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

VI. Publication or "Die Aetiologie"

(übertragbar) to a normal healthy puerpera. For example, a puerpera is suffering from the malady in the form of septic endometritis . . . from such a patient is puerperal fever capable of being carried (übertragbar).

Hence it is that a controversy has arisen among the contagionists owing to the non-recognition of these two classes of cases. No final decision could be arrived at because the contagionists could quote cases in which the spread of puerperal fever from a sick to a normal puerpera could not be denied; and the opponents of the contagion theory could also quote cases in which the spread of the disease had not occurred when it must have occurred if the disease were contagious.

“Puerperal fever is not a contagious disease, but puerperal fever is conveyable from a sick to a sound puerpera by means of a decomposed animal organic material.

“After death the body of every lying-in woman becomes a source of decomposed material which may produce puerperal fever; in the cadaver of the puerpera we consider only the degree of putrefaction. When we have reflected that the overwhelming majority of cases of puerperal fever are produced by infection from outside, and that these cases can be prevented, and that in only a small minority of cases puerperal fever is the result of unavoidable self-infection, the question arises : if all fatal cases, not resulting from puerperal fever, and if all cases of infection from without are prevented by suitable measures, how many lying in women die as the consequence of self-infection ?

“It is not possible to answer this question for want of statistics, and we must attain complete control of material and environment so as to banish conveyed infection from our hospitals before we can obtain reliable statistics of self-infection.”

Then follows a laborious effort to analyse the statistics of the Vienna Lying-in Hospital before the anatomical trend of medical science, that is from 1784 till the time when Boer was dismissed and Klein came on as successor,

IMPORT OF CHILDBED FEVER 207