In country practice, all kinds of work must be done since there are not enough men to specialize, but it is inexcusable in the city where a man can always be clean and keep clean, if he is willing to forego the income derived from attendance upon septic and infectious cases. Any article not surgically clean may contaminate the patient by contact; but ulcers, suppurating wounds, abscesses, and hands improperly or insufficiently cleaned are the deadliest causes of post partum temperature. Infections are said to be either self-produced or brought to the patient from without. The only organism that is demonstrably self-infectious is the gonococcus, which may be present in the vagina before labor and may infect the puerperal woman; but it is wiser, safer, and more nearly accords with the facts, to regard all infections as alien borne, as brought to the patient and introduced by the unclean hands or instruments of her medical attendants. =Prevention.=—A conscientious and capable nurse or doctor will not go from an infected case to a confinement. Both will keep their bodies clean, the teeth filled, and pyorrhœas scraped and treated. The occurrence of pus anywhere on the body is sufficient reason for the doctor to give up his confinements for a time, and the nurse to report off duty. No raw, and but few mucous surfaces should be touched by the fingers of the attendants, where a sterile instrument can be used. The nurse should never make vaginal examinations unless an emergency exists, and then only when her instruction has been thorough and her experience great. Every examination is a possible source of danger, no matter how carefully the hands and patient are prepared. The nurse is not to change the pads without washing her hands, and she must wash her hands always after changing the pads, before dressing the navel of the child. The navel or eyes of the child may be infected easily by the hands of nurse, doctor, or patient. The breasts of the mother may be infected by the hands of nurse, doctor or patient. The vulva and vagina of the puerperal woman is highly susceptible to infection from the hands of nurse, doctor or patient. _Rule._—_All temperatures arising in the puerperium are due to infection, unless satisfactorily explained by finding the source._ The possibility of a slightly elevated temperature from insignificant causes may be kept in mind, but such temperatures are transient and yield quickly to appropriate treatment or to none at all. Puerperal infection is most apt to appear during the first week of the lying-in period, and it generally develops about the third or fourth day post partum. If the symptoms come on later than this, there is always a hope that the infection has taken its origin in something else than the labor.