Willa Cather - "O Pioneers!"

John Hay - "Pike County Ballads and Other Poems"

Eliza Lee Follen - "Little Songs"

John Martin Crawford, trans. - "The Kalevala (complete)"

New Philadelphia Book Publisher Highlights Local Talent
Book and Publishing News from Publishers Newswire(tm)

Looking for Child to be on Cover of a New Book, 'The Model Child'
PHILADELPHIA, Pa. -- The Philadelphia literary world will celebrate the launch of two new players today, April 10th: Kay Square Press, a new publishing company focused on Philadelphia-area artists, their stories, and their art; and Kay Square's first release, 'With the Rich and Mighty: Emlen Etting of Philadelphia' (ISBN: 978-0-9815129-0-7), a critical biography by Kenneth C. Kaleta.

FlatSigned Press Alleges Don Imus Remarks Damage Legacy of President Gerald R. Ford
NEW YORK, N.Y. -- Nathan Yungerberg, an accomplished model scout and professional child photographer is launching a nation-wide casting call to find the cover model for his highly anticipated book release, 'The Model Child: A Parents Guide to the Child Modeling Industry' (ISBN: 978-0-9817018-0-6).

Books: The Harvard Classics Volume 38

V >> Various >> The Harvard Classics Volume 38




The three following statements are now for the first time given
to the public. All of the cases referred to occurred within this
State, and two of the three series in Boston and its immediate
vicinity.

I. The first is a series of cases which took place during the
last spring in a town at some distance from this neighborhood. A
physician of that town, Dr. C, Had the following consecutive
cases:

No. 1, delivered March 20, died March 24.
" 2, " April 9, " April 14.
" 3, " " 10, " " 14.
" 4, " " 11, " " 18.
" 5, " " 27, " May 3.
" 6, " " 28, had some symptoms, recovered.
" 7, " May 8, had some symptoms, also recovered.

These were the only cases attended by this physician during the
period referred to, "They were all attended by him until their
termination, with the exception of the patient No. 6, who fell
into the hands of another physician on the 2d of May." (Dr. C.
left town for a few days at this time.) Dr. C. attended cases
immediately before and after the above-named periods, none of
which, however, presented any peculiar symptoms of the disease.

About the 1st of July he attended another patient in a
neighboring village, who died two or three days after delivery.

The first patient, it is stated, was delivered on the 20th of
March. "On the 19th Dr. C. made the autopsy of a man who had died
suddenly, sick only forty-eight hours; had oedema of the thigh
and gangrene extending from a little above the ankle into the
cavity of the abdomen." Dr. C. wounded himself very slightly in
the right hand during the autopsy. The hand was quite painful the
night following, during his attendance on the patient No. 1. He
did not see this patient after the 20th, being confined to the
house, and very sick from the wound just mentioned, from this
time until the 3d of April.

Several cases of erysipelas occurred in the house where the
autopsy mentioned above took place, soon after the examination.
There were also many cases of erysipelas in town at the time of
the fatal puerperal cases which have been mentioned.

The nurse who laid out the body of the patient No. 3 was taken on
the evening of the same day with sore throat and erysipelas, and
died in ten days from the first attack.

The nurse who laid out the body of the patient No. 4 was taken on
the day following with symptoms like those of this patient, and
died in a week, without any external marks of erysipelas.

"No other cases of similar character with those of Dr. C.
occurred in the practice of any of the physicians in the town or
vicinity at the time. Deaths following confinement have occurred
in the practice of other physicians during the past year, but
they were not cases of puerperal fever. No post-mortem
examinations were held in any of these puerperal cases."

Some additional statements in this letter are deserving of
insertion:

"A physician attended a woman in the immediate neighborhood of
the cases numbered 2, 3, and 4. This patient was confined the
morning of March 1st, and died on the night of Match 7th. It is
doubtful whether this should be considered a case of puerperal
fever. She had suffered from canker, indigestion, and diarrhoea
for a year previous to her delivery. Her complaints were much
aggravated for two or three months previous to delivery; she had
become greatly emaciated, and weakened to such an extent that it
had not been expected that she would long survive her
confinement, if indeed she reached that period. Her labor was
easy enough; she flowed a good deal, seemed exceedingly
prostrated, had ringing in her ears, and other symptoms of
exhaustion; the pulse was quick and small. On the second and
third day there was some tenderness and tumefaction of the
abdomen, which increased somewhat on the fourth and fifth. He had
cases in midwifery before and after this, which presented nothing
peculiar.

It is also mentioned in the same letter that another physician
had a case during the last summer and another last fall, both of
which recovered.

Another gentleman reports a case last December, a second case
five weeks, and another three weeks, since. All these recovered,
A case also occurred very recently in the practice of a physician
in the village where the eighth patient of Dr. C. resides, which
proved fatal "This patient had some patches of erysipelas on the
legs and arms. The same physician has delivered three cases
since, which have all done well. There have been no other cases
in this town or its vicinity recently. There have been some few
cases of erysipelas." It deserves notice that the partner of Dr.
C, who attended the autopsy of the man above mentioned and took
an active part in it, who also suffered very slightly from a
prick under the thumb-nail received during the examination, had
twelve cases of midwifery between March 26th and April 12th, all
of which did well, and presented no peculiar symptoms. It should
also be stated that during these seventeen days he was in
attendance on all the cases of erysipelas in the house where the
autopsy had been performed. I owe these facts to the prompt
kindness of a gentleman whose intelligence and character are
sufficient guaranty for their accuracy.

The two following letters were addressed to my friend Dr. Storer
by the gentleman in whose practice the cases of puerperal fever
occurred. His name renders it unnecessary to refer more
particularly to these gentlemen, who on their part have
manifested the most perfect freedom and courtesy in affording
these accounts of their painful experience.

"January 38, 1843.

II ... "The time to which you allude was in 1830. The first case
was in February, during a very cold time. She was confined the
4th, and died the 12th. Between the 10th and 28th of this month I
attended six women in labor, all of whom did well except the
last, as also two who were confined March 1st and 5th. Mrs. E.,
confined February 28th, sickened, and died March 8th. The next
day, 9th, I inspected the body, and the night after attended a
lady, Mrs. B., who sickened, and died 16th. The 10th, I attended
another, Mrs. G., who sickened, but recovered. March 16th I went
from Mrs. G.'s room to attend a Mrs. H., who sickened, and died
21st. The 17th, I inspected Mrs. B. On the 19th, I went directly
from Mrs. H.'s room to attend another lady, Mrs. G., who also
sickened, and died 22d. While Mrs. B. was sick, on 15th, I went
directly from her room a few rods, and attended another woman,
who was not sick. Up to 20th of this month I wore the same
clothes. I now refused to attend any labor, and did not till
April 21st, when, having thoroughly cleansed myself, I resumed my
practice, and had no more puerperal fever.

"The cases were not confined to a narrow space. The two nearest
were half a mile from each other, and half that distance from my
residence. The others were from two to three miles apart, and
nearly that distance from my residence. There were no other cases
in their immediate vicinity which came to my knowledge. The
general health of all the women was pretty good, and all the
labors as good as common, except the first. This woman, in
consequence of my not arriving in season, and the child being
half-born at some time before I arrived, was very much exposed to
the cold at the time of confinement, and afterwards, being
confined in a very open, cold room. Of the six cases, you
perceive only one recovered.

"In the winter of 1817 two of my patients had puerperal fever,
one very badly, the other not so badly. Both recovered. One other
had swelled leg or phlegmasia dolens, and one or two others did
not recover as well as usual.

"In the summer of 1835 another disastrous period occurred in my
practice. July 1st I attended a lady in labor, who was afterwards
quite ill and feverish; but at the time I did not consider her
case a decided puerperal fever. On the 8th I attended one who did
well. On the 12th, one who was seriously sick. This was also an
equivocal case, apparently arising from constipation and
irritation of the rectum. These women were ten miles apart and
five from my residence. On 15th and 2Oth two who did well. On
25th I attended another. This was a severe labor, and followed by
unequivocal puerperal fever, or peritonitis. She recovered.
August 2nd and 3rd, in about twenty-four hours, I attended four
persons. Two of them did very well; one was attacked with some of
the common symptoms, which, however, subsided in a day or two,
and the other had decided puerperal fever, but recovered. This
woman resided five miles from me. Up to this time I wore the same
coat. All my other clothes had frequently been changed. On 6th, I
attended two women, one of whom was not sick at all; but the
other, Mrs. L., was afterwards taken ill. On 10th, I attended a
lady, who did very well. I had previously changed all my clothes,
and had no garment on which had been in a puerperal room. On
12th, I was called to Mrs. S., in labor. While she was ill, I
left her to visit Mrs. L., one of the ladies who was confined on
6th. Mrs. L. had been more unwell than usual, but I had not
considered her case anything more than common till this visit. I
had on a surtout at this visit, which, on my return to Mrs. S., I
left in another room. Mrs. S. was delivered on 13th with forceps.
These women both died of decided puerperal fever.

"While I attended these women in their fevers I changed my
clothes, and washed my hands in a solution of chloride of lime
after each visit. I attended seven women in labor during this
period, all of whom recovered without sickness.

"In my practice I have had several single cases of puerperal
fever, some of whom have died and some have recovered. Until the
year 1830 I had no suspicion that the disease could be
communicated from one patient to another by a nurse or midwife;
but I now think the foregoing facts strongly favor that idea. I
was so much convinced of this fact that I adopted the plan before
related.

"I believe my own health was as good as usual at each of the
above periods. I have no recollection to the contrary.

"I believe I have answered all your questions. I have been more
particular on some points perhaps than necessary; but I thought
you could form your own opinion better than to take mine. In 1830
I wrote to Dr. Channing a more particular statement of my cases.
If I have not answered your questions sufficiently, perhaps Dr.
C. may have my letter to him, and you can find your answer
there." [Footnote: In a letter to myself this gentleman also
stated," I do not recollect that there was any erysipelas or any
other disease particularly prevalent at the time."]

"Boston, February 3, 1843.

III. "My Dear Sir: I received a note from you last evening
requesting me to answer certain questions therein proposed,
touching the cases of puerperal fever which came under my
observation the past summer. It gives me pleasure to comply with
your request, so far as it is in my power so to do, but, owing to
the hurry in preparing for a journey, the notes of the cases I
had then taken were lost or mislaid. The principal facts,
however, are too vivid upon my recollection to be soon forgotten.
I think, therefore, that I shall be able to give you all the
information you may require.

"All the cases that occurred in my practice took place between
the 7th of May and the 17th of June, 1842.

They were not confined to any particular part of the city. The
first two cases were patients residing at the South End, the next
was at the extreme North End, one living in Sea Street and the
other in Roxbury. The following is the order in which they
occurred:

"CASE 1.--Mrs.-- was confined on the 7th of May, at 5 o'clock, P.
M., after a natural labor of six hours. At 12 o'clock at night,
on the 9th (thirty-one hours after confinement), she was taken
with severe chill, previous to which she was as comfortable as
women usually are under the circumstances. She died on the 10th.

"CASE 2.--Mrs.-- was confined on the 10th of June (four weeks
after Mrs. C), at 11 A. M., after a natural, but somewhat severe,
labor of five hours. At 7 o'clock, on the morning of the 11th,
she had a chill. Died on the 12th.

"CASE 3.--Mrs.--, confined on the 14th of June, was comfortable
until the 18th, when symptoms of puerperal fever were manifest.
She died on the 20th.

"CASE 4.--Mrs.--, confined June 17th, at 5 o'clock, A. M., was
doing well until the morning of the 19th. She died on the evening
of the 21st.

"CASE 5.--Mrs.--was confined with her FIFTH child on the 17th of
June, at 6 o'clock in the evening. This patient had been attacked
with puerperal fever, at three of her previous confinements, but
the disease yielded to depletion and other remedies without
difficulty. This time, I regret to say, I was not so fortunate.
She was not attacked, as were the other patients, with a chill,
but complained of extreme pain in the abdomen, and tenderness on
pressure, almost from the moment of her confinement. In this, as
in the other cases, the disease resisted all remedies, and she
died in great distress on the 22d of the same month. Owing to the
extreme heat of the season and my own indisposition, none of the
subjects were examined after death. Dr. Channing, who was in
attendance with me on the three last cases, proposed to have a
post-mortem examination of the subject of case No. 5, but from
some cause which I do not now recollect it was not obtained.

"You wish to know whether I wore the same clothes when attending
the different cases. I cannot positively say, but I should think
I did not, as the weather became warmer after, the first two
cases; I therefore think it probable that I made a change of at
least a PART of my dress. I have had no other case of puerperal
fever in my own practice for three years, save those above
related, and I do not remember to have lost a patient before with
this disease. While absent, last July, I visited two patients
sick with puerperal fever, with a friend of mine in the country.
Both of them recovered.

"The cases that I have recorded were not confined to any
particular constitution or temperament, but it seized upon the
strong and the weak, the old and the young--one being over forty
years, and the youngest under eighteen years of age... If the
disease is of an erysipelatous nature, as many suppose,
contagionists may perhaps find some ground for their belief in
the fact that, for two weeks previous to my first case of
puerperal fever, I had been attending a severe case of
erysipelas, and the infection may have been conveyed through me
to the patient; but, on the other hand, why is not this the case
with other physicians, or with the same physician at all times,
for since my return from the country I have had a more inveterate
case of erysipelas than ever before, and no difficulty whatever
has attended any of my midwifery cases?"

I am assured, on unquestionable authority, that "about three
years since a gentleman in extensive midwifery business, in a
neighboring State, lost in the course of a few weeks eight
patients in child-bed, seven of them being undoubted cases of
puerperal fever. No other physician of the town lost a single
patient of this disease during the same period." And from what I
have heard in conversation with some of our most experienced
practitioners, I am inclined to think many cases of the kind
might be brought to light by extensive inquiry.

This long catalogue of melancholy histories assumes a still
darker aspect when we remember how kindly nature deals with the
parturient female, when she is not immersed in the virulent
atmosphere of an impure lying-in hospital, or poisoned in her
chamber by the unsuspected breath of contagion. From all causes
together not more than four deaths in a thousand births and
miscarriages happened in England and Wales during the period
embraced by the first Report of the Registrar-General. [Footnote:
First Report, p. 105.] In the second Report the mortality was
shown to be about five in one thousand. [Footnote: Second Report,
p. 73.] In the Dublin Lying-in Hospital, during the seven years
of Dr. Collins's mastership, there was one case of puerperal
fever to 178 deliveries, or less than six to the thousand, and
one death from this disease in 278 cases, or between three and
four to the thousand. [Footnote: Collins's Treatise on Midwifery,
p. 228, etc.] Yet during this period the disease was endemic in
the hospital, and might have gone on to rival the horrors of the
pestilence of the Maternite, had not the poison been destroyed by
a thorough purification.

In private practice, leaving out of view the cases that are to be
ascribed to the self-acting system of propagation, it would seem
that the disease must be far from common. Mr. White, of
Manchester, says: "Out of the whole number of lying-in patients
whom I have delivered (and I may safely call it a great one), I
have never lost one, nor to the best of my recollection has one
been greatly endangered, by the puerperal, miliary, low nervous,
putrid malignant, or milk fever." [Footnote: Op. cit., p. 115.]
Dr. Joseph Clarke informed Dr. Collins that in the course of
FORTY-FIVE years' most extensive practice he lost but FOUR
patients from this disease. [Footnote: Op. cit., p.228.] One of
the most eminent practitioners of Glasgow who has been engaged in
very extensive practice for upwards of a quarter of a century
testifies that he never saw more than twelve cases of real
puerperal fever. [Footnote: Lancet, May 4, 1833.]

I have myself been told by two gentlemen practicing in this city,
and having for many years a large midwifery business, that they
had neither of them lost a patient from this disease, and by one
of them that he had only seen it in consultation with other
physicians. In five hundred cases of midwifery, of which Dr.
Storer has given an abstract in the first number of this journal,
there was only one instance of fatal puerperal peritonitis.

In the view of these facts it does appear a singular coincidence
that one man or woman should have ten, twenty, thirty, or seventy
cases of this rare disease following his or her footsteps with
the keenness of a beagle, through the streets and lanes of a
crowded city, while the scores that cross the same paths on the
same errands know it only by name. It is a series of similar
coincidences which has led us to consider the dagger, the musket,
and certain innocent-looking white powders as having some little
claim to be regarded as dangerous. It is the practical
inattention to similar coincidences which has given rise to the
unpleasant but often necessary documents called INDICTMENTS,
which has sharpened a form of the cephalotome sometimes employed
in the case of adults, and adjusted that modification of the
fillet which delivers the world of those who happen to be too
much in the way while such striking coincidences are taking
place.

I shall now mention a few instances in which the disease appears
to have been conveyed by the process of direct inoculation.

Dr. Campbell, of Edinburgh, states that in October, 1821, he
assisted at the post-mortem examination of a patient who died
with puerperal fever. He carried the pelvic viscera in his pocket
to the class-room. The same evening he attended a woman in labor
without previously changing his clothes; this patient died. The
next morning he delivered a woman with the forceps; she died
also, and of many others who were seized with the disease within
a few weeks, three shared the same fate in succession.

In June, 1823, he assisted some of his pupils at the autopsy of a
case of puerperal fever. He was unable to wash his hands with
proper care, for want of the necessary accommodations. On getting
home he found that two patients required his assistance. He went
without further ablution or changing his clothes; both these
patients died with puerperal fever. [Footnote: Lond. Med.
Gazette, December 10, 1831.] This same Dr. Campbell is one of Dr.
Churchill's authorities against contagion.

Mr. Roberton says that in one instance within his knowledge a
practitioner passed the catheter for a patient with puerperal
fever late in the evening; the same night he attended a lady who
had the symptoms of the disease on the second day. In another
instance a surgeon was called while in the act of inspecting the
body of a woman who had died of this fever, to attend a labor;
within forty-eight hours this patient was seized with the fever
[Footnote: Ibid. for January 1832].

On the 16th of March, 1831, a medical practitioner examined the
body of a woman who had died a few days after delivery, from
puerperal peritonitis. On the evening of the 17th he delivered a
patient, who was seized with puerperal fever on the 19th, and
died on the 24th. Between this period and the 6th of April the
same practitioner attended two other patients, both of whom were
attacked with the same disease and died. [Footnote: London Cyc.
of Pract. Med., art., "Fever, Puerperal."]

In the autumn of 1829 a physician was present at the examination
of a case of puerperal fever, dissected out the organs, and
assisted in sewing up the body. He had scarcely reached home when
he was summoned to attend a young lady in labor. In sixteen hours
she was attacked with the symptoms of puerperal fever, and
narrowly escaped with her life. [Footnote: Ibid.]

In December, 1830, a midwife, who had attended two fatal cases of
puerperal fever at the British Lying-in Hospital, examined a
patient who had just been admitted, to ascertain if labor had
commenced. This patient remained two days in the expectation that
labor would come on, when she returned home and was then suddenly
taken in labor and delivered before she could set out for the
hospital. She went on favorably for two days, and was then taken
with puerperal fever and died in thirty-six hours. [Footnote:
Ibid.]

A young practitioner, contrary to advice, examined the body of a
patient who had died from puerperal fever; there was no epidemic
at the time; the case appeared to be purely sporadic. He
delivered three other women shortly afterwards; they all died
with puerperal fever, the symptoms of which broke out very soon
after labor. The patients of his colleague did well, except one,
where he assisted to remove some coagula from the uterus; she was
attacked in the same manner as those whom he had attended, and
died also." The writer in the "British and Foreign Medical
Review," from whom I quote this statement,--and who is no other
than Dr. Rigby,--adds: "We trust that this fact alone will
forever silence such doubts, and stamp the well-merited epithet
of 'criminal,' as above quoted, upon such attempts [Footnote:
Brit. and For. Medical Review for January, 1842, p. 112.]

From the cases given by Mr. Ingleby I select the following: Two
gentlemen, after having been engaged in conducting the post-
mortem examination of a case of puerperal fever, went in the same
dress, each respectively, to a case of midwifery. "The one
patient was seized with the rigor about thirty hours afterwards.
The other patient was seized with a rigor the third morning after
delivery. ONE RECOVERED, ONE DIED." [Footnote: Edin. Med. and
Surg. Journal, April 1838.] One of these same gentlemen attended
another woman in the same clothes two days after the autopsy
referred to. "The rigor did not take place until the evening of
the fifth day from the first visit. RESULT FATAL." These cases
belonged to a series of seven, the first of which was thought to
have originated in a case of erysipelas. "Several cases of a mild
character followed the foregoing seven, and their nature being
now most unequivocal, my friend declined visiting all midwifery
cases for a time, and there was no recurrence of the disease."
These cases occurred in 1833. Five of them proved fatal. Mr.
Ingleby gives another series of seven cases which occurred to a
practitioner in 1836, the first of which was also attributed to
his having opened several erysipelatous abscesses a short time
previously.

I need not refer to the case lately read before this society, in
which a physician went, soon after performing an autopsy of a
case of puerperal fever, to a woman in labor, who was seized with
the same disease and perished. The forfeit of that error has been
already paid.

At a meeting of the Medical and Chirurgical Society before
referred to, Dr. Merriman related an instance occurring in his
own practice, which excites a reasonable suspicion that two lives
were sacrificed to a still less dangerous experiment. He was at
the examination of a case of puerperal fever at two o'clock in
the afternoon. HE TOOK CARE NOT TO TOUCH THE BODY. At nine
o'clock the same evening he attended a woman in labor; she was so
nearly delivered that he had scarcely anything to do. The next
morning she had severe rigors, and in forty-eight hours she was a
corpse. Her infant had erysipelas and died in two days.
[Footnote: Lancet, May 2, 1840.]

In connection with the facts which have been stated it seems
proper to allude to the dangerous and often fatal effects which
have followed from wounds received in the post-mortem examination
of patients who have died of puerperal fever. The fact that such
wounds are attended with peculiar risk has been long noticed. I
find that Chaussier was in the habit of cautioning his students
against the danger to which they were exposed in these
dissections. [Footnote: Stein, L'Art d'Accoucher, 1794; Dict. des
Sciences Medicales, art., "Puerperal."] The head pharmacien of
the Hotel Dieu, in his analysis of the fluid effused in puerperal
peritonitis, says that practitioners are convinced of its
deleterious qualities, and that it is very dangerous to apply it
to the denuded skin. [Footnote: Journal de Pharmacie, January
1836.] Sir Benjamin Brodie speaks of it as being well known that
the inoculation of lymph or pus from the peritoneum of a
puerperal patient is often attended with dangerous and even fatal
symptoms. Three cases in confirmation of this statement, two of
them fatal, have been reported to this society within a few
months.