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temper was infectious。〃 Dr。 Armstrong goes on to mention six other instances within his knowledge; in which the disease had at different times and places been limited; in the same singular manner; to the practice of individuals; while it existed scarcely if at all among the patients of others around them。 Two of the gentlemen became so convinced of their conveying the contagion; that they withdrew for a time from practice。
I find a brief notice; in an American Journal; of another series of cases; first mentioned by Mr。 Davies; in the 〃Medical Repository。〃 This gentleman stated his conviction that the disease is contagious。
〃In the autumn of 1822 he met with twelve cases; while his medical friends in the neighborhood did not meet with any; ' or at least very few。' He could attribute this circumstance to no other cause than his having been present at the examination; after death; of two cases; some time previous; and of his having imparted the disease to his patients; notwithstanding every precaution。'〃
Dr。 Gooch says; 〃It is not uncommon for the greater number of cases to occur in the practice of one man; whilst the other practitioners of the neighborhood; who are not more skilful or more busy; meet with few or none。 A practitioner opened the body of a woman who had died of puerperal fever; and continued to wear the same clothes。 A lady whom he delivered a few days afterwards was attacked with and died of a similar disease; two more of his lying…in patients; in rapid succession; met with the same fate; struck by the thought; that he might have carried contagion in his clothes; he instantly changed them; and met with no more cases of the kind。' A woman in the country; who was employed as washerwoman and nurse; washed the linen of one who had died of puerperal fever; the next lying…in patient she nursed died of the same disease; a third nursed by her met with the same fate; till the neighborhood; getting afraid of her; ceased to employ her。〃
In the winter of the year 1824; 〃Several instances occurred of its prevalence among the patients of particular practitioners; whilst others who were equally busy met with few or none。 One instance of this kind was very remarkable。 A general practitioner; in large midwifery practice; lost so many patients from puerperal fever; that he determined to deliver no more for some time; but that his partner should attend in his place。 This plan was pursued for one month; during which not a case of the disease occurred in their practice。 The elder practitioner; being then sufficiently recovered; returned to his practice; but the first patient he attended was attacked by the disease and died。 A physician; who met him in consultation soon afterwards; about a case of a different kind; and who knew nothing of his misfortune; asked him whether puerperal fever was at all prevalent in his neighborhood; on which he burst into tears; and related the above circumstances。
〃Among the cases which I saw this season in consultation; four occurred in one month in the practice of one medical man; and all of them terminated fatally。〃 'Lond。 Med。 Gaz。 May 2; 1835。'
Dr。 Ramsbotham asserted; in a Lecture at the London Hospital; that he had known the disease spread through a particular district; or be confined to the practice of a particular person; almost every patient being attacked with it; while others had not a single case。 It seemed capable; he thought; of conveyance; not only by common modes; but through the dress of the attendants upon the patient。
In a letter to be found in the 〃London Medical Gazette〃for January; 1840; Mr。 Roberton of Manchester makes the statement which I here give in a somewhat condensed form。
A midwife delivered a woman on the 4th of December; 1830; who died soon after with the symptoms of puerperal fever。 In one month from this date the same midwife delivered thirty women; residing in different parts of an extensive suburb; of which number sixteen caught the disease and all died。 These were the only cases which had occurred for a considerable time in Manchester。 The other midwives connected with the same charitable institution as the woman already mentioned are twenty…five in number; and deliver; on an average; ninety women a week; or about three hundred and eighty a month。 None of these women had a case of puerperal fever。 〃Yet all this time this woman was crossing the other midwives in every direction; scores of the patients of the charity being delivered by them in the very same quarters where her cases of fever were happening。〃
Mr。 Roberton remarks; that little more than half the women she delivered during this month took the fever; that on some days all escaped; on others only one or more out of three or four; a circumstance similar to what is seen in other infectious maladies。
Dr。 Blundell says; 〃Those who have never made the experiment can have but a faint conception how difficult it is to obtain the exact truth respecting any occurrence in which feelings and interests are concerned。 Omitting particulars; then; I content myself with remarking; generally; that from more than one district I have received accounts of the prevalence of puerperal fever in the practice of some individuals; while its occurrence in that of others; in the same neighborhood; was not observed。 Some; as I have been told; have lost ten; twelve; or a greater number of patients; in scarcely broken succession; like their evil genius; the puerperal fever has seemed to stalk behind them wherever they went。 Some have deemed it prudent to retire for a time from practice。 In fine; that this fever may occur spontaneously; I admit; that its infectious nature may be plausibly disputed; I do not deny; but I add; considerately; that in my own family I had rather that those I esteemed the most should be delivered; unaided; in a stable; by the manger…side; than that they should receive the best help; in the fairest apartment; but exposed to the vapors of this pitiless disease。 Gossiping friends; wet…nurses; monthly nurses; the practitioner himself; these are the channels by which; as I suspect; the infection is principally conveyed。〃
At a meeting of the Royal Medical and Chirurgical Society; Dr。 King mentioned that some years since a practitioner 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 neighboring surgeons any cases of this disease。
At the same meeting Mr。 Hutchinson mentioned the occurrence of three consecutive cases of puerperal fever; followed subsequently by two others; all in the practice of one accoucheur。'Lancet; May 2; 1840。'
Dr。 Lee makes the following statement: 〃In the last two weeks of September; 1827; five fatal cases of uterine inflammation came under our observation。 All the individuals so attacked had been attended in labor by the same midwife; 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 t