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This chapter examines the puerperal fever epidemic in English towns during the late 18th and early 19th centuries. Town epidemics seem to have escaped the attention of historians. They were terrible outbreaks that arrived suddenly and without warning. Puerperal fever epidemics often began in winter or early spring and they were usually preceded by an outbreak of sepsis in various forms, including erysipelas. Some of the notable features of these epidemics include high fatality rate, frequent tendency to be limited to the patients of one or two medical practitioners of midwives, and the transmission of the disease to mothers by birth attendants.

This chapter discusses the coverage of this book, which is about puerperal or childhood fever that was prevalent in England during the 18th and 19th centuries. This book provides case histories and describes the clinical features, pathology, mortality rate, bacteriology, and the nomenclature and synonyms for puerperal fever. It chronicles the story of puerperal fever from its earliest recognition to the development of antiseptics and other treatments by Louis Pasteur, Lord Lister, and Ignaz Semmelweis.

This chapter examines the earliest ideas about puerperal fever in England during the 18th century. Puerperal fever came into existence in terms of being named and recognized only between the late 17th and middle 18th centuries. It is believed to have been first described by Francois Mauriceau but it was Thomas Willis who first used the term ‘febris puerperarum’ in 1676. The term puerperal fever appeared in 1716 in the essays of physician Edward Strother.

This chapter examines the changing views of mid-century authorities in England on the nature and causes of puerperal fever. During this period, there was a constant change in ideas on the nature, cause, prevention, and treatment of infectious diseases including puerperal fever. There were some authorities who believed puerperal fever was a disease of the uterus, others considered it a form of peritonitis, and suspected that puerperal fever might not be one but several different diseases.

This chapter discusses the reduction in puerperal fever mortality in Great Britain during the 20th century. The improvement in the prevention and treatment of the disease is attributed to the development of vaccines, antisepsis, and important research on the biology of the streptococcus. Between 1890 and 1912, maternal mortality was significantly reduced. From about twenty-five deaths for every 10,000 births in the 1890s it was reduced to only about thirteen or fourteen in England and Wales and sixteen or seventeen in Scotland.

This chapter examines puerperal fever epidemics in lying-in hospitals in England during the 18th century. Though lying-in hospitals were intended to bring skill and comfort to the poor in childbirth, they were from the early years plagued by recurrent epidemics of puerperal fever with appalling mortality rates. Some critics have suggested that it was so much safer for poor pregnant women to give birth in the worst of slums with an untrained midwife than in a lying-in hospital.

This chapter discusses physician Alexander Gordon of Aberdeen's publication of an account of epidemic of puerperal fever in 1795. His treatise provided the first clear and irrefutable evidence that puerperal fever was a contagious disease closely linked with erysipelas and transmitted from one woman to another by midwives and doctors. His publication provided a detailed description of the disease and his proposed treatment. However, his contemporaries considered Aberdeen's observations about the disease to be too cocksure, too dogmatic, and too provincial to command the respect he deserved.

This chapter relocates the debate about the theoretical virtues to the empirical level and argues that the question of whether the virtues (and what virtues, if any) have epistemic import is best answered empirically, through an examination of actual scientific theories and hypotheses in the history of science. As a concrete example of this approach, the chapter discusses a case study from the mid-nineteenth-century debate about the transmissibility of puerperal fever. It argues that this case shows that the virtues are at least sometimes epistemic, but also that neither scientific realists nor anti-realists get it quite right: the virtues, even if epistemic, are not necessarily truth-conducive, but neither are they merely pragmatic. It also argues that the discussion of puerperal fever shows that the virtue question, as it is currently featured in the scientific realism debate, ought to be reformulated. We should examine not just whether a given scientific theory has virtues or not, but rather how debates among competing theories, all of which have some virtues, get resolved.