“Case 1.  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 9th
(thirty-one hours after confinement), she was taken with severe chill,
previous to which she was as comfortable as women usually are under the
circumstances.  She died on the 10th.

“Case 2.  Mrs._____ was confined on the 10th of June (four weeks after
Mrs. C.), at 11 A. M., after a natural, but somewhat severe labor of
five hours.  At 7 o’clock, on the morning of the 11th, she had a chill. 
Died on the 12th.

“Case 3.  Mrs._____ , confined on the 14th of June, was comfortable until
the 18th, when symptoms of puerperal fever were manifest.  She died on
the 20th.

“Case 4.  Mrs._____ , confined June 17th, at 5 o’clock, A. M., was doing
well until the morning of the 19th.  She died on the evening of the 21st.

“Case 5.  Mrs._____ was confined with her fifth child on the 17th 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 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. Channing, who was in attendance
with me on the three last cases, proposed to have a post-mortem
examination of the subject of case No. 5, but from some cause which I do
not now recollect it was not obtained.

“You wish to know whether I wore the same clothes when attending the different cases.  I cannot positively say, but I should think I did not, as the weather became warmer after the first two cases; I therefore think it probable that I made a change of at least a part of my dress.  I have had no other case of puerperal fever in my own practice for three years, save those above related, and I do not remember to have lost a patient before with this disease.  While absent, last July, I visited two patients sick with puerperal fever, with a friend of mine in the country.  Both of them recovered.

“The cases that I have recorded were not confined to any particular constitution or temperament, but it seized upon the strong and the weak, the old and the young,—­one being over forty years, and the youngest under eighteen years of age . . . .  If the disease is of an erysipelatous nature, as many suppose, contagionists may perhaps find some ground for their belief in the fact, that, for two weeks previous to my first case of puerperal fever, I had been attending a severe case of erysipelas, and the infection may have been conveyed through me to the patient; but, on the other hand, why is not this the case with other physicians, or with the same physician at all times, for since my return from the country I have had a more inveterate case of erysipelas than ever before, and no difficulty whatever has attended any of my midwifery cases?”