Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
i8 ETIOLOGY BEFORE SEMMELWEIS his work on Semmelweis, of v. Winckel in his “ Pathologie und Therapie des Wochenbetts” and of Fehling in “ Die Physiologie und Pathologie des Wochenbetts.” All these and other authors are here laid under contribution in an attempt to state as concisely as possible an exasperatingly complicated subject. According to the most generally accepted doctrine there were two etiological factors : one external, acting from without, the other internal, depending upon the condition of the organism during pregnancy and parturition ; and whatever changes of nomenclature were introduced and whatever more or less obscurely expressed opinions became most prominent and generally accepted in a generation, we always find these two etiological factors at work in producing the phenomena of the malady. Willis (about 1662) was the first in modern times to write the term Febris puerperarum; and Strother in 1718 translated it into Puerperal Fever. To go no further back than the middleof the eighteenth century we find a school of believers in anomalies of the lochia. Among British teachers of the doctrine of Lochial Suppression as the central fact in puerperal fever was Smellie. He probably brought it from France where it was taught in the School of Mauriceau, and his influence as a teacher spread it over Western Europe. To many prominent teachers puerperal fever was a milk-fever. By it they explained serious symptoms as milk-pneumonia, milk-peritonitis, and so on. One French observer actually found milk in its natural form within the peritoneal cavity ! This theory had many supporters in England, and that is probably why it was adopted by Boer and taught with some modifications in the Vienna School, at least up to the end of the first third of the nineteenth century. Boer’s successor, Professor Klein, was incapable of evolving anything original, hence in all probability Semmelweis as a student was taught Boer’s theories of the etiology of puerperal fever.
