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

VI. Publication or "Die Aetiologie"

226 CORRESPONDENCE AND OPINIONS

to carry away from the lying-in wards the exhalations from patients before they can form a puerperal miasma.

It is also essential for the welfare of patients of a lying-in hospital that several rooms for isolation be provided so as to promptly separate infected from normal puerperae.

It does not matter how many lying-in women are nursed in one room provided “when the number of lying-in women is in due proportion to the size of the room.”

Small lying-in hospitals have no advantage over large hospitals where proper precautions are taken. This point is illustrated by the history of the small hospital at Würzburg where Kiwisch, an epidemicist, lost 265 per cent, in one year from puerperal fever, whereas in the vast lying-in hospital of Vienna the highest mortality ever reached was 1575 per cent, in 1842.

The paragraphs devoted to the prophylaxis of self- infection might stand to-day in any text-book of practical midwifery containing the opinions and advice of an experienced obstetrician. “ If after all a decomposed material has actually been produced in the individual then it must be at once got rid of by cleanliness and injections so as to prevent resorption as far as possible.”

“ Whoever practices this prophylaxis will experience the pleasure, not from time to time to lose every third or every fourth patient from puerperal fever, but perhaps to lose only one in four hundred, certainly not more than one in a hundred ” (p. 272).

Correspondence and Opinions in the Literature for

AND AGAINST MY DOCTRINE.

“ If this treatise had no other object than to establish our Doctrine on an unshakable foundation, and to make perfectly clear the sad error of the epidemic theory of puerperal fever, if this only was our object, we might suitably bring our treatise to a close here.

“But that alone cannot be the object of this treatise,