Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
VIRCHOW 239 was long before Virchow in these observations, and that Semmelweis, as a favoured pupil of Rokitansky, worked at the pathological anatomy of gynaecology and puerperal fever steadfastly for five years at least from 1844 until his departure from Vienna. Virchow, recognising the infectious nature of the disease which produced the anatomical changes, called it an ischorrhcemia. Not satisfied with the official report of his remarks at Speyer in 1861, Virchow published an article in his Archiv entitled “ Investigations on Diffuse Puerperal Metritis and Parametritis.” He describes simple metritis and parametritis, and proceeds with his account of the serious cases resulting from epidemic influences which present the characters of diffuse phlegmon. Among its phenomena are phlegmasia dolens. Here the lymphatics play such an important part that Cruveilhier designated the disease a lymphangitis. Without going into irrelevant details it may be sufficient to state here that Virchow speaks of necrosis as characterising the severer cases of phlegmon, and introduces his term “diphtheritic degeneration” which might affect the deeper structures or remain on the surface. He finds in the transformation of the periuterine tissues, including the broad ligaments and ovaries, a resemblance to a pseudo-erysipelatous condition, hence his term “ erysipelas malignum internum The introduction of the word erysipelas produced a certain confusion of thought among obstetricians all over the world for many years to come, and long before bacteriology began to shed its light upon the pathology of certain forms of puerperal fever. In 1864 Virchow produced a further communication in the Gynaecological Society of Berlin on the “ Nosology and Etiology of Puerperal Fever,” that is to say, between three and four years after the publication of the AEtiologie of Semmelweis. According to the mature conclusions of Virchow the pathological anatomy of the disease must be divided into two groups—(1) diph-
