Medical essays, 1842-1882

Medical Essays is a collection of Oliver Wendell Holmes Sr.’s major medical writings from the four decades that included his most influential professional work as a physician and as the dean of Harvard Medical School. The volume includes his famous 1843 paper The Contagiousness of Puerperal Fever, one of the foundational documents in the history of American medicine and one of the earliest substantive arguments that doctors themselves were carrying the often fatal infection from one childbirth patient to the next.

The puerperal fever paper deserves particular attention. Decades before Joseph Lister’s antiseptic surgery and Ignaz Semmelweis’s better known parallel work in Vienna, Holmes had used careful observation and statistical analysis to argue that physicians needed to wash their hands and change their clothes between patients. His paper was not received warmly by the medical establishment, and his follow up, the 1855 essay also collected here, is even more pointed in his frustration with the colleagues who had refused to accept obvious evidence and who continued to spread the infection that killed thousands of new mothers across the country.

The other essays in the volume cover Holmes’s wider professional concerns. The proper training of physicians. The relationship between medical theory and clinical practice. The use of statistics in medical research. The dangers of excessive faith in particular treatments and pharmacological fashions of the day. Holmes wrote with the same wit that made his Breakfast Table books popular with general readers, and the medical essays manage to be readable as well as substantive.

For historians of medicine, Holmes is one of the central American figures of the nineteenth century, and these essays are primary sources of real importance. For general readers interested in the development of modern medical practice, particularly in the long, slow movement toward germ theory and infection control, the volume is a valuable read. The puerperal fever paper alone is worth the price of admission.