Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
240 HECKER theritic, affecting the surface of the vagina and the uterus, and (2) the phlegmonous, affecting the deeper parts. Not satisfied with observations as pathological anatomist, Virchow goes on to explain the causes as a clinician. The internal surface of the uterus, as had been often said for a hundred years before, is to be compared to an amputation wound, and this idea introduces questions with regard to phlebitis and thrombosis. Sometimes there is a morbid condition previous to labour, but the diseases of the pathological puerperium do not appear to be metastatic. Virchow accepts auto-infection, and cannot dispute infection from without. What he has to say about treatment is singularly advanced theoretically, but his suggestions have been long forgotten by his own countrymen. In other countries with the exception of France, it has taken nearly forty years for the recognition of his principle of cleansing the “ diphtheritic ” wound as soon as possible after the onset of symptoms. As to the causes, epidemic origin does not cover all cases. We should recognise the merit of Semmelweis in restraining the ravages of this cruel malady, but the infection is not such a special kind as Semmelweis alleged. So Virchow also must be accused of writing about the Semmelweis Doctrine with only second-hand knowledge. Still this contribution by Virchow to the pathology of puerperal fever, recognising infection by some external poison, carried great influence into the practice of the subject, and although we have largely changed the nomenclature we have not even now added largely to the sum of our knowledge. This contribution has been summarised here to show how far Virchow went in making amends to Semmelweis for what had caused him great pain. But the reparation came too late to cheer the unhappy author of the JEtiologie. Hecker. As an instance of ignorant resistance of evidence we may select for this same year 1861 Hecker of
