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August 20, 1887


JAMA. 1887;IX(8):243-244. doi:10.1001/jama.1887.02400070019003

Dr. A. MacLaren, of St. Paul, in a paper appearing in another column, reports a number of cases of puerperal sepsis, alleged to be caused by erysipelas. His argument is, briefly: A woman is attended during a normal confinement by a medical man, who had been exposed recently to erysipelas or was himself the subject of the disease. The woman has puerperal fever. There is no epidemic of puerperal fever, at that time in St. Paul, possibly, not even another case. Ergo, erysipelas is the probable cause of the puerperal fever. It seems scarcely necessary to point out the fallacy in this mode of reasoning. Dr. MacLaren premises his paper by a statement of the Semmelweis1 theory of puerperal fever,—that "Every case arises from the absorption of decomposing organic matter from lesions of the genital tract." He accepts this theory.

The possible sources of infection are well-nigh innumerable. Puerperal