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Holmes, Oliver Wendell, 1809-1894

"Medical Essays, 1842-1882"

"In the practice of one gentleman extensively engaged as an
obstetrician, nearly every female he has attended in confinement, during
several weeks past, within the above limits" (the southern sections and
neighboring districts), "had been attacked by the fever."
"An important query presents itself, the Doctor observed, in reference to
the particular form of fever now prevalent. Is it, namely, capable of
being propagated by contagion, and is a physician who has been in
attendance upon a case of the disease warranted in continuing, without
interruption, his practice as an obstetrician? Dr. C., although not a
believer in the contagious character of many of those affections
generally supposed to be propagated in this manner, has nevertheless
become convinced by the facts that have fallen under his notice, that the
puerperal fever now prevailing is capable of being communicated by
contagion. How otherwise can be explained the very curious circumstance
of the disease in one district being exclusively confined to the practice
of a single physician, a Fellow of this College, extensively engaged in
obstetrical practice,--while no instance of the disease has occurred in
the patients under the care of any other accoucheur practising within the
same district; scarcely a female that has been delivered for weeks past
has escaped an attack?"
Dr. Rutter, the practitioner referred to, "observed that, after the
occurrence of a number of cases of the disease in his practice, he had
left the city and remained absent for a week, but on returning, no
article of clothing he then wore having been used by him before, one of
the very first cases of parturition he attended was followed by an attack
of the fever, and terminated fatally; he cannot, readily, therefore,
believe in the transmission of the disease from female to female, in the
person or clothes of the physician.


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