Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
34 ELIMINATION OF FACTORS So we see that the destructive influence of the epidemic is not restrained by any season of the year; it rages in the severe cold of winter and in the oppressive heat of summer with equal violence. But the epidemic influence is not impartial inasmuch as it does not swing its scourge over all lying-in hospitals alike; it spares some and rages without pity in others, and it goes so far in its partiality that it invades with very different results the separate divisions of the same institution. It is a fact that lying-in hospitals where instruction is not given, or where only midwives are admitted for training, present with few exceptions better results than those which are devoted to the education of students of medicine. Table No. I. shows how different were the results as regards mortality in the two divisions of the same hospital. At Strassburg,* under exactly analogous conditions, the results were exactly similar. “It was on these grounds that I came to the conclusion, and became increasingly stronger in the conviction, that the high mortality in the First Obstetric Clinic was the result of injurious influences originating and operating within the bounds of the First Clinic itself.” If we were to critically examine the hitherto accepted endemic causes of this disease and the alleged causes of the mortality in the two divisions of the great Maternity Hospital of Vienna, we must conclude that either no difference could exist, or that there must be actually a higher mortality in the Second Division. If overcrowding, as has been alleged, were a cause of mortality in the First Division, then it must have produced a higher mortality in the Second Division, for it was always more crowded than the First Division. The evil reputation of the First Obstetric Clinic drove the women in large numbers to seek admission to the Second; and it often happened that the First Division had to be filled by overflow because there was not an available bed in the Second. In spite of all this the Ameth.
