Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
32 ELIMINATION OF FACTORS another as to have an ante-room in common, must necessarily be subjected to the same atmospheric-cosmic- telluric influences. It was the consideration of these facts which compelled me to the settled conviction that it was no epidemic influence which produced the shocking ravages among the lying-in women of the First Obstetric Clinic. After this conviction was formed immovably and had completely mastered me, many reasons were soon discovered which still further confirmed my belief. Let us take them in turn : — If the atmospheric influences of the city of Vienna produce a puerperal fever epidemic in the Lying-in Hospital, it would be impossible that the people of the city, subjected to the same influences, could escape an epidemic among their lying-in women; but as a matter of fact when the fever was raging at its worst in the Lying-in Hospital there was hardly ever a case heard of in the city or surrounding country. When a cholera epidemic broke out it was well known that the people sickened of the malady both in the hospitals and throughout the city. A very common and successful method of diminishing the ravages of a puerperal fever epidemic is to close the lying-in hospital. The hospital is not closed in the expectation that the patients will die somewhere else, but because of the belief that if they remain in the hospital they will die owing to the epidemic influences at work within the hospital; whereas if they are confined outside away from the hospital, they will remain well. Hence it follows, as demonstrated, that we act as if we believed that we have not to do with an epidemic disease but with an endemic disease, that is to say with a disease resulting from causes which are restricted in their action within the bounds of the hospital. What would the defenders of the epidemic theory say if any one were to propose that with the object of mastering an epidemic of cholera, the best method would be to shut up the cholera hospital ? Again, the puerperal
