“A physician attended a woman in the immediate neighborhood of the cases numbered 2, 3, and 4.  This patient was confined the morning of March 1st, and died on the night of Match 7th.  It is doubtful whether this should be considered a case of puerperal fever.  She had suffered from canker, indigestion, and diarrhoea for a year previous to her delivery.  Her complaints were much aggravated for two or three months previous to delivery; she had become greatly emaciated, and weakened to such an extent that it had not been expected that she would long survive her confinement, if indeed she reached that period.  Her labor was easy enough; she flowed a good deal, seemed exceedingly prostrated, had ringing in her ears, and other symptoms of exhaustion; the pulse was quick and small.  On the second and third day there was some tenderness and tumefaction of the abdomen, which increased somewhat on the fourth and fifth.  He had cases in midwifery before and after this, which presented nothing peculiar.

It is also mentioned in the same letter that another physician had a case during the last summer and another last fall, both of which recovered.

Another gentleman reports a case last December, a second case five weeks, and another three weeks, since.  All these recovered, A case also occurred very recently in the practice of a physician in the village where the eighth patient of Dr. C. resides, which proved fatal “This patient had some patches of erysipelas on the legs and arms.  The same physician has delivered three cases since, which have all done well.  There have been no other cases in this town or its vicinity recently.  There have been some few cases of erysipelas.”  It deserves notice that the partner of Dr. C, who attended the autopsy of the man above mentioned and took an active part in it, who also suffered very slightly from a prick under the thumb-nail received during the examination, had twelve cases of midwifery between March 26th and April 12th, all of which did well, and presented no peculiar symptoms.  It should also be stated that during these seventeen days he was in attendance on all the cases of erysipelas in the house where the autopsy had been performed.  I owe these facts to the prompt kindness of a gentleman whose intelligence and character are sufficient guaranty for their accuracy.

The two following letters were addressed to my friend Dr. Storer by the gentleman in whose practice the cases of puerperal fever occurred.  His name renders it unnecessary to refer more particularly to these gentlemen, who on their part have manifested the most perfect freedom and courtesy in affording these accounts of their painful experience.

“January 38, 1843.