ING　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。〃
  Even　previously　to　Gordon；　Mr。　White　of　Manchester　had　said；　〃I　am　acquainted　with　two　gentlemen　in　another　town；　where　the　whole　business　of　midwifery　is　divided　betwixt　them；　and　it　is　very　remarkable　that　one　of　them　loses　several　patients　every　year　of　the　puerperal　fever；　and　the　other　never　so　much　as　meets　with　the　disorder；〃a　difference　which　he　seems　to　attribute　to　their　various　modes　of　treatment。　＇On　the　Management　of　Lying…in　Women；　p。　　120。＇
  Dr。　Armstrong　has　given　a　number　of　instances　in　his　Essay　on　Puerperal　Fever；　of　the　prevalence　of　the　disease　among　the　patients　of　a　single　practitioner。　　At　Sunderland；　〃in　all；　forty…three　cases　occurred　from　the　1st　of　January　to　the　1st　of　October；　when　the　disease　ceased；　and　of　this　number　forty　were　witnessed　by　Mr。　Gregson　and　his　assistant；　Mr。　Gregory；　the　remainder　having　been　separately　seen　by　three　accoucheurs。〃　　There　is　appended　to　the　London　edition　of　this　Essay；　a　letter　from　Mr。　Gregson；　in　which　that　gentleman　says；　in　reference　to　the　great　number　of　cases　occurring　in　his　practice；　〃The　cause　of　this　I　cannot　pretend　fully　to　explain；　but　I　should　be　wanting　in　common　liberality　if　I　were　to　make　any　hesitation　in　asserting；　that　the　disease　which　appeared　in　my　practice　was　highly　contagious；　and　communicable　from　one　puerperal　woman　to　another。〃　　〃It　is　customary　among　the　lower　and　middle　ranks　of　people　to　make　frequent　personal　visits　to　puerperal　women　resident　in　the　same　neighborhood；　and　I　have　ample　evidence　for　affirming　that　the　infection　of　the　disease　was　often　carried　about　in　that　manner；　and；　however　painful　to　my　feelings；　I　must　in　candor　declare；　that　it　is　very　probable　the　contagion　was　conveyed；　in　some　instances；　by　myself；　though　I　took　every　possible　care　to　prevent　such　a　thing　from　happening；　the　moment　that　I　ascertained　that　the　distemper　was　infectious。〃　　Dr。　Armstrong　goes　on　to　mention　six　other　instances　within　his　knowledge；　in　which　the　disease　had　at　different　times　and　places　been　limited；　in　the　same　singular　manner；　to　the　practice　of　individuals；　while　it　existed　scarcely　if　at　all　among　the　patients　of　others　around　them。　　Two　of　the　gentlemen　became　so　convinced　of　their　conveying　the　contagion；　that　they　withdrew　for　a　time　from　practice。
  I　find　a　brief　notice；　in　an　American　Journal；　of　another　series　of　cases；　first　mentioned　by　Mr。　Davies；　in　the　〃Medical　Repository。〃　This　gentleman　stated　his　conviction　that　the　disease　is　contagious。
  〃In　the　autumn　of　1822　he　met　with　twelve　cases；　while　his　medical　friends　in　the　neighborhood　did　not　meet　with　any；　'　or　at　least　very　few。'　　He　could　attribute　this　circumstance　to　no　other　cause　than　his　having　been　present　at　the　examination；　after　death；　of　two　cases；　some　time　previous；　and　of　his　having　imparted　the　disease　to　his　patients；　notwithstanding　every　precaution。'〃
  Dr。　Gooch　says；　〃It　is　not　uncommon　for　the　greater　number　of　cases　to　occur　in　the　practice　of　one　man；　whilst　the　other　practitioners　of　the　neighborhood；　who　are　not　more　skilful　or　more　busy；　meet　with　few　or　none。　　A　practitioner　opened　the　body　of　a　woman　who　had　died　of　puerperal　fever；　and　continued　to　wear　the　same　clothes。　　A　lady　whom　he　delivered　a　few　days　afterwards　was　attacked　with　and　died　of　a　similar　disease；　two　more　of　his　lying…in　patients；　in　rapid　succession；　met　with　the　same　fate；　struck　by　the　thought；　that　he　might　have　carried　contagion　in　his　clothes；　he　instantly　changed　them；　and　met　with　no　more　cases　of　the　kind。'　　A　woman　in　the　country；　who　was　employed　as　washerwoman　and　nurse；　washed　the　linen　of　one　who　had　died　of　puerperal　fever；　the　next　lying…in　patient　she　nursed　died　of　the　same　disease；　a　third　nursed　by　her　met　with　the　same　fate；　till　the　neighborhood；　getting　afraid　of　her；　ceased　to　employ　her。〃
  In　the　winter　of　the　year　1824；　〃Several　instances　occurred　of　its　prevalence　among　the　patients　of　particular　practitioners；　whilst　others　who　were　equally　busy　met　with　few　or　none。　　One　instance　of　this　kind　was　very　remarkable。　　A　general　practitioner；　in　large　midwifery　practice；　lost　so　many　patients　from　puerperal　fever；　that　he　determined　to　deliver　no　more　for　some　time；　but　that　his　partner　should　attend　in　his　place。　　This　plan　was　pursued　for　one　month；　during　which　not　a　case　of　the　disease　occurred　in　their　practice。　The　elder　practitioner；　being　then　sufficiently　recovered；　returned　to　his　practice；　but　the　first　patient　he　attended　was　attacked　by　the　disease　and　died。　　A　physician；　who　met　him　in　consultation　soon　afterwards；　about　a　case　of　a　different　kind；　and　who　knew　nothing　of　his　misfortune；　asked　him　whether　puerperal　fever　was　at　all　prevalent　in　his　neighborhood；　on　which　he　burst　into　tears；　and　related　the　above　circumstances。
  〃Among　the　cases　which　I　saw　this　season　in　consultation；　four　occurred　in　one　month　in　the　practice　of　one　medical　man；　and　all　of　them　terminated　fatally。〃　＇Lond。　　Med。　　Gaz。　　May　2；　1835。＇
  Dr。　Ramsbotham　asserted；　in　a　Lecture　at　the　London　Hospital；　that　he　had　known　the　disease　spread　through　a　particular　district；　or　be　confined　to　the　practice　of　a　particular　person；　almost　every　patient　being　attacked　with　it；　while　others　had　not　a　single　case。　　It　seemed　capable；　he　thought；　of　conveyance；　not　only　by　common　modes；　but　through　the　dress　of　the　attendants　upon　the　patient。
  In　a　letter　to　be　found　in　the　〃London　Medical　Gazette〃for　January；　1840；　Mr。　Roberton　of　Manchester　makes　the　statement　which　I　here　give　in　a　somewhat　condensed　form。
  A　midwife　delivered　a　woman　on　the　4th　of　December；　1830；　who　died　soon　after　with　the　symptoms　of　puerperal　fever。　　In　one　month　from　this　date　the　same　midwife　delivered　thirty　women；　residing　in　different　parts　of　an　extensive　suburb；　of　which　number　sixteen　caught　the　disease　and　all　died。　　These　were　the　only　cases　which　had　occurred　for　a　considerable　time　in　Manchester。　　The　other　midwives　connected　with　the　same　charitable　institution　as　the　woman　already　mentioned　are　twenty…five　in　number；　and　deliver；　on　an　average；　ninety　women　a　week；　or　about　three　hundred　and　eighty　a　month。　　None　of　these　women　had　a　case　of　puerperal　fever。　　〃Yet　all　this　time　this　woman　was　crossing　the　other　midwives　in　every　direction；　scores　of　the　patients　of　the　charity　being　delivered　by　them　in　the　very　same　quarters　where　her　cases　of　fever　were　happening。〃
  Mr。　Roberton　remarks；　that　little　more　than　half　the　women　she　delivered　during　this　month　took　the　fever；　that　on　some　days　all　escaped；　on　others　only　one　or　more　out　of　three　or　four；　a　circumstance　similar　to　what　is　seen　in　other　infectious　maladies。
  Dr。　Blundell　says；　〃Those　who　have　never　made　the　experiment　can　have　but　a　faint　conception　how　difficult　it　is　to　obtain　the　exact　truth　respecting　any　occurrence　in　which　feelings　and　interests　are　concerned。　　Omitting　particulars；　then；　I　content　myself　with　remarking；　generally；　that　from　more　than　one　district　I　have　received　accounts　of　the　prevalence　of　puerperal　fever　in　the　practice　of　some　individuals；　while　its　occurrence　in　that　of　others；　in　the　same　neighborhood；　was　not　observed。　　Some；　as　I　have　been　told；　have　lost　ten；　twelve；　or　a　greater　number　of　patients；　in　scarcely　broken　succession；　like　their　evil　genius；　the　puerperal　fever　has　seemed　to　stalk　behind　them　wherever　they　went。　　Some　have　deemed　it　prudent　to　retire　for　a　time　from　practice。　　In　fine；　that　this　fever　may　occur　spontaneously；　I　admit；　that　its　infectious　nature　may　be　plausibly　disputed；　I　do　not　deny；　but　I　add；　considerately；　that　in　my　own　family　I　had　rather　that　those　I　esteemed　the　most　should　be　delivered；　unaided；　in　a　stable；　by　the　manger…side；　than　that　they　should　receive　the　best　help；　in　the　fairest　apartment；　but　exposed　to　the　vapors　of　this　pitiless　disease。　　Gossiping　friends；　wet…nurses；　monthly　nurses；　the　practitioner　himself；　these　are　the　channels　by　which；　as　I　suspect；　the　infection　is　principally　conveyed。〃
  At　a　meeting　of　the　Royal　Medical　and　Chirurgical　Society；　Dr。　King　mentioned　that　some　years　since　a　practitioner　at　Woolwich　lost　sixteen　patients　from　puerperal　fever　in　the　same　year。　　He　was　compelled　to　give　up　practice　for　one　or　two　years；　his　business　being　divided　among　the　neighboring　practitioners。　　No　case　of　puerperal　fever　occurred　afterwards；　neither　had　any　of　the　neighboring　surgeons　any　cases　of　this　disease。
  At　the　same　meeting　Mr。　Hutchinson　mentioned　the　occurrence　of　three　consecutive　cases　of　puerperal　fever；　followed　subsequently　by　two　others；　all　in　the　practice　of　one　accoucheur。＇Lancet；　May　2；　1840。＇
  Dr。　Lee　makes　the　following　statement：　〃In　the　last　two　weeks　of　September；　1827；　five　fatal　cases　of　uterine　inflammation　came　under　our　observation。　　All　the　individuals　so　attacked　had　been　attended　in　labor　by　the　same　midwife；　and　no　example　of　a　febrile　or　inflammatory　disease　of　a　serious　nature　occurred　during　that　period　among　the　other　patients　of　the　Westminster　General　Dispensary；　who　had　been　attended　by　t