Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
30 ELIMINATION OF FACTORS Thus we see that over these six years the average mortality in the First Clinic was three times that of the Second. Great as is the difference here shown, it was really greater because of the custom of transferring severe cases of puerperal fever from the First Division to some part of the General Hospital, where they died. The patients wTere not then registered as dying from puerperal fever. Le Fort, the friend of Tarnier, who visited the hospital the year before Semmelweis died, says in his remarkable book, Des Maternités (p. 151), in reference to puerperal fever in Vienna, “ High as the figures are they are, however, still below the reality, for it is almost certain, according to Prof. Späth, that they do not include the women suffering from puerperal fever who were transferred to the General Hospital and died there.” In the Second Division few patients were transferred to the General Hospital : only one now and again considered too dangerous to the other patients, such as cases of smallpox and severe forms of venereal disease. This high mortality in the First Division as compared with that of the Second, was contributed to by many hundreds of patients whom Semmelweis saw dying from puerperal processes of which, as has been said, he could not detect the etiological factors according to the generally received theories. In order to convince the reader that this higher mortality could not be explained by the usually accepted ■etiology, Semmelweis proceeds to pass in review the hitherto recognised etiological factors in the production of puerperal fever. In the first place, the frightful devastation wrought by childbed fever in the First Division was confidently attributed to epidemic influences. By epidemic influences we alleged that we understood some not exactly defined atmospheric-cosmic-telluric changes which often spread over whole districts of country, and cause puerperal fever in women disposed to it by the puerperal state.
