Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VII. Last Illness and Death
OBSTETRICAL SOCIETY OF LONDON 305 determinating influences that we may generally trace nearly every ill-getting-up to some depressing or disturbing influence . . . The “intensification” of the puerperal fever is explained by the peculiar condition of the blood and the impressible nervous system . . . . . . Respecting the contagious nature of the conditions grouped together as puerperal fever, the majority are contagious to puerperal women; whether all are so is uncertain. Those forms derived from the zymotic diseases are most contagious : those self-generated the least so. Some few seem not at all contagious . . . “But, surrounded as we all are by contagion, it is very difficult to say how far any case is free from zymotic influence.” Mr. Jonathan Hutchinson, even then a distinguished surgeon, had nothing to do with obstetrics or with puerperal fever, but he believed that the subject had analogies in general surgical practice . . . “I express in the most unqualified terms my belief that erysipelas is not a specific fever, that it is only a local form of inflammation . . . the pyrexial symptoms and general disturbance are secondary to the local inflammation, and are proportionate to it” . . . Very erroneous opinions respecting pyaemia have gained admission into some of our most important text-books . . . What we call pyaemia in all its more typical forms is due to phlebitis ... “In what has been known as puerperal fever I have no doubt that phenomena, precisely analogous to pyaemia on the one hand and septicaemia on the other, will find their respective places.” Dr. Richardson.—The woman after delivery is physiologically in a peculiar position. Her blood is in a peculiar condition : the fibrine is in excess and “in trembling equilibrium, ready on the slightest possible disturbance to be precipitated.” Then, there is a diminution of the salts in the blood favourable to the precipitation of colloidal fibrin. The woman is in the condition of a person who has lost a limb : the bloodU
