Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
ETIOLOGY 213 cases of self-infection might occur instead of actually an average mortality of 2'5 per cent. The explanation of the incidence of childbed fever in the paying department is that the chief medical officers were both working at gynaecology in the General Hospital; then there were 600 to 800 autopsies for medico-legal purposes in the General Hospital, and these medical officers had to conduct these autopsies between them. Is the unfavourable condition of the health of the women confined in the paying division still an enigma ? Lying-in hospitals which are at the same time teaching institutions shew more unfavourable results than those hospitals which are not schools of midwifery. And among teaching institutions the best results are obtained by those which are specially reserved for the instruction of midwives. The reason of this is that midwives are not to anything like the same extent as medical men employed upon things which bring their hands into contact with decomposed matter. . . . An apparent exception to this rule is to be found in the Maternité of Paris, which is exclusively devoted to the training of midwives, yet has as high a mortality as Dubois’ Clinique in Paris which is reserved for the teaching of students of medicine. This statement is made on the authority of Arneth who was an eye-witness of the state of things which he described in his book. Semmelweis compares the Maternité and the Clinique of Dubois in great detail, and he goes into the history of the Maternité in order to explain the deplorable results obtained there for a generation and more. The matter is all fairly relevant to the argument on etiology, but it is too voluminous, and the statistics may be convincing, but they are not attractive reading. For us the conclusions are sufficient. In the first place, we learn by the tables that for a long series of years the mortality at the Maternité had been
