Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
ETIOLOGY 223 “ The doctrine of epidemic puerperal fever explains something unknown by that which is also unknown.” Such are the grounds of my convictions; I wish in the interests of humanity that all who are interested in the questions relating to puerperal fever could form the same convictions with me. Here then we have a vast mass of evidence stated in ( a clear and convincing manner. It seems to us now absolutely convincing and irresistible. And it was convincing to the younger and unprejudiced men, according to the evidence of Fritsch and Hugenberger and others. How it came to be resisted in favour of mere unintelligible formulae by the contemporary professors of midwifery makes one of the most remarkable chapters in the psychological history of medicine. We see in it the consequences of importing emotional bias into the discussion of purely scientific questions. The chapter headed the‘‘Endemic Causes of Puerperal Fever” consists of a discussion of the real relation of certain alleged factors to the etiology of puerperal fever, but with the exception of a large number of new tables and some minor points which do not add to the force of the argument, there is no fresh matter. The place for this chapter is early in the work, where the discovery of the true etiology is discussed and proved by a process of elimination of alleged causal factors. Semmelweis rejected overcrowding of a lying-in hospital as an etiological factor of any importance, and thereby damaged his case in the opinion of Western obstetricians. He was logically, and in fact practically right, by reason of the conditions and qualifications attached to the broad statement of his opinion, but misrepresentation was made easy; qualifying statements could be so readily omitted. ‘‘Overfilling of lying-in hospitals is only conditionally an endemic factor in the production of puerperal fever, inasmuch as in an overfilled lying-in hospital it is more difficult to maintain the requisite standard of cleanliness, inasmuch as in an overfilled hospital it is more difficult
