Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)

III. Life in Vienna

but also the new-born infants, without regard to sex, died of puerperal fever. The anatomical changes observed in post-mortem examination of the new-born were, apart from the genital sphere, identical with those seen in the cadavera of the victims of puerperal fever.

If it is one and the same disease from which lying-in women and their infants die, then the etiology of the disease in the new-born must be the equivalent of the etiology of the mother’s malady. But a much larger number of the new-born died in the First than in the Second Division (Table XIV.).

The factors which produce the equivalent of child-bed fever in the new-born are at work before the completion of labour, or the disease is conveyed to the child after birth.

By a long process of elimination of the alleged factors in the production of child-bed fever in pregnant or puerperal women, which cannot possibly apply to the new-born, it is demonstrated that the ordinary conception of puerperal fever in the woman must be erroneous.

Street-births: Owing to the great expanse of the city of Vienna it often happened that women were overtaken with labour on the way to the hospital.

These women who had finished their labour on the way to the lying-in hospital—on the glacis, under archways, anywhere—reached the hospital with the new-born babes in their arms. These cases counted for charity, just the same as if the birth had occurred inside the hospital, and the new-born were admitted to the Foundling Hospital and maintained by the State. Many such cases occurred owing to attempts to evade “public instruction.’’ The women were confined in the houses of midwives, and then came to the hospital alleging Gassengeburt (Street-birth). The authorities appear to have winked a good deal at these practices.

In the genuine cases of Gassengeburt the puerperium was usually free from illness of any kind, and this in spite of the unfavourable condition of the women during

42 ELIMINATION OF FACTORS-