Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
ELIMINATION OF FACTORS 31 Well now, if the atmospheric-cosmic-telluric conditions of the city of Vienna are of such a nature that they can cause puerperal fever in individuals disposed to it by reason of the puerperium, how does it happen that the atmospheric-cosmic-telluric influences have for a long series of years preferably carried off the predisposed occupants of the First Obstetric Clinic, while at the same time in Vienna, and in fact at the same time under the same roof, women predisposed owing to the puerperium but occupying the Second Obstetric Clinic, have been spared in such a remarkable manner ? This fact appears without doubt to imply that if the devastation wrought by puerperal fever in the First Obstetric Clinic is to be attributed to epidemic influences, the same influences must with very slight variations (Schwankungen) recur in the Second Division, else are we driven to the absurd conclusion that the epidemic influences are subject in their destructive activity to remissions and exacerbations every twenty-four hours, and that these remissions have for years coincided with the time of admission to the Second Division, and the exacerbations have for a similar series of years come on at exactly the time for admission to the First Division. Even if we were to accept such an absurdity as explanation, the difference in the mortality of the two divisions cannot be rationally attributed to epidemic influences. The epidemic influences act during the exacerbation upon the individual either before her admission to the Lying-in Hospital, or they act during her residence in the hospital. If they act upon the individual before her admission to the hospital, then both the patients who come to be admitted to the First Division and those who come into the Second Division, have been subjected to the same destructive epidemic influences, and the great difference in the mortality is not explained. If the epidemic influences work upon the individuals during their residence in the hospital there cannot be such a great difference in the mortality, inasmuch as the two divisions which lie so near to one
