Let me begin by throwing out certain incidental questions, which, without
being absolutely essential, would render the subject more complicated,
and by making such concessions and assumptions as may be fairly supposed
to be without the pale of discussion.
1. It is granted that all the forms of what is called puerperal fever
may not be, and probably are not, equally contagious or infectious. I do
not enter into the distinctions which have been drawn by authors, because
the facts do not appear to me sufficient to establish any absolute line
of demarcation between such forms as may be propagated by contagion and
those which are never so propagated. This general result I shall only
support by the authority of Dr. Ramsbotham, who gives, as the result of
his experience, that the same symptoms belong to what he calls the
infectious and the sporadic forms of the disease, and the opinion of
Armstrong in his original Essay. If others can show any such
distinction, I leave it to them to do it. But there are cases enough
that show the prevalence of the disease among the patients of a single
practitioner when it was in no degree epidemic, in the proper sense of
the term. I may refer to those of Mr. Roberton and of Dr. Peirson,
hereafter to be cited, as examples.
2. I shall not enter into any dispute about the particular mode of
infection, whether it be by the atmosphere the physician carries about
him into the sick-chamber, or by the direct application of the virus to
the absorbing surfaces with which his hand comes in contact.
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