Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VIII. Forerunners and Contemporaries
328 ITALY throughout the country. The sequence of events was much the same in every Italian state: a school for midwives at an old university, then theoretical teaching to young surgeons, and at last a small clinic established in some old religious house, taken over or bestowed by the authorities for the purpose. In Rome, for example, a school of midwifery was not commenced till 1786: Asdrubali, like Semmelweis, taught both students of medicine and midwives, and he and his assistants occasionally visited Paris to learn the most recent changes or improvements in the theory and practice of obstetrics. It was in some measure this process of professional intercourse which led to scientific progress, while fixing the preconceptions of the older schools upon the younger. Italian obstetrics borrowing from France became epidemicist in its doctrine of puerperal fever. In illustration of how little opportunity was granted in the medical schools of Italy for the prolonged observation and generalisation such as are required for the elucidation of such difficult subjects as puerperal fever, it may be mentioned that Genoa did not obtain an obstetric clinic until 1834, and it was not until 1852 that midwifery was entirely separated from surgery both in teaching and hospital arrangements. Owing to the domination of the midwife a century after she was almost superseded in England, and the defective education of the medical student, nothing was to be expected from the general practitioner towards solving any obstetric problem even of the simpler sort. In the portion of Corradi’s vast work which is devoted to puerperal fever (Della cost detta Febre Puerperale) we find a review of all the ancient theories. From early in the 19th century we trace the influence of the doctrine of the constitutional causes of local diseases of which the chief British authority was Abernethy. For example, Fasola, in 1811, not quite emancipated from the milk- fever doctrine, “ la febbre mostrando sempre tendenza a render locale la malattia con morbosa mutazione nel
