2. I shall not enter into any dispute about the particular MODE
of infection, whether it be by the atmosphere the physician
carries about him into the sick-chamber, or by the direct
application of the virus to the absorbing surfaces with which his
hand comes in contact. Many facts and opinions are in favour of
each of these modes of transmission. But it is obvious that, in
the majority of cases, it must be impossible to decide by which
of these channels the disease is conveyed, from the nature of the
intercourse between the physician and the patient.
3. It is not pretended that the contagion of puerperal fever must
always be followed by the disease. It is true of all contagious
diseases that they frequently spare those who appear to be fully
submitted to their influence. Even the vaccine virus, fresh from
the subject, fails every day to produce its legitimate effect,
though every precaution is taken to insure its action. This is
still more remarkably the case with scarlet fever and some other
diseases.
4. It is granted that the disease may be produced and variously
modified by many causes besides contagion, and more especially by
epidemic and endemic influences. But this is not peculiar to the
disease in question. There is no doubt that smallpox is
propagated to a great extent by contagion, yet it goes through
the same records of periodical increase and diminution which have
been remarked in puerperal fever. If the question is asked how we
are to reconcile the great variations in the mortality of
puerperal fever in different seasons and places with the
supposition of contagion, I will answer it by another question
from Mr. Farr's letter to the Registrar-General. He makes the
statement that "FIVE die weekly of smallpox in the metropolis
when the disease is not epidemic," and adds, "The problem for
solution is, Why do the five deaths become 10, 15, 20, 31, 58,
88, weekly, and then progressively fall through the same measured
steps?"
5. I take it for granted that if it can be shown that great
numbers of lives have been and are sacrificed to ignorance or
blindness on this point, no other error of which physicians or
nurses may be occasionally suspected will be alleged in
palliation of this; but that whenever and wherever they can be
shown to carry disease and death instead of health and safety,
the common instincts of humanity will silence every attempt to
explain away their responsibility.
The treatise of Dr. Gordon, of Aberdeen, was published in the
year 1795, being among the earlier special works upon the
disease. A part of his testimony has been occasionally copied
into other works, but his expressions are so clear, his
experience is given with such manly distinctness and
disinterested honesty, that it may be quoted as a model which
might have been often followed with advantage.
Public-domain text, read in full here on John Shaqi.
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