As one humble member of a profession which for more than two thousand years has devoted itself to the pursuit of the best earthly interests of mankind, always assailed and insulted from without by such as are ignorant of its infinite perplexities and labors, always striving in unequal contest with the hundred-armed giant who walks in the noonday, and sleeps not in the midnight, yet still toiling, not merely for itself and the present moment, but for the race and the future, I have lifted my voice against this lifeless delusion, rolling its shapeless bulk into the path of a noble science it is too weak to strike, or to injure.
THE CONTAGIOUSNESS OF PUERPERAL FEVER
Printed in 1843; reprinted with additions, 1855.
THE POINT AT ISSUE.
THE AFFIRMATIVE.
"The disease known as Puerperal Fever is so far contagious as to be frequently carried from patient to patient by physicians and nurses."
O. W. Holmes, 1843.
THE NEGATIVE.
"The result of the whole discussion will, I trust, serve, not only to exalt your views of the value and dignity of our profession, but to divest your minds of the overpowering dread that you can ever become, especially to woman, under the extremely interesting circumstances of gestation and parturition, the minister of evil; that you can ever convey, in any possible manner, a horrible virus, so destructive in its effects, and so mysterious in its operations as that attributed to puerperal fever." --Professor Hodge, 1852.
"I prefer to attribute them to accident, or Providence, of which I can form a conception, rather than to a contagion of which I cannot form any clear idea, at least as to this particular malady."--
Professor Meigs, 1852.
" . . . in the propagation of which they have no more to do, than with the propagation of cholera from Jessore to San Francisco, and from Mauritius to St. Petersburg."--Professor Meigs, 1854.
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"I arrived at that certainty in the matter, that I could venture to foretell what women would be affected with the disease, upon hearing by what midwife they were to be delivered, or by what nurse they were to be attended, during their lying-in; and, almost in every instance, my prediction was verified." --Gordon, 1795.
"A certain number of deaths is caused every year by the contagion of puerperal fever, communicated by the nurses and medical attendants."
Farr, in Fifth Annual Report of Registrar-General of England, 1843.
". . . boards of health, if such exist, or, without them, the medical institutions of a country, should have the power of coercing, or of inflicting some kind of punishment on those who recklessly go from cases of puerperal fevers to parturient or puerperal females, without using due precaution; and who, having been shown the risk, criminally encounter it, and convey pestilence and death to the persons they are employed to aid in the most interesting and suffering period of female existence." --Copland's Medical Dictionary, Art. Puerperal States and Diseases, 1852.
"We conceive it unnecessary to go into detail to prove the contagious nature of this disease, as there are few, if any, American practitioners who do not believe in this doctrine." --Dr. Lee, in Additions to Article last cited.
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[INTRODUCTORY NOTE.] It happened, some years ago, that a discussion arose in a Medical Society of which I was a member, involving the subject of a certain supposed cause of disease, about which something was known, a good deal suspected, and not a little feared. The discussion was suggested by a case, reported at the preceding meeting, of a physician who made an examination of the body of a patient who had died with puerperal fever, and who himself died in less than a week, apparently in consequence of a wound received at the examination, having attended several women in confinement in the mean time, all of whom, as it was alleged, were attacked with puerperal fever.
Whatever apprehensions and beliefs were entertained, it was plain that a fuller knowledge of the facts relating to the subject would be acceptable to all present. I therefore felt that it would be doing a good service to look into the best records I could find, and inquire of the most trustworthy practitioners I knew, to learn what experience had to teach in the matter, and arrived at the results contained in the following pages.
The Essay was read before the Boston Society for Medical Improvement, and, at the request of the Society, printed in the "New England Quarterly Journal of Medicine and Surgery" for April, 1843. As this Journal never obtained a large circulation, and ceased to be published after a year's existence, and as the few copies I had struck off separately were soon lost sight of among the friends to whom they were sent, the Essay can hardly be said to have been fully brought before the Profession.
The subject of this Paper has the same profound interest for me at the present moment as it had when I was first collecting the terrible evidence out of which, as it seems to me, the commonest exercise of reason could not help shaping the truth it involved. It is not merely on account of the bearing of the question,--if there is a question,--on all that is most sacred in human life and happiness, that the subject cannot lose its interest. It is because it seems evident that a fair statement of the facts must produce its proper influence on a very large proportion of well-constituted and unprejudiced minds. Individuals may, here and there, resist the practical bearing of the evidence on their own feelings or interests; some may fail to see its meaning, as some persons may be found who cannot tell red from green; but I cannot doubt that most readers will be satisfied and convinced, to loathing, long before they have finished the dark obituary calendar laid before them.
