Antall József szerk.: Orvostörténeti közlemények 55-56. (Budapest, 1970)

TANULMÁNYOK - Benedek, István: The Illness and Death of Semmelweis (angol nyelvű közlemény)

time he recognized neither the best methods for discussion, nor the then modern experimental devices which could have been used to support his theses in a moie convincing way than his excessively repeated or exaggerated statistical tables, or the — just or unjust, but by all means unreasonable — repeated insults thrown at the international authorities. This "obsessed psychopathic behaviour" was pathological but never reached the scale of psychosis, consequently Semmelweis had neither paranoia, nor mania, nor any other constitutional mental illness. 2. ORGANIC DISTURBANCE OF THE NERVOUS SYSTEM In his last years — having written his Open Letters — he lead a quieter, calmer, and above all less monomaniac life; his sphere of interest was no longer restricted to the problem of puerperal fever. He preferred to deal with the organizational questions of the university and with gynaecology. His "calming down" was occasioned also by the fact that his teaching began to produce more favourable responses, especially at home, but abroad as well. But in the spring of 1805 the alarming symptoms of derangement appeared suddenly, for which he soon had to be taken to a mental hospital, where a few weeks later he died in sepsis. Before the outbreak of the illness there was one symptom that might have struck those who were around him: his conspicuously early senescence. Semmelweis was then 47 years old, but the surviving photographs show him much older. Yet there was no sign of mental decline; he was working on a very thorough gynaecological tract almost until the last minute. On the traceable symptoms of his illness let me quote the passage in my monograph describing them briefly (2) : "Lately Semmelweis was absent-minded, locquacious, burst into tears without reason (emotionalis incontinentia), spoke in a confused way (incoherentia), used indecent expressions (coprolalia) and behaved improperly (uncritical behaviour), became stubborn and lacked understanding, ate conspicuously much (b u 1 a e m i a), had headache, his sleep was troubled, his movements excessive (hypermotilitas). In addition to these symptoms, which were not pathognomonic in themselves but were typical occuring simultaneously, one must add raptus, that is fit of anger, and dysgraphia, pathologically disturbed writing... The above list, together with the already mentioned premature ageing (senium praecox), unequivocally and unquestionably show that Semmelweis suffered from some sort of chronic disorder in the mental system, most probably progressive paralysis." Whether the illness in question was indeed paralysis or some other organic nervous disease — spirochetic or tuberculotic chronic cerebritis-meningitis, premature cerebral atrophy due to arteriosclerosis or something else, Pick's or Alzheimer's praesenilis dementia, encephalopathy of unknown aetiology,