Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
200 VI. Publication of “Die ^Etiologie.” Although the Clinic was improved in some respects it was still very defective. It was again placed on the second floor with the Surgery Clinic immediately beneath it, and the space was still so limited that no room or ward could be reserved for isolation. Still by his watchfulness and by the example of keen interest in the work, and of conscientiousness in the performance of his duties, Semmelweis had now around him a specially intelligent and loyal staff of assistants and nurses upon whom he could rely to carry out his instructions with exactness and punctuality. Consequently in spite of all the drawbacks with regard to space and the construction of the Clinic, he had only five fatal cases of puerperal fever among 520 patients in the School-year 1859-60, a mortality of o'9 per cent. Semmelweis worried about the number of cases of self-infection of which he had a definition of his own : but his was not quite the self-infection which some teachers of midwifery in the twentieth century still appear to be believe in. Then again he attached too much importance to the atmosphere as a carrier of infection, and though by his watchfulness and attention to details he overcame the real dangers and difficulties, the dread of non-existent dangers was continually with him and kept him restless and worried. What the want of isolation accommodation implied is brought out in the Nachtrag which is a sort of afterthought in a few short paragraphs added on at the end of the sEtiologie. The chief relevant facts with regard to difficulties in the Clinic were, that mixed up with the lying-in women were gynaecological cases, and that patients died of tuberculosis pulmonum and typhoid
