Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
40 ELIMINATION OF FACTORS the First Division, while the same unfavourable endemic influences were at work in a more active form in the Second Division than in the First. The unfavourable position of the Lying-in Hospital was blamed because of its association with a great general hospital, although in this respect both Divisions had everything in common; they had one common anteroom for both and the construction of both Divisions was the same in every respect. The disadvantages of uninterrupted clinical instruction, the communication of the rooms reserved for infected cases with the ordinary lying-in wards, the free intercourse of the nursing staff attending the fever cases with those in attendance on the normal puerperae, alleged to be factors in producing the mortality, were matters common to both Divisions. Yet since the time when the First Division was devoted entirely to the teaching of students of medicine the mortality there had always been notably greater than in the Second Division. “Since neither the epidemic nor the hitherto prevailing endemic influences explain in any way the greater mortality of the First Division, let us try to test the value of some other alleged causes of puerperal fever. “By some recent investigators conception was set down as one cause owing to some metamorphoses produced by the sperma virile, and some partly unknown changes of the blood. But I presume I fall into no error when I state the opinion that with the women who have borne children in the Second Obstetric Clinic a conception had previously occurred. “Whence then the difference in the mortality of the two Clinics? What about the other alleged factors? Hyperinosis, hydraemia, plethora, disturbances caused by the pregnant uterus, damming up of the circulation, the act of parturition itself, the diminished blood- pressure owing to the emptying of the uterus, prolonged labour, injury to the inner surface of the uterus, insufficient contraction, defective involution in childbed,
