Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
V. Life in Buda-Pesth
PARIS ACADEMY i8i began by asking a series of questions which were in all men’s mind: Is there a general malady which may be designated puerperal fever? In what does it consist? What is the value of measures of treatment? What means can we employ to prevent it? These questions have a remarkable resemblance to those formulated by Sir Spencer Wells in opening the discussion of the Obstetrical Society of London in 1875. Depaul referred to the observations of Tarnier, described in the thesis quite recently published, to the evidence advanced by Wieger, of Strassburg, on the work of Semmelweis at Vienna. He also gave an account of some very remarkable observations of his own. As to the contagiosity, there can be no room for doubt. The disease is strongly analogous to purulent or septic infection, but it is neither a pyaemia nor a septicaemia. Treatment is completely powerless to influence the course of the disease: our only resource is prevention. Depaul can only suggest smaller maternity hospitals as a palliative. The next speaker, Beau, controverted the opinion of Depaul that puerperal fever is a special fever in which the local lesions are secondary : it is rather essentially a local inflammation to which the economy is predisposed by a special constitution of the organism, including augmentation of fibrin. As to treatment Beau believes in large doses of quinine. Hervez de Chégoin maintained that puerperal fever is nothing but an infection of the blood, as Dubois has also recognised. It does not precede the labour, but follows it, and manifests itself under a putrid or purulent form. Its site is the uterus; one might say with truth, “ morbus totus ab utero procedit.” From this point of view there is nothing strange or inexplicable about puerperal fever. Trousseau next gave a long address extending in part over two sittings. He asked whether it was not possible that puerperal fever did not exist as a malady special to the lying-in woman. He recalled episodes in the
