Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
V. Life in Buda-Pesth
VIRCHOW transformation of the thrombus into puerperal fever, and vice versa. Among the agencies which produce firm contraction of the uterus, according to Virchow, is “in all probability” a special nervous influence. This is probably the reason why women who are confined secretly (heimlich), and who are consequently subject to such nervous excitement, are so seldom the victims of dangerous accidents, whilst we often see such untoward results in the case of weakly women in spite of the best nursing, and still more in overcrowded lying-in hospitals under miasmatic influences. So Virchow believes that nervous excitement and lactation prevent puerperal fever. Kiwisch says: “With regard to milk secretion, it was my experience that non-suckling women, during an epidemic, were more seldom attacked than the women who suckled. ... In the portion of the Prague lying-in institution reserved for paying patients, in which no woman gives the breast to her infant, the proportion of sick puerperas was much smaller than in the division for suckling women.” Scanzoni finds in nervous excitement just the cause of a higher mortality among the patients of an institution devoted to the education of students of medicine, as compared with a school for midwives. And Professor Braun is of the same opinion as Scanzoni. But women confined in concealment, or in the paying wards at Prague, are not made material for clinical teaching purposes : therefore they are not infected; in schools for medical men the patients are more frequently infected than in schools for midwives, hence the relatively unfavourable condition in the former. “It is ridiculous for a set of men such as these to pass judgment upon conditions which they do not understand. Veit’s declaration that “The mortality of the Vienna Lying-in Hospital affords a shocking example, I repudiate with all the indignation of which I am capable. The mortality of the Vienna Hospital was not more shocking than that of other institutions where similar conditions 169
