INTRODUCTION. 1 1 



lated his first patient with cow-pox. In a few years the practice 

 of vaccination spread to all parts of the world.* 



It was introduced into the United States by Dr. Benjamin 

 Waterhouse of Harvard. President Thomas Jefferson was 

 active in bringing it into general use, especially in the South. 



As early as 1847 Semmelweis of Vienna attributed the origin 

 of puerperal fever to poisons carried by the fingers of physicians 

 and students, whose hands had been soiled in the dissecting 

 room. To this he was led by the death of a friend from pyemia 

 following a dissection-wound. He noted the similarity of the 

 course of his friend's case with cases of puerperal fever. He 

 advocated washing the hands of the attendant in solutions of 

 chlorine or chloride of hme, in addition to cleansing them with 

 soap and water. 



The cause of puerperal fever was still unknown. Endeavors 

 to connect it with atmospheric influences and the like had been 

 unsuccessful. During the seventeenth and eighteenth centuries 

 it had been attributed to the absorption of milk into the blood 

 from the breasts. Semmelweis stood his ground in spite of 

 opposition and ridicule, though he somewhat modified his 

 doctrine. His views agree substantially with the practice of 

 the present day, which they have greatly influenced. 



During the same period similar ideas were advanced by Dr. 

 Oliver Wendell Holmes in the United States. His paper on 

 "The Contagiousness of Puerperal Fever" appeared in 1843. 

 A hvely controversy lasting several years was provoked, in which 

 Holmes defended his position with great vigor. His admirable 

 literary style served him effectively, f 



In the first half of the nineteenth century, with improved 

 microscopes, knowledge of minute Hving things grew rapidly, 



* See the works of Edward Jenner by Dock. New York Medical Journal. 

 Nov. 29 and Dec. 6, igo2. Also Dulles. The History of Vaccination. 

 Philadelphia Medical Journal. May 30, 1903. 



f See O. W. Holmes. Medical Essays. Houghton, Mifflin & Co., i88g. 



