II ...  “The time to which you allude was in 1830.  The first case was in February, during a very cold time.  She was confined the 4th, and died the 12th.  Between the 10th and 28th of this month I attended six women in labor, all of whom did well except the last, as also two who were confined March 1st and 5th.  Mrs. E., confined February 28th, sickened, and died March 8th.  The next day, 9th, I inspected the body, and the night after attended a lady, Mrs. B., who sickened, and died 16th.  The 10th, I attended another, Mrs. G., who sickened, but recovered.  March 16th I went from Mrs. G.’s room to attend a Mrs. H., who sickened, and died 21st.  The 17th, I inspected Mrs. B. On the 19th, I went directly from Mrs. H.’s room to attend another lady, Mrs. G., who also sickened, and died 22d.  While Mrs. B. was sick, on 15th, I went directly from her room a few rods, and attended another woman, who was not sick.  Up to 20th of this month I wore the same clothes.  I now refused to attend any labor, and did not till April 21st, when, having thoroughly cleansed myself, I resumed my practice, and had no more puerperal fever.

“The cases were not confined to a narrow space.  The two nearest were half a mile from each other, and half that distance from my residence.  The others were from two to three miles apart, and nearly that distance from my residence.  There were no other cases in their immediate vicinity which came to my knowledge.  The general health of all the women was pretty good, and all the labors as good as common, except the first.  This woman, in consequence of my not arriving in season, and the child being half-born at some time before I arrived, was very much exposed to the cold at the time of confinement, and afterwards, being confined in a very open, cold room.  Of the six cases, you perceive only one recovered.

“In the winter of 1817 two of my patients had puerperal fever, one very badly, the other not so badly.  Both recovered.  One other had swelled leg or phlegmasia dolens, and one or two others did not recover as well as usual.

“In the summer of 1835 another disastrous period occurred in my practice.  July 1st I attended a lady in labor, who was afterwards quite ill and feverish; but at the time I did not consider her case a decided puerperal fever.  On the 8th I attended one who did well.  On the 12th, one who was seriously sick.  This was also an equivocal case, apparently arising from constipation and irritation of the rectum.  These women were ten miles apart and five from my residence.  On 15th and 2Oth two who did well.  On 25th I attended another.  This was a severe labor, and followed by unequivocal puerperal fever, or peritonitis.  She recovered.  August 2nd and 3rd, in about twenty-four hours, I attended four persons.  Two of them did very well; one was attacked with some of the common symptoms, which, however, subsided in a day or two, and the other had decided puerperal fever, but recovered.  This woman resided