Part 19 (1/2)

No 1, delivered March 20, died March 24

” 2, ”April 9, ” April 14

” 3, ” ” 10, ” ” 14

” 4, ” ” 11, ” ” 18

” 5, ” ” 27, ” May 3

” 6, ” ” 28, had some symptoms, recovered

” 7, ” May 8, had some symptoms, also recovered

These were the only cases attended by this physician during the period referred to, ”They were all attended by him until their termination, with the exception of the patient No 6, who fell into the hands of another physician on the 2d of May” (Dr C

left town for a few days at this time) Dr C attended cases immediately before and after the above-named periods, none of which, however, presented any peculiar symptoms of the disease

About the 1st of July he attended another patient in a neighboring village, who died two or three days after delivery

The first patient, it is stated, was delivered on the 20th of March ”On the 19th Dr C made the autopsy of a ht hours; had oede from a little above the ankle into the cavity of the abdoht hand during the autopsy The hand was quite painful the night following, during his attendance on the patient No 1 He did not see this patient after the 20th, being confined to the house, and very sick from the wound just mentioned, from this time until the 3d of April

Several cases of erysipelas occurred in the house where the autopsy mentioned above took place, soon after the examination

There were also many cases of erysipelas in town at the time of the fatal puerperal cases which have been mentioned

The nurse who laid out the body of the patient No 3 was taken on the evening of the same day with sore throat and erysipelas, and died in ten days from the first attack

The nurse who laid out the body of the patient No 4 was taken on the day folloith symptoms like those of this patient, and died in a week, without any external marks of erysipelas

”No other cases of similar character with those of Dr C

occurred in the practice of any of the physicians in the town or vicinity at the ti confine the past year, but they were not cases of puerperal fever No post-mortem examinations were held in any of these puerperal cases”

So of insertion:

”A physician attended a wohborhood of the cases nu 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 froestion, and diarrhoea for a year previous to her delivery Her coravated for two or three reatly 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, see 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 inpeculiar

It is also mentioned in the sa 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 sos 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 fro the examination, had twelve cases of midwifery between March 26th and April 12th, all of which did well, and presented no peculiar sy these seventeen days he was in attendance on all the cases of erysipelas in the house where the autopsy had been perforentleuaranty for their accuracy

The two following letters were addressed to entleman in whose practice the cases of puerperal fever occurred His name renders it unnecessary to refer entlemen, who on their part havethese accounts of their painful experience

”January 38, 1843

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 tere 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, as 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 ieneral health of all the woood as common, except the first This wo in season, and the child being half-born at some time before I arrived, was very much exposed to the cold at the ti 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, as 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 as 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 tho 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 five miles from me Up to this time I wore the saed On 6th, I attended tomen, one of as not sick at all; but the other, Mrs L, was afterwards taken ill On 10th, I attended a lady, who did very well I had previously changed all arment on which had been in a puerperal room On 12th, I was called to Mrs S, in labor While she was ill, I left her to visit Mrs L, one of the ladies as confined on 6th Mrs L had been more unwell than usual, but I had not considered her case anything more than common till this visit I had on a surtout at this visit, which, on my return to Mrs S, I left in another room Mrs S was delivered on 13th with forceps

These women both died of decided puerperal fever