hysician, the disease
not existing or prevailing in the neighborhood, he would do wisely to
relinquish his obstetrical practice for at least one month, and endeavor
to free himself by every available means from any noxious influence he
may carry about with him.

6. The occurrence of three or more closely connected cases, in the
practice of one individual, no others existing in the neighborhood, and
no other sufficient cause being alleged for the coincidence, is prima
facie evidence that he is the vehicle of contagion.

7. It is the duty of the physician to take every precaution that the
disease shall not be introduced by nurses or other assistants, by making
proper inquiries concerning them, and giving timely warning of every
suspected source of danger.

8. Whatever indulgence may be granted to those who have heretofore
been the ignorant causes of so much misery, the time has come when the
existence of a private pestilence in the sphere of a single physician
should be looked upon, not as a misfortune, but a crime; and in the
knowledge of such occurrences the duties of the practitioner to his
profession should give way to his paramount obligations to society.
ADDITIONAL REFERENCES AND CASES.

Fifth Annual Report of the Registrar-General of England.

1843. Appendix. Letter from William Farr, Esq.--Several new series of
cases are given in the Letter of Mr. Stows, contained in the Appendix to
this Report. Mr. Stows suggests precautions similar to those I have laid
down, and these precautions are strongly enforced by Mr. Farr, who is,
therefore, obnoxious to the same criticisms as myself.

Hall and Dexter, in Am. Journal of Med. Sc. for January, 1844.--Cases of
puerperal fever seeming to originate in erysipelas.

Elkington, of Birmingham, in Provincial Med. Journal, cited in Am.
Journ. Med. Sc. for April, 1844.--Six cases in less than a fortnight,
seeming to originate in a case of erysipelas.

West's Reports, in Brit. and For. Med. Review for October, 1845, and
January, 1847.--Affection of the arm, resembling malignant pustule,
after removing the placenta of a patient who died from puerperal fever.
Reference to cases at Wurzburg, as proving contagion, and to Keiller's
cases in the Monthly Journal for February, 1846, as showing connection
of puerperal fever and erysipelas.

Kneeland.--Contagiousness of Puerperal Fever. Am. Jour. Med. Se.,
January, 1846. Also, Connection between Puerperal Fever and Epidemic
Erysipel