he suggested significant changes in the care of women in pregnancy, during childbirth and in the puerperium. Medical students today will learn of the apparently seminal work of Ignazz Semmelweis in changing the course of maternity care from 1845-1860. However almost all of the suggestions that Semmelweis was to make had been encouraged and practiced by Charles White of Manchester starting a century before and detailed in this remarkable book. In it he describes the prevailing practice. The room for a woman to deliver in was often crowded. A fire was lit, the windows were all shut, the curtains stitched. The woman was encouraged to lie flat and be completely covered by blankets. After delivery she was confined in a horizontal position for days so that the lochia tended to remain in the vagina stagnating and festering. He made a point of having the room cooled, the windows to be opened to encourage a flow of fresh air. He insisted on hygienic conditions, regular hand washing, changes of bed linen, towels and sponges and instruments. Although unaware specifically of bacteria he urged not only scrupulous cleaning but also separate bed chambers for women in labour. Where this was not possible then if any woman developed fever she should be isolated for a week or ten days to prevent spread of the fever. In such a case, after the woman had left the hospital, the room should be scrubbed including the woodwork, the curtains and floor. He even advocated where possible stoving with brimstone. He also encouraged rapid mobilisation of women after delivery in the first or second days. The normal was for them to be bed bound for days. This again was farsighted and although we would agree today even a hundred years later his advocates could not quite believe this. Puerpural Fever was a common cause of illness and mortality in women. White's practices practically eliminated this terror. He was sure that free flow of noxious fluids by gravitational drainage. For this he designed a chair to encourage such flow. Such an innovation is also often called a Fowler Chair after the American Surgeon who designed something similar a hundred years later for treatment of Peritonitis. Again White is credited in being the originator by Curtis. White was so successful in this that he practically eliminated Puerpural Fever from his wards. In 1789 in Vienna they appointed Professor Boer