Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VII. Last Illness and Death
MATTHEWS DUNCAN 315 contagiousness of the latter malady, will confuse the simple and clear doctrine of Semmelweis with these distracted (zerfahren) and unsettled opinions.” Here we have a weighty expression of opinion which we gladly welcome as beneficial. But few in England ever did confuse the ‘‘simple and clear” with the zerfahren until claims began to be advanced many years later for Oliver Wendell Holmes as the discoverer of the etiology of puerperal fever. Matthews Duncan. Although Matthews Duncan could not take any part in the Discussion on Puerperal Fever at the Obstetrical Society, his opinions are interesting as being the clearest and most advanced of that time, and it might be added, truest, as proved by the subsequent experience of over thirty years. A contribution to the science of the subject had appeared in the Obstetrical Journal in September, 1874, entitled ‘‘On Puerperal Pyaemia, etc.,” by J. Matthews Duncan, Physician to the Royal Maternity Hospital .... Edinburgh. The following is a summary. The term ‘ pyaemia ’ may be considered identical with septicaemia and ichorrhaemia employed by some. Our knowledge has been retarded in its growth by the way in which autopsies used to be made—not the work of specialists in pathology, and therefore worthless. Now an autopsy is a matter understood to demand the labour for a long time .... of an expert. In some acute and rapidly fatal cases of septicaemia no postmortem appearances were made out, except an alteration of the blood with enlargement and degeneration of the spleen, etc. This used to be an argument for the essential character of the disease. van Swieten, Willis, and many old writers on puerperal fever, regarded the malady as a wound-fever, and Eisenmann’s work, published in 1837, is called ‘‘Wound-Fever and Childbed Fever.” The wound they had in view was that produced by the separation of the placenta, but now we recognise that the wound may
