Puerperal Fever, Anticontagionists, and Miasmatic Infection, 1840-1860: Toward a New History of Puerperal Fever in Antebellum America

Journal of the History of Medicine and Allied Sciences

Volumn 52, Issue 4, 1997, Pages 424-452

  Parsons, Gail Pat ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DISEASE TRANSMISSION; EPIDEMIC; FEMALE; HISTORY; HUMAN; IATROGENIC DISEASE; PREGNANCY; PUERPERAL INFECTION; UNITED STATES;

DISEASE OUTBREAKS; DISEASE TRANSMISSION, PROFESSIONAL-TO-PATIENT; FEMALE; HISTORY, 19TH CENTURY; HUMANS; IATROGENIC DISEASE; PREGNANCY; PUERPERAL INFECTION; UNITED STATES;

EID: 0031240871     PISSN: 00225045     EISSN: None     Source Type: Journal    
DOI: 10.1093/jhmas/52.4.424     Document Type: Article

References (112)

1. Charles Hall and George Dexter, "Account of erysipelatous fever, as it appeared in the northern section of Vermont and New Hampshire, in the years 1842-3," Am. J. Med. Sci., 1844, 7, p. 21.
2. Ibid., p. 21. Limiting the scope of this essay to a discussion of puerperal fever in the home precludes discussion of doctors' response to the periodic outbreaks of the disease in hospitals.
3. William Bowen, "Epidemic puerperal fever, at Millersburgh, Ohio," West. Lancet, 1843, 2, 63-66, p. 64.
4. Austin Flint, "Report of cases of epidemic puerperal fever, occurring at Buffalo, New York," N. Y. J. Med. Collat. Sci., 1845, 5, 25-41.
5. Ezra Bennett, "On the identity of erysipelas and a certain form of puerperal fever, and its contagiousness," Am. J. Med. Sci., 1850, 19, 376-83.
6. George W. Sickles, "Epidemic puerperal fever - black tongue - erysipelas, etc," St. Louis Med. Surg. J., 1850, 7, p. 1.
7. Ibid., p. 5 The doctor's comment recalls a caution from Richard Shryock, who acknowledged the importance of studying the response to dramatic, periodic epidemics, such as cholera, but also urged attention to common diseases, which, "in the long run, were more fatal and perhaps equally signficant in the social consequences." Richard Harrison Shryock, "Medical sources and the social historian," chap. in Medicine in America: Historical Essays (Baltimore, Md.: Johns Hopkins Press, 1966): pp. 275-97, p. 278. Shryock's point seems pertinent to puerperal fever, which represented the seamier reality of the sentimentalized image of motherhood common to the era. Indeed, future research may reveal that the loss of maternal life to the disease contributed to the veneration.
8. Ibid., p. 5 The doctor's comment recalls a caution from Richard Shryock, who acknowledged the importance of studying the response to dramatic, periodic epidemics, such as cholera, but also urged attention to common diseases, which, "in the long run, were more fatal and perhaps equally signficant in the social consequences." Richard Harrison Shryock, "Medical sources and the social historian," chap. in Medicine in America: Historical Essays (Baltimore, Md.: Johns Hopkins Press, 1966): pp. 275-97, p. 278. Shryock's point seems pertinent to puerperal fever, which represented the seamier reality of the sentimentalized image of motherhood common to the era. Indeed, future research may reveal that the loss of maternal life to the disease contributed to the veneration.
9. D. C. Colebrook, The Source of Infection in Puerperal Fever due to Haemoylitic Streptococci, Medical Research Council Special Report No. 205 (London: HMOS, 1935), quoted in Leonard Colebrook, "Puerperal infection, 1800-1950, "in Historical Review of British Obstetrics and Gynecology, eds. John Martin Munro Kerr, R. W. Johnstone, and Miles H. Phillips (Edinburgh: E. & S. Livingstone, 1954), pp. 202-25, p. 208.
10. D. C. Colebrook, The Source of Infection in Puerperal Fever due to Haemoylitic Streptococci, Medical Research Council Special Report No. 205 (London: HMOS, 1935), quoted in Leonard Colebrook, "Puerperal infection, 1800-1950, "in Historical Review of British Obstetrics and Gynecology, eds. John Martin Munro Kerr, R. W. Johnstone, and Miles H. Phillips (Edinburgh: E. & S. Livingstone, 1954), pp. 202-25, p. 208.
11. Mary Roth Walsh, Doctors Wanted, No Women Need Apply: Sexual Barriers to the Medical Profession, 1835-1975 (New Haven, Conn.: Yale University Press, 1977); Laurel Thatcher Ulrich, "'The living mother of a living child': Midwifery and mortality in post-revolutionary New England," Wm. Mary Q., 1989, 46, 27-48; Richard W. Wertz and Dorothy C. Wertz, Lying-in: A History of Childbirth in America (New York: Free Press, 1977).
12. Mary Roth Walsh, Doctors Wanted, No Women Need Apply: Sexual Barriers to the Medical Profession, 1835-1975 (New Haven, Conn.: Yale University Press, 1977); Laurel Thatcher Ulrich, "'The living mother of a living child': Midwifery and mortality in post-revolutionary New England," Wm. Mary Q., 1989, 46, 27-48; Richard W. Wertz and Dorothy C. Wertz, Lying-in: A History of Childbirth in America (New York: Free Press, 1977).
13. Mary Roth Walsh, Doctors Wanted, No Women Need Apply: Sexual Barriers to the Medical Profession, 1835-1975 (New Haven, Conn.: Yale University Press, 1977); Laurel Thatcher Ulrich, "'The living mother of a living child': Midwifery and mortality in post-revolutionary New England," Wm. Mary Q., 1989, 46, 27-48; Richard W. Wertz and Dorothy C. Wertz, Lying-in: A History of Childbirth in America (New York: Free Press, 1977).
14. Donald M. McIntyre, "An epidemic of Streptococcus pyogenes, puerperal and postoperative sepsis with an unusual carrier site - the anus," Am. J. Obstet., Gynecol., 1968, 101, 308-13, p. 312; B. E. B. Claesson and U. L.-B. Claesson, "An outbreak of endometritis in a maternity unit caused by spread of the group A streptococci from a showerhead," J. Hosp. Infect., 1985, 6, 304-11.
15. Donald M. McIntyre, "An epidemic of Streptococcus pyogenes, puerperal and postoperative sepsis with an unusual carrier site - the anus," Am. J. Obstet., Gynecol., 1968, 101, 308-13, p. 312; B. E. B. Claesson and U. L.-B. Claesson, "An outbreak of endometritis in a maternity unit caused by spread of the group A streptococci from a showerhead," J. Hosp. Infect., 1985, 6, 304-11.
16. Ronald S. Gibbs and Allan J. Weinstein, "Puerperal infection in the antibiotic era," Am. J. Obstet. Gynecol., 1976, 124, 769-87.
17. Oliver Wendell Holmes, "The contagiousness of puerperal fever [1843]," in Medical Classics, comp. Emerson Crosby Kelly, 1936, 1, 211-43, p. 242. An expanded version of this essay, Puerperal Fever as a Private Pestilence, was published in 1855. Ibid., 245-68. One author seems to have misread Holmes, claiming that he "never suggests that patients suffering from other diseases or corpses of persons who died from other diseases present any special danger to delivering women." Ignaz Semmelweis, The Etiology, Concept, and Prophylaxis of Childbed Fever, trans. K. Codell Carter (1861; rprt. ed., Madison: University of Wisconsin Press, 1983), p. 11.
18. Oliver Wendell Holmes, "The contagiousness of puerperal fever [1843]," in Medical Classics, comp. Emerson Crosby Kelly, 1936, 1, 211-43, p. 242. An expanded version of this essay, Puerperal Fever as a Private Pestilence, was published in 1855. Ibid., 245-68. One author seems to have misread Holmes, claiming that he "never suggests that patients suffering from other diseases or corpses of persons who died from other diseases present any special danger to delivering women." Ignaz Semmelweis, The Etiology, Concept, and Prophylaxis of Childbed Fever, trans. K. Codell Carter (1861; rprt. ed., Madison: University of Wisconsin Press, 1983), p. 11.
19. Oliver Wendell Holmes, "The contagiousness of puerperal fever [1843]," in Medical Classics, comp. Emerson Crosby Kelly, 1936, 1, 211-43, p. 242. An expanded version of this essay, Puerperal Fever as a Private Pestilence, was published in 1855. Ibid., 245-68. One author seems to have misread Holmes, claiming that he "never suggests that patients suffering from other diseases or corpses of persons who died from other diseases present any special danger to delivering women." Ignaz Semmelweis, The Etiology, Concept, and Prophylaxis of Childbed Fever, trans. K. Codell Carter (1861; rprt. ed., Madison: University of Wisconsin Press, 1983), p. 11.
20. The following list is abbreviated, but may be sufficient to suggest the ongoing allure of this episode to historians. Fielding H. Garrison, An Introduction to the History, 3rd rev. ed. (Philadelphia:W. B. Saunders Company, 1924); Charles Edward-Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1843 rprt ed., Madison: University of Wisconsin Press, 1980); Richard H. Shryock, Medicine and Society in America, 1660-1860 (New York: New York University Press, 1960); James H. Cassedy, Medicine in America: A Short History (Baltimore, Md.: Johns Hopkins University Press, 1991), W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1995).
21. The following list is abbreviated, but may be sufficient to suggest the ongoing allure of this episode to historians. Fielding H. Garrison, An Introduction to the History, 3rd rev. ed. (Philadelphia:W. B. Saunders Company, 1924); Charles Edward-Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1843 rprt ed., Madison: University of Wisconsin Press, 1980); Richard H. Shryock, Medicine and Society in America, 1660-1860 (New York: New York University Press, 1960); James H. Cassedy, Medicine in America: A Short History (Baltimore, Md.: Johns Hopkins University Press, 1991), W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1995).
22. The following list is abbreviated, but may be sufficient to suggest the ongoing allure of this episode to historians. Fielding H. Garrison, An Introduction to the History, 3rd rev. ed. (Philadelphia:W. B. Saunders Company, 1924); Charles Edward-Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1843 rprt ed., Madison: University of Wisconsin Press, 1980); Richard H. Shryock, Medicine and Society in America, 1660-1860 (New York: New York University Press, 1960); James H. Cassedy, Medicine in America: A Short History (Baltimore, Md.: Johns Hopkins University Press, 1991), W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1995).
23. The following list is abbreviated, but may be sufficient to suggest the ongoing allure of this episode to historians. Fielding H. Garrison, An Introduction to the History, 3rd rev. ed. (Philadelphia:W. B. Saunders Company, 1924); Charles Edward-Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1843 rprt ed., Madison: University of Wisconsin Press, 1980); Richard H. Shryock, Medicine and Society in America, 1660-1860 (New York: New York University Press, 1960); James H. Cassedy, Medicine in America: A Short History (Baltimore, Md.: Johns Hopkins University Press, 1991), W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1995).
24. The following list is abbreviated, but may be sufficient to suggest the ongoing allure of this episode to historians. Fielding H. Garrison, An Introduction to the History, 3rd rev. ed. (Philadelphia:W. B. Saunders Company, 1924); Charles Edward-Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1843 rprt ed., Madison: University of Wisconsin Press, 1980); Richard H. Shryock, Medicine and Society in America, 1660-1860 (New York: New York University Press, 1960); James H. Cassedy, Medicine in America: A Short History (Baltimore, Md.: Johns Hopkins University Press, 1991), W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1995).
25. Charles D. Meigs, Obstetrics: The Science and the Art (Philadelphia: Lea & Blanchard, 1852), p. 631.
26. Flint, (n. 4) "Epidemic puerperal fever," p. 25.
27. Ibid., 30, 39. Flint would later record in a popular textbook that, "puerperal peritonitis prevailed in conjunction with the epidemic [of erysipelas in the mid-1840s] so uniformly as to show a pathological relationship between these two affections." Austin Flint [Sr.], William Welch, and Austin Flint, Jr., eds., A Treatise on the Principles and Practice of Medicine, 6th rev. ed. (Philadelphia: Lea Brothers & Co., 1886), p. 995.
28. Ibid., 30, 39. Flint would later record in a popular textbook that, "puerperal peritonitis prevailed in conjunction with the epidemic [of erysipelas in the mid-1840s] so uniformly as to show a pathological relationship between these two affections." Austin Flint [Sr.], William Welch, and Austin Flint, Jr., eds., A Treatise on the Principles and Practice of Medicine, 6th rev. ed. (Philadelphia: Lea Brothers & Co., 1886), p. 995.
29. Philip Davenport, "An essay on puerperal fever," N.Y. J. Med. Surg.,1841, 4, 314.
30. "Breaths," in Hippocrates, trans. W. H. S. Jones, 2 (Cambridge: Harvard University Press, 1923), p. 235.
31. Stephen Smith, "New York the Unclean," New York Times, 16 March 1865, pp. 1-2, rprtd. in Gert Brieger, ed., Medical America in the Nineteenth Century (Baltimore, Md.: Johns Hopkins University Press, 1972), p. 267.
32. Stephen Smith, "New York the Unclean," New York Times, 16 March 1865, pp. 1-2, rprtd. in Gert Brieger, ed., Medical America in the Nineteenth Century (Baltimore, Md.: Johns Hopkins University Press, 1972), p. 267.
33. "Breaths," (n. 18), p. 235.
34. William P. Dewees, A Treatise on the Diseases of Females (Philadelphia: H. C. Carey & I. Lea, 1826), p. 407n (emphasis added). The book went through ten editions, and his Compendious System of Midwifery (1824) went through twelve.
35. Samuel Henry Dickson, "On contagion," Am. J. Med. Sci., 1849, 18, 107-18, p. 108.
36. Benjamin Rush, "Observations upon the origin of the malignant bilious or yellow fever in Philadelphia," quoted in Winslow, (n. 13) Conquest, p. 203.
37. Charles D. Meigs, Females and Their Diseases (Philadelphia: Lea and Blanchard, 1848), pp. 580-81.
38. Semmelweis, (n. 12), Etiology, p. 117.
39. Charles E. Rosenberg, The Cholera Years,The United States in 1832, 1849 and 1866 (Chicago: University of Chicago Press, 1962; rprtd. Phoenix Books, 1974); Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Baltimore, Md.: Johns Hopkins University Press, 1994); John V. Pickstone, "Dearth, dirt and fever epidemics: rewriting the history of British 'public health,' 1780-1850," in Epidemics and Ideas: Essays on the Historical Perception of Pestilence, eds. Terence Ranger and Paul Slack (Cambridge: Cambridge University Press, 1995).
40. Charles E. Rosenberg, The Cholera Years,The United States in 1832, 1849 and 1866 (Chicago: University of Chicago Press, 1962; rprtd. Phoenix Books, 1974); Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Baltimore, Md.: Johns Hopkins University Press, 1994); John V. Pickstone, "Dearth, dirt and fever epidemics: rewriting the history of British 'public health,' 1780-1850," in Epidemics and Ideas: Essays on the Historical Perception of Pestilence, eds. Terence Ranger and Paul Slack (Cambridge: Cambridge University Press, 1995).
41. Charles E. Rosenberg, The Cholera Years,The United States in 1832, 1849 and 1866 (Chicago: University of Chicago Press, 1962; rprtd. Phoenix Books, 1974); Sheila M. Rothman, Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (Baltimore, Md.: Johns Hopkins University Press, 1994); John V. Pickstone, "Dearth, dirt and fever epidemics: rewriting the history of British 'public health,' 1780-1850," in Epidemics and Ideas: Essays on the Historical Perception of Pestilence, eds. Terence Ranger and Paul Slack (Cambridge: Cambridge University Press, 1995).
42. Quoted in Winslow, (n. 13) Conquest, pp. 215, 223 (emphasis added).
43. Thomas D. Mitchell, "Practical remarks on contagion and infection," West. Lancet, 1846, 5, 1-8, p. 5.
44. D. A. Morse, "On contagion," Med. Surg. J. 1866, 15, 529-31, p. 529 (emphasis added).
45. Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 1750-1950 (New York: Oxford University Press, 1986), p. 155.
46. Genevieve Miller, "Medicine in 1847 - the United States," Bull. Hist. Med., 1947, 21, 493. The essay won Kneeland the prestigious Boylston prize at the Harvard Medical School, from which he had graduated in 1843.
47. Samuel Kneeland, "On the contagiousness of puerperal fever," Am. J. Med. Sci. 1847, 11, 45-63.
48. Barbara Gutniann Rosenkrantz, Public Health and the State: Changing Views in Massachusetts (Cambridge: Harvard University Press, 1972), p. 12n. Similar comments are in Charles E. Rosenberg, The Care of the Sick: The Rise of America's Hospital System (New York: Basic Books, 1987).
49. Barbara Gutniann Rosenkrantz, Public Health and the State: Changing Views in Massachusetts (Cambridge: Harvard University Press, 1972), p. 12n. Similar comments are in Charles E. Rosenberg, The Care of the Sick: The Rise of America's Hospital System (New York: Basic Books, 1987).
50. The seminal study of the physician as moral arbiter is Carroll Smith-Rosenberg and Charles E. Rosenberg, "The female animal: medical and biological views of women in nineteenth-century America," J. Am. Hist., 1973, 60, 131-54. Rejoinders include Regina Markell Morantz, "The lady and her physician," in Clio's Consciousness Raised: New Perspectives on the History of Women, eds. Mary Hartman and Lois W. Banner (New York: Harper & Row, 1973; Harper Torchbooks, 1974), pp. 38-53; Gail Pat Parsons, "Equal treatment for all: American medical remedies for male sexual problems, 1850-1900," J. Hist. Med. Allied Sci., 1977, 33, 55-71.
51. The seminal study of the physician as moral arbiter is Carroll Smith-Rosenberg and Charles E. Rosenberg, "The female animal: medical and biological views of women in nineteenth-century America," J. Am. Hist., 1973, 60, 131-54. Rejoinders include Regina Markell Morantz, "The lady and her physician," in Clio's Consciousness Raised: New Perspectives on the History of Women, eds. Mary Hartman and Lois W. Banner (New York: Harper & Row, 1973; Harper Torchbooks, 1974), pp. 38-53; Gail Pat Parsons, "Equal treatment for all: American medical remedies for male sexual problems, 1850-1900," J. Hist. Med. Allied Sci., 1977, 33, 55-71.
52. The seminal study of the physician as moral arbiter is Carroll Smith-Rosenberg and Charles E. Rosenberg, "The female animal: medical and biological views of women in nineteenth-century America," J. Am. Hist., 1973, 60, 131-54. Rejoinders include Regina Markell Morantz, "The lady and her physician," in Clio's Consciousness Raised: New Perspectives on the History of Women, eds. Mary Hartman and Lois W. Banner (New York: Harper & Row, 1973; Harper Torchbooks, 1974), pp. 38-53; Gail Pat Parsons, "Equal treatment for all: American medical remedies for male sexual problems, 1850-1900," J. Hist. Med. Allied Sci., 1977, 33, 55-71.
53. Flint, (n. 4) "Epidemic puerperal fever," p. 29.
54. Bennett, (n. 5) "Identity of erysipelas," p. 377.
55. Ibid., p. 382. Chloride of lime was an informed choice, since doctors believed its strong smell destroyed miasmata. See L. C. Beck, "On the nature of the compounds, usually denominated chlorides of soda, lime, etc.; with remarks on their uses as disinfecting agents," N. Y. Med. Phys. J., 1828, 7, 47-65; Joseph Brown, "Disinfection," in The Cyclopedia of Practical Medicine, 1, eds. Robley Dunglison and John Forbes (Philadelphia: Blanc, 1849), 690-95.
56. Ibid., p. 382. Chloride of lime was an informed choice, since doctors believed its strong smell destroyed miasmata. See L. C. Beck, "On the nature of the compounds, usually denominated chlorides of soda, lime, etc.; with remarks on their uses as disinfecting agents," N. Y. Med. Phys. J., 1828, 7, 47-65; Joseph Brown, "Disinfection," in The Cyclopedia of Practical Medicine, 1, eds. Robley Dunglison and John Forbes (Philadelphia: Blanc, 1849), 690-95.
57. Ibid., p. 382. Chloride of lime was an informed choice, since doctors believed its strong smell destroyed miasmata. See L. C. Beck, "On the nature of the compounds, usually denominated chlorides of soda, lime, etc.; with remarks on their uses as disinfecting agents," N. Y. Med. Phys. J., 1828, 7, 47-65; Joseph Brown, "Disinfection," in The Cyclopedia of Practical Medicine, 1, eds. Robley Dunglison and John Forbes (Philadelphia: Blanc, 1849), 690-95.
58. Bennett, (n. 5), "Identity of erysipelas," pp. 380-81.
59. Hall and Dexter, (n. 1) "Account of erysipelatous fever," pp. 17, 19. The nationwide epidemic of erysipelas is described by Madge E. Pickard and R. Carlyle Buley in The Midwest Pioneer: His Ills, Cures and Doctors (New York: Henry Schuman, 1948).
60. Sickles, (n. 6), p. 7.
61. Ibid., 7.
62. "Quarterly summary of the transactions of the College of Physicians of Philadelphia," Am. J. Med. Sci., 1842, 4, 410-18, p. 416.
63. Walter Channing, "On the contagiousness of puerperal fever," Boston Med. Surg. J., 1855, 52, 294.
64. Davenport, (n. 17), p. 320.
65. J. G. F. Holston, "Report on the Committee on Obstetrics," Transactions of the [Sandusky] Ohio Medical Society (Sandusky, Ohio: n.p.,1857), pp. 53-54, 63.
66. Sally MacMillan, Motherhood in the Old South: Pregnancy, Childbirth and Infant Rearing (Baton Rouge: Louisiana State University Press, 1990).
67. Ibid.; Leavitt, (n. 30); Ulrich, (n. 9).
68. Ibid.; Leavitt, (n. 30); Ulrich, (n. 9).
69. L. IfFy, "Control of perinatal infection by traditional preventive measures," Obstet. Gynecol., 1979, 54, 403-11; A. C. Steere and G. F. Mallison, "Handwashing practices for the prevention of nosocomical infections," Ann. Intern. Med., 1975, 52, 683-90.
70. L. IfFy, "Control of perinatal infection by traditional preventive measures," Obstet. Gynecol., 1979, 54, 403-11; A. C. Steere and G. F. Mallison, "Handwashing practices for the prevention of nosocomical infections," Ann. Intern. Med., 1975, 52, 683-90.
71. Charles E. Rosenberg, No Other Gods, On Science and American Social Thought (Baltimore, Md.: Johns Hopkins University Press, 1976), p. 14.
72. Meigs, (n. 24) Females, p. 584.
73. J. W. C. Cuddy, "The true physician," The Baltimorean, 12 February 1887, quoted in J. Wister Meigs, "Puerperal fever and nineteenth century contagionism: the obstetrician's dilemma," Trans. Coll. Phys. Phila., 1975, 52, 273-80, p. 274.
74. J. W. C. Cuddy, "The true physician," The Baltimorean, 12 February 1887, quoted in J. Wister Meigs, "Puerperal fever and nineteenth century contagionism: the obstetrician's dilemma," Trans. Coll. Phys. Phila., 1975, 52, 273-80, p. 274.
75. J. F. Peebles, "Facts in relation to epidemic erysipelas, as it prevailed in Petersburg, Virginia during the winter and spring. 1844-45." Am. J. Med. Sci., 1846, 11, 23-44, p. 25.
76. Ibid., pp. 25, 28.
77. Ibid., p. 28.
78. William Harris, "Contagion of puerperal fever," Boston Med. Surg. J., 1845-46, 33, 238-40, p. 238. See also D. Fordyce Barker, Remarks on Puerperal Fever Before the New York Academy of Medicine, Oct. 7, 1857 (New York: Edward P. Allen, 1857).
79. William Harris, "Contagion of puerperal fever," Boston Med. Surg. J., 1845-46, 33, 238-40, p. 238. See also D. Fordyce Barker, Remarks on Puerperal Fever Before the New York Academy of Medicine, Oct. 7, 1857 (New York: Edward P. Allen, 1857).
80. Joseph M. Smith, "Puerperal fever, its causes and modes of propagation," N. Y. J. Med., 1857, 3, 159.
81. Holmes, (n. 12), p. 214.
82. Ibid., pp. 249, 257 (emphasis added).
83. Charles Knowlton, "Erysipelas and puerperal fever," Boston Med. Surg. J., 1844, 30, 89-95; pp. 90, 94, 95.
84. Ibid., pp. 92, 93
85. Ibid., pp. 91, 93, 94.
86. Ibid., p. 95.
87. James Reed, From Private Vice to Public Virtue: The Birth Control Movement and American Society Since 1830 (New York: Basic Books, 1978), pp. 7-11.
88. Holmes, (n. 12), Private Pestilence, p. 249.
89. Ibid., p. 257.
90. Knowlton, (n. 59), p. 95.
91. Nancy Shrom Dye, "History of childbirth in America," Signs, 1980, 6, 97-108, p. 103.
92. Patricia Branca, Silent Sisterhood: Middle Class Women in the Victorian Home (Philadelphia: Temple University Press, 1976), pp. 86-89.
93. D. F. Leasure, "The erysipelatous disease of lying-in women," Am. J. Med. Sci., 1856, 33, 45-49, pp. 45, 46, 47.
94. Ibid., p. 47.
95. Ibid., p. 47
96. Ibid., p. 48.
97. Jane B. Donegan, "Man-midwifery and the delicacy of the sexes," in Remember the Ladies: New Perspectives on Women in American History, ed. Carol V. R. George (Syracuse, N.Y.: Syracuse University Press, 1975): 99-109.
98. Janet Carlisle Bogdan, "Care or cure?: Childbirth practices in nineteenth century America," Feminist Studies, 1978, 4, 92-99; p. 92.
99. Holmes made the case for the contagiousness of puerperal fever, in part, by reference to the pronouncements of numerous British physicians. Many of them are discussed by Gail Pat Parsons in "The British medical profession and contagion theory: puerperal fever as a case study, 1830-1860," Med. Hist., 1978, 22, 138-50.
100. Meigs, (n. 24) Females, p. 588.
101. A. Clark, "Discussion," N. Y. J. Med., 1857, 2, 370.
102. Fordyce Barker, The Puerperal Diseases. Clinical Lectures Delivered at Bellevue Hospital (New York: D. Appleton & Co., 1874), p. 463.
103. This article supports the conclusion that the rise of anticontagionism in the antebellum era had less to do with acquiesence to economic concerns and more to do with the influence of available epidemiological theory. See John Blake, Public Health in the Town of Boston, 1630-1822 (Cambridge: Harvard University Press, 1959). The seminal economic interpretation is Erwin H. Ackerknecht, "Anticontagionism between 1821 and 1867," Bull. Hist. Med., 1948, 22: 562-93.
104. This article supports the conclusion that the rise of anticontagionism in the antebellum era had less to do with acquiesence to economic concerns and more to do with the influence of available epidemiological theory. See John Blake, Public Health in the Town of Boston, 1630-1822 (Cambridge: Harvard University Press, 1959). The seminal economic interpretation is Erwin H. Ackerknecht, "Anticontagionism between 1821 and 1867," Bull. Hist. Med., 1948, 22: 562-93.
105. L. Nathan et al., "The return of life-threatening puerperal sepsis caused by group A streptococci," Am. J. Obstet. Gynec., 1993, 169, 571-72.
106. I have identified another group of anticontagionists, the absorptionists, who cited decomposing matter rather than miasmata as the cause of puerperal fever; but they also formed factions as a result of their disagreement about the source of the pathogen and, thus, about preventive techniques. One faction believed the decomposing matter was autogenerated within a woman's body, and advocated intrauterine irrigations. Another faction, which included Ignaz Semmelweis, believed that the material was inoculated into a woman's body by doctors whose hands were contaminated by contact with cadavers and weeping sores, among other things. For this reason, they advocated handwashing in chlorinated water. A fuller discussion of the absorptionist wing of antebellum anticontagionists is in my manuscript, "Anticontagionists, decomposing matter and the communicability of puerperal fever."
107. Judy Barrett Litoff, The American Midwife Debate: A Sourcebook on Its Modern Origins (New York: Greenwood Press, 1986); Sylvia D. Hoffert, Private Matters: American Attitudes Toward Childbearing and Infant Nurture in the Urban North, 1800-1860 (Urbana: University of Illinois Press 1989); Ruth Ginzburg, "Uncovering gynocentric science," in Feminism and Science, ed. Nancy Tuana (Bloomington: Indiana University Press 1989), pp. 67-84.
108. Judy Barrett Litoff, The American Midwife Debate: A Sourcebook on Its Modern Origins (New York: Greenwood Press, 1986); Sylvia D. Hoffert, Private Matters: American Attitudes Toward Childbearing and Infant Nurture in the Urban North, 1800-1860 (Urbana: University of Illinois Press 1989); Ruth Ginzburg, "Uncovering gynocentric science," in Feminism and Science, ed. Nancy Tuana (Bloomington: Indiana University Press 1989), pp. 67-84.
109. Judy Barrett Litoff, The American Midwife Debate: A Sourcebook on Its Modern Origins (New York: Greenwood Press, 1986); Sylvia D. Hoffert, Private Matters: American Attitudes Toward Childbearing and Infant Nurture in the Urban North, 1800-1860 (Urbana: University of Illinois Press 1989); Ruth Ginzburg, "Uncovering gynocentric science," in Feminism and Science, ed. Nancy Tuana (Bloomington: Indiana University Press 1989), pp. 67-84.
110. Judy Barrett Litoff, "Midwives and history," in Women, Health and Medicine in America: A Historical Handbook, ed. Rima D. Apple (New Brunswick, N.J.: Rutgers University Press, 1992), pp. 435-50.
111. Faulty contraceptive techniques meant that sexual intercourse could result in pregnancy, and future research may uncover a link between the increasing popularity of prescriptive literature promoting female "passionlessness" and women s fear of dying in childbed. This fear is recounted by Kenneth Lockridge and Jan Lewis in "'Sally has been sick': Pregnancy and family limitation among Virginia gentry women, 1770-1830," J. Social Hist., 1988, 22, 5-19. We may surmise how the fear of puerperal fever influenced women's attitudes toward sexual intercourse in the observation that, "If [puerperal fever] should recur annually, or be one of our common diseases, the process of child-bearing, instead of being a source of health and enjoyment to females, will become, as we have reason to believe it already has in certain regions, a source of great dread and terror." Dr. Dawson "Remarks on puerperal fever," in Proceedings of the Ohio Medical Convention (Columbus, Oh.: S. Medary, 1847), p. 21.
112. Faulty contraceptive techniques meant that sexual intercourse could result in pregnancy, and future research may uncover a link between the increasing popularity of prescriptive literature promoting female "passionlessness" and women s fear of dying in childbed. This fear is recounted by Kenneth Lockridge and Jan Lewis in "'Sally has been sick': Pregnancy and family limitation among Virginia gentry women, 1770-1830," J. Social Hist., 1988, 22, 5-19. We may surmise how the fear of puerperal fever influenced women's attitudes toward sexual intercourse in the observation that, "If [puerperal fever] should recur annually, or be one of our common diseases, the process of child-bearing, instead of being a source of health and enjoyment to females, will become, as we have reason to believe it already has in certain regions, a source of great dread and terror." Dr. Dawson "Remarks on puerperal fever," in Proceedings of the Ohio Medical Convention (Columbus, Oh.: S. Medary, 1847), p. 21.