It is not pretended that the disease
is always, or even, it may be, in the majority of cases, carried about by
attendants; only that it is so carried in certain cases. That it may
have local and epidemic causes, as well as that depending on personal
transmission, is not disputed. Remember how small-pox often disappears
from a community in spite of its contagious character, and the necessary
exposure of many persons to those suffering from it; in both diseases
contagion is only one of the coefficients of the disease.
I have already spoken of the possibility that Dr. Meigs may have been the
medium of transfer of puerperal fever in some of the cases he has briefly
catalogued. Of Dr. Rutter's cases I do not know how to speak. I only
ask the student to read the facts stated by Dr. Condie, as given in my
Essay, and say whether or not a man should allow his wife to be attended
by a practitioner in whose hands "scarcely a female that has been
delivered for weeks past has escaped an attack," "while no instance of
the disease has occurred in the patients of any other accoucheur
practising in the same district." If I understand Dr. Meigs and Dr.
Hodge, they would not warn the physician or spare the patient under such
circumstances. They would "go on," if I understand them, not to seven,
or seventy, only, but to seventy times seven, if they could find
patients.
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