PUERPERAL FEVER 261 



in severity, the cases of puerperal origin being among the 

 most formidable and fatal. Now a moment's reflection will 

 show that the number of cases of serious consequences ensu- 

 ing from the dissection of the bodies of those who had per- 

 ished of puerperal fever is so vastly disproportioned to the 

 relatively small number of autopsies made in this complaint 

 as compared with typhus or pneumonia (from which last 

 disease not one case of poisoning happened), and still more 

 from all diseases put together, that the conclusion is irresist- 

 ible that a most fearful morbid poison is often generated in 

 the course of this disease. Whether or not it is sui generis 

 confined to this disease, or produced in some others, as, for 

 instance, erysipelas, I need not stop to inquire. 



In connection with this may be taken the following state- 

 ment of Dr. Rigby: "That the discharges from a patient 

 under puerperal fever are in the highest degree contagious 

 we have abundant evidence in the history of lying-in hos- 

 pitals. The puerperal abscesses are also contagious, and may 

 be communicated to healthy lying-in women by washing with 

 the same sponge ; this fact has been repeatedly proved in the 

 Vienna Hospital; but they are equally communicable to 

 women not pregnant ; on more than one occasion the women 

 engaged in washing the soiled bed-linen of the General 

 Lying-in Hospital have been attacked with abscesses in the 

 fingers or hands, attended with rapidly spreading inflamma- 

 tion of the cellular tissue."* 



Now add to all this the undisputed fact that within the 

 walls of lying-in hospitals there is often generated a miasm, 

 palpable as the chlorine used to destroy it, tenacious so as 

 in some cases almost to defy extirpation, deadly in some in- 

 stitutions as the plague ; which has killed women in a private 

 hospital of London so fast that they were buried two in one 

 coffin to conceal its horrors; which enabled Tonnelle to 

 record two hundred and twenty-two autopsies at the 

 Maternite of Paris; which has led Dr. Lee to express his 

 deliberate conviction that the loss of life occasioned by 

 these institutions completely defeats the objects of their 

 founders; and out of this train of cumulative evidence, the 

 multiplied groups of cases clustering about individuals, the 

 n Sy*ttm of Midvnftry, p. 292. 



