Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)

VI. Publication or "Die Aetiologie"

204

IMPORT OF CHILDBED FEVER

time soaking the bed-linen and undergoing decomposition.

“ The carrier of the decomposed animal organic material is the examining finger, the operating hand, the bed-clothes, the atmospheric air, sponges, the hands of midwives and nurses which come into contact with the excrementa of sick lying-in women or other patients, and then come again into contact with the genitals of women in labour or just confined; in a word the carrier of the decomposed animal organic material is everything which can be rendered unclean by such material and then come into contact with the genitals of the patient.”

The site of infection by the decomposed animal organic material is the internal os uteri and upwards from there. The inner surface of the uterus ... is robbed of its mucosa and presents an area where absorption occurs with extreme readiness (ungemein resorb- tionsfähige Flache). The other parts of the mucosa are well clad with epithelium and do not absorb unless they are wounded. If it is injured any portion of the genitals becomes capable of absorption.

With regard to the time of infection, it seldom occurs during pregnancy because of the inaccessibility of the inner absorbing surface of the uterus by reason of the closure of the os internum. In cases in which the internal os uteri is open during pregnancy infection may occur then, but these cases are rare because there is seldom any need for passing the finger within the cervix uteri.

“ I neglected to take notes of the cases in which puerperal fever began during pregnancy at the First Obstetric Clinic of Vienna but I believe it to be near the truth if I put down the number of cases as about twenty. By puerperal infection the pregnancy was always interrupted ...”

The time within which infection most frequently occurs is during the stage of dilatation. This is owing