE 3. Mrs. , confined on the I4th of June, was 



comfortable until the i8th, when symptoms of puerperal 

 fever were manifest. She died on the 20th. 



"CASE 4. Mrs. , confined June I7th, at 5 o'clock, A. M., 



was doing well until the morning of the I9th. She died on 

 the evening of the 21 st. 



"CASE 5. Mrs. was confined with her fifth child on 



the I7th of June, at 6 o'clock in the evening. This patient 

 had been attacked with puerperal fever, at three of her 

 previous confinements, but the disease yielded to depletion 

 and other remedies without difficulty. This time, I regret 

 to say, I was not so fortunate. She was not attacked, as were 

 the other patients, with a chill, but complained of extreme 

 pain in the abdomen, and tenderness on pressure, almost 

 from the moment of her confinement. In this, as in the 

 other cases, the disease resisted all remedies, and she died 

 in great distress on the 22d of the same month. Owing 

 to the extreme heat of the season and my own indisposition, 

 none of the subjects were examined after death. Dr. Chan- 

 ning, who was in attendance with me on the three last cases, 

 proposed to have a post-mortem examination of the subject 







