I am assured, on unquestionable authority, that “about three years since a gentleman in extensive midwifery business, in a neighboring State, lost in the course of a few weeks eight patients in child-bed, seven of them being undoubted cases of puerperal fever.  No other physician of the town lost a single patient of this disease during the same period.”  And from what I have heard in conversation with some of our most experienced practitioners, I am inclined to think many cases of the kind might be brought to light by extensive inquiry.

This long catalogue of melancholy histories assumes a still darker aspect when we remember how kindly nature deals with the parturient female, when she is not immersed in the virulent atmosphere of an impure lying-in hospital, or poisoned in her chamber by the unsuspected breath of contagion.  From all causes together not more than four deaths in a thousand births and miscarriages happened in England and Wales during the period embraced by the first Report of the Registrar-General. [Footnote:  First Report, p. 105.] In the second Report the mortality was shown to be about five in one thousand. [Footnote:  Second Report, p. 73.] In the Dublin Lying-in Hospital, during the seven years of Dr. Collins’s mastership, there was one case of puerperal fever to 178 deliveries, or less than six to the thousand, and one death from this disease in 278 cases, or between three and four to the thousand. [Footnote:  Collins’s Treatise on Midwifery, p. 228, etc.] Yet during this period the disease was endemic in the hospital, and might have gone on to rival the horrors of the pestilence of the Maternite, had not the poison been destroyed by a thorough purification.

In private practice, leaving out of view the cases that are to be ascribed to the self-acting system of propagation, it would seem that the disease must be far from common.  Mr. White, of Manchester, says:  “Out of the whole number of lying-in patients whom I have delivered (and I may safely call it a great one), I have never lost one, nor to the best of my recollection has one been greatly endangered, by the puerperal, miliary, low nervous, putrid malignant, or milk fever.” [Footnote:  Op. cit., p. 115.] Dr. Joseph Clarke informed Dr. Collins that in the course of forty-five years’ most extensive practice he lost but four patients from this disease. [Footnote:  Op. cit., p.228.] One of the most eminent practitioners of Glasgow who has been engaged in very extensive practice for upwards of a quarter of a century testifies that he never saw more than twelve cases of real puerperal fever. [Footnote:  Lancet, May 4, 1833.]

I have myself been told by two gentlemen practicing in this city, and having for many years a large midwifery business, that they had neither of them lost a patient from this disease, and by one of them that he had only seen it in consultation with other physicians.  In five hundred cases of midwifery, of which Dr. Storer has given an abstract in the first number of this journal, there was only one instance of fatal puerperal peritonitis.