第14章

findonlookingatthebooksellers’cataloguesthatoneBigel，orBigelius，tospeakmoreclassically，hasbeenatvarioustimespublishingHomoeopathicbooksforsomeyears。

Again，onlookingintothe“EncyclographiedesSciencesMedicales“

forApril，1840，Ifindaworkentitled“ManualofHYDROSUDOPATHY，ortheTreatmentofDiseasesbyColdWater，etc。，etc。，byDr。Bigel，PhysicianoftheSchoolofStrasburg，MemberoftheMedico-

ChirurgicalInstituteofNaples，oftheAcademyofSt。Petersburg，——

AssessoroftheCollegeoftheEmpireofRussia，PhysicianofhislateImperialHighnesstheGrandDukeConstantine，ChevalieroftheLegionofHonor，etc。“HydrosudopathyorHydropathy，asitissometimescalled，isanewmedicaldoctrineorpracticewhichhassprungupinGermanysinceHomoeopathy，whichitbidsfairtodriveoutofthemarket，if，asDr。Bigelsays，fourteenphysiciansafflictedwithdiseaseswhichdefiedthemselvesandtheircolleaguescametoGraefenberg，intheyear1836alone，andwerecured。NowDr。

Bigel，“whoseelevatedreputationiswellknowninEurope，“writesasfollows：“ThereaderwillnotfailtoseeinthisdefenceofthecurativemethodofGraefenbergaprofessionofmedicalfaith，andhewillbecorrectinsodoing。“Andhisworkcloseswiththefollowingsentence，worthyofsodistinguishedanindividual：“Webelieve，withreligion，thatthewaterofbaptismpurifiesthesoulfromitsoriginalsin；letusbelievealso，withexperience，thatitisforourcorporealsinstheredeemerofthehumanbody。“IfBigel，PhysiciantothelateGrandDukeConstantine，isidenticalwithBigelwhomthe“Examiner“callsPhysiciantotheEmperorofRussia，itappearsthatheisnowactivelyengagedinthrowingcoldwateratonceuponhispatientsandthefutureprospectsofHomoeopathy。

If，asmustbeadmitted，nooneofHahnemann’sdoctrinesisreceivedwithtolerableunanimityamonghisdisciples，exceptthecentralaxiom，Similiasimilibuscurantur；ifthisaxiomitselfreliesmainlyforitssupportuponthefollyandtrickeryofHahnemann，whatcanwethinkofthosewhoannouncethemselvesreadytorelinquishalltheaccumulatedtreasuresofourart，totriflewithlifeuponthestrengthofthesefantastictheories？Whatshallwethinkofprofessedpractitionersofmedicine，if，inthewordsofJahr，“fromignorance，fortheirpersonalconvenience，orthroughcharlatanism，theytreattheirpatientsonedayHomoeopathicallyandthenextAllopathically；“iftheyparadetheirpretendednewsciencebeforetheunguardedportionofthecommunity；iftheysuffertheirnamestobecoupledwithitwhereveritmaygainacredulouspatient；anddenyallresponsibilityforitscharacter，refuseallargumentforitsdoctrines，allegenopalliationfortheignoranceanddeceptioninterwovenwitheverythreadofitsflimsytissue，whentheyarequestionedbythosecompetenttojudgeandentitledtoananswer？

SuchisthepretendedscienceofHomoeopathy，towhichyouareaskedtotrustyourlivesandthelivesofthosedearesttoyou。Amingledmassofperverseingenuity，oftinselerudition，ofimbecilecredulity，andofartfulmisrepresentation，toooftenmingledinpractice，ifwemaytrusttheauthorityofitsfounder，withheartlessandshamelessimposition。Becauseitissufferedsooftentoappealunansweredtothepublic，becauseithasitsjournals，itspatrons，itsapostles，someareweakenoughtosupposeitcanescapetheinevitabledoomofutterdisgraceandoblivion。NotmanyyearscanpassawaybeforethesamecuriosityexcitedbyoneofPerkins’sTractorswillbeawakenedatthesightofoneoftheInfinitesimalGlobules。Ifitshouldclaimalongerexistence，itcanonlybebyfallingintothehandsofthesordidwretcheswhowringtheirbreadfromthecoldgraspofdiseaseanddeathinthehovelsofignorantpoverty。

Asonehumblememberofaprofessionwhichformorethantwothousandyearshasdevoteditselftothepursuitofthebestearthlyinterestsofmankind，alwaysassailedandinsultedfromwithoutbysuchasareignorantofitsinfiniteperplexitiesandlabors，alwaysstrivinginunequalcontestwiththehundred-armedgiantwhowalksinthenoonday，andsleepsnotinthemidnight，yetstilltoiling，notmerelyforitselfandthepresentmoment，butfortheraceandthefuture，Ihaveliftedmyvoiceagainstthislifelessdelusion，rollingitsshapelessbulkintothepathofanoblescienceitistooweaktostrike，ortoinjure。

THECONTAGIOUSNESSOFPUERPERALFEVER

Printedin1843；reprintedwithadditions，1855。

THEPOINTATISSUE。

THEAFFIRMATIVE。

“ThediseaseknownasPuerperalFeverissofarcontagiousastobefrequentlycarriedfrompatienttopatientbyphysiciansandnurses。“

O。W。Holmes，1843。

THENEGATIVE。

“Theresultofthewholediscussionwill，Itrust，serve，notonlytoexaltyourviewsofthevalueanddignityofourprofession，buttodivestyourmindsoftheoverpoweringdreadthatyoucaneverbecome，especiallytowoman，undertheextremelyinterestingcircumstancesofgestationandparturition，theministerofevil；thatyoucaneverconvey，inanypossiblemanner，ahorriblevirus，sodestructiveinitseffects，andsomysteriousinitsoperationsasthatattributedtopuerperalfever。“——ProfessorHodge，1852。

“Iprefertoattributethemtoaccident，orProvidence，ofwhichI

canformaconception，ratherthantoacontagionofwhichIcannotformanyclearidea，atleastastothisparticularmalady。“——

ProfessorMeigs，1852。

“……inthepropagationofwhichtheyhavenomoretodo，thanwiththepropagationofcholerafromJessoretoSanFrancisco，andfromMauritiustoSt。Petersburg。“——ProfessorMeigs，1854——

“Iarrivedatthatcertaintyinthematter，thatIcouldventuretoforetellwhatwomenwouldbeaffectedwiththedisease，uponhearingbywhatmidwifetheyweretobedelivered，orbywhatnursetheyweretobeattended，duringtheirlying-in；and，almostineveryinstance，mypredictionwasverified。“——Gordon，1795。

“Acertainnumberofdeathsiscausedeveryyearbythecontagionofpuerperalfever，communicatedbythenursesandmedicalattendants。“

Farr，inFifthAnnualReportofRegistrar-GeneralofEngland，1843。

“……boardsofhealth，ifsuchexist，or，withoutthem，themedicalinstitutionsofacountry，shouldhavethepowerofcoercing，orofinflictingsomekindofpunishmentonthosewhorecklesslygofromcasesofpuerperalfeverstoparturientorpuerperalfemales，withoutusingdueprecaution；andwho，havingbeenshowntherisk，criminallyencounterit，andconveypestilenceanddeathtothepersonstheyareemployedtoaidinthemostinterestingandsufferingperiodoffemaleexistence。“——Copland’sMedicalDictionary，Art。PuerperalStatesandDiseases，1852。

“Weconceiveitunnecessarytogointodetailtoprovethecontagiousnatureofthisdisease，astherearefew，ifany，Americanpractitionerswhodonotbelieveinthisdoctrine。“——Dr。Lee，inAdditionstoArticlelastcited。

[INTRODUCTORYNOTE。]Ithappened，someyearsago，thatadiscussionaroseinaMedicalSocietyofwhichIwasamember，involvingthesubjectofacertainsupposedcauseofdisease，aboutwhichsomethingwasknown，agooddealsuspected，andnotalittlefeared。Thediscussionwassuggestedbyacase，reportedattheprecedingmeeting，ofaphysicianwhomadeanexaminationofthebodyofapatientwhohaddiedwithpuerperalfever，andwhohimselfdiedinlessthanaweek，apparentlyinconsequenceofawoundreceivedattheexamination，havingattendedseveralwomeninconfinementinthemeantime，allofwhom，asitwasalleged，wereattackedwithpuerperalfever。

Whateverapprehensionsandbeliefswereentertained，itwasplainthatafullerknowledgeofthefactsrelatingtothesubjectwouldbeacceptabletoallpresent。IthereforefeltthatitwouldbedoingagoodservicetolookintothebestrecordsIcouldfind，andinquireofthemosttrustworthypractitionersIknew，tolearnwhatexperiencehadtoteachinthematter，andarrivedattheresultscontainedinthefollowingpages。

TheEssaywasreadbeforetheBostonSocietyforMedicalImprovement，and，attherequestoftheSociety，printedinthe“NewEnglandQuarterlyJournalofMedicineandSurgery“forApril，1843。AsthisJournalneverobtainedalargecirculation，andceasedtobepublishedafterayear’sexistence，andasthefewcopiesIhadstruckoffseparatelyweresoonlostsightofamongthefriendstowhomtheyweresent，theEssaycanhardlybesaidtohavebeenfullybroughtbeforetheProfession。

ThesubjectofthisPaperhasthesameprofoundinterestformeatthepresentmomentasithadwhenIwasfirstcollectingtheterribleevidenceoutofwhich，asitseemstome，thecommonestexerciseofreasoncouldnothelpshapingthetruthitinvolved。Itisnotmerelyonaccountofthebearingofthequestion，——ifthereisaquestion，——onallthatismostsacredinhumanlifeandhappiness，thatthesubjectcannotloseitsinterest。Itisbecauseitseemsevidentthatafairstatementofthefactsmustproduceitsproperinfluenceonaverylargeproportionofwell-constitutedandunprejudicedminds。Individualsmay，hereandthere，resistthepracticalbearingoftheevidenceontheirownfeelingsorinterests；

somemayfailtoseeitsmeaning，assomepersonsmaybefoundwhocannottellredfromgreen；butIcannotdoubtthatmostreaderswillbesatisfiedandconvinced，toloathing，longbeforetheyhavefinishedthedarkobituarycalendarlaidbeforethem。

IdonotknowthatIshalleveragainhavesogoodanopportunityofbeingusefulaswasgrantedmebytheraisingofthequestionwhichproducedthisEssay。ForIhaveabundantevidencethatithasmademanypractitionersmorecautiousintheirrelationswithpuerperalfemales，andIhavenodoubtitwilldosostill，ifithasachanceofbeingread，thoughitshouldcalloutahundredcounterblasts，provingtothesatisfactionoftheirauthorsthatitprovednothing。

Andformypart，Ihadratherrescueonemotherfrombeingpoisonedbyherattendant，thanclaimtohavesavedfortyoutoffiftypatientstowhomIhadcarriedthedisease。Thus，Iamwillingtoavailmyselfofanyhintcomingfromwithouttoofferthispaperoncemoretothepress。Theoccasionhaspresenteditself，aswillbeseen，inaconvenientifnotinaflatteringform。

IsendthisEssayagaintotheMEDICALPROFESSION，withoutthechangeofawordorsyllable。Ifind，onreviewingit，thatitanticipatesandeliminatesthosesecondaryquestionswhichcannotbeentertainedforamomentuntiltheonegreatpointoffactisperemptorilysettled。Initsverystatementofthedoctrinemaintaineditavoidsalldiscussionofthenatureofthedisease“knownaspuerperalfever，“andallthesomewhatstalephilologyofthewordcontagion。

Itmentions，fairlyenough，thenamesofsceptics，orunbelieversastotherealityofpersonaltransmission；ofDewees，ofTonnelle，ofDuges，ofBaudelocque，andothers；ofcourse，notincludingthosewhoseworkswerethenunwrittenorunpublished；norenumeratingalltheContinentalwriterswho，inignoranceofthegreatmassofevidenceaccumulatedbyBritishpractitioners，couldhardlybecalledwellinformedonthissubject。Itmeetsallthearrayofnegativecases，——thoseinwhichdiseasedidnotfollowexposure，——bythestrikingexampleofsmall-pox，which，althoughoneofthemostcontagiousofdiseases，issubjecttothemostremarkableirregularitiesandseemingcapricesinitstransmission。Itmakesfullallowanceforothercausesbesidespersonaltransmission，especiallyforepidemicinfluences。Itallowsforthepossibilityofdifferentmodesofconveyanceofthedestructiveprinciple。Itrecognizesandsupportsthebeliefthataseriesofcasesmayoriginatefromasingleprimitivesourcewhichaffectseachnewpatientinturn；andespeciallyfromcasesofErysipelas。Itdoesnotundertaketodiscussthetheoreticalaspectofthesubject；thatisasecondarymatterofconsideration。Wherefactsarenumerous，andunquestionable，andunequivocalintheirsignificance，theorymustfollowthemasitbestmay，keepingtimewiththeirstep，andnotgobeforethem，marchingtothesoundofitsowndrumandtrumpet。Havingthusnarroweditsareatoalimitedpracticalplatformofdiscussion，amatteroflifeanddeath，andnotofphrasesortheories，itcoverseveryinchofitwithamassofevidencewhichIconceiveaCommitteeofHusbands，whocancountcoincidencesanddrawconclusionsaswellasaSynodofAccoucheurs，wouldjustlyconsiderasaffordingamplereasonsforanunceremoniousdismissalofapractitioner(ifitisconceivablethatsuchastepcouldbewaitedfor)，afterfiveorsixfuneralshadmarkedthepathofhisdailyvisits，whileotherpractitionerswerenotthusescorted。TotheProfession，therefore，Isubmitthepaperinitsoriginalform，andleaveittotakecareofitself。

TotheMEDICALSTUDENTS，intowhosehandsthisEssaymayfall，somewordsofintroductionmaybeappropriate，andperhaps，toasmallnumberofthem，necessary。Therearesomeamongthemwho，fromyouth，orwantoftraining，areeasilybewilderedandconfusedinanyconflictofopinionsintowhichtheirstudiesleadthem。Theyareliabletolosesightofthemainquestionincollateralissues，andtoberunawaywithbysuggestivespeculations。Theyconfoundbeliefwithevidence，oftentrustingthefirstbecauseitisexpressedwithenergy，andslightingthelatterbecauseitiscalmandunimpassioned。Theyarenotsatisfiedwithproof；theycannotbelieveapointissettledsolongaseverybodyisnotsilenced。

Theyhavenotlearnedthaterrorisgotoutofthemindsthatcherishit，asthetaeniaisremovedfromthebody，onejoint，orafewjointsatatime，forthemostpart，rarelythewholeevilatonce。

Theynaturallyhavefaithintheirinstructors，turningtothemfortruth，andtakingwhattheymaychoosetogivethem；babesinknowledge，notyetabletotellthebreastfromthebottle，pumpingawayforthemilkoftruthatallthatoffers，wereitnothingbetterthanaProfessor’sshrivelledforefinger。