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

TANULMÁNYOK - Réti, Endre: Does the Problem "The Illness of Semmelweis" Exist? (angol nyelvű közlemény)

before the death, consequently it preceded the appearance of thet pathogenic symptoms of the nervous system/' That means that the hand injury and the infection had to take place between 13—27 June. Semmelweis was taken to Vienna either on the 20th or the 31st of July: he was admitted to the hospital on July 31st. The certificate issued by his fellow-physicians dates from July 29, which makes the latter date more probable. According to the description in the Nyirő textbook he ought to have been in delirium for long: ''The initial stage usually passes very quickly and te delirium reaches its climax". But the symptoms referred to by Nyirő did not occur in Semmelweis's case, or if they did, only in the mental home, of which we have no knowledge. Medical literature knows nothing of osteomyelitis followed by septic delirium which is not accompanied by fever. Acute osteomyelitis is described by Hedri in his Detailed Chirurgy : "The general symptoms usually begin with sudden great pains, followed by high temperature (39—40°) accompanied by frequent fits of shivering. The pulse is frequent, 120—140, easily repressable. Furred tongue, rapid breath, dry, aglow face, dysorexia are the characteristic symptoms. Later the symptoms of overall sepsis ensue, with intermittent fever (endocarditis, pneumonia, pleuritis, nephritis); in the gravest cases the high fever is accompanied by delirious coma, when the outcome may be fatal." Glauber's Textbook of Orthopaedics (10) says in the chapter on osteomyelitis: "the clinical symptoms usually start with pain... The general symptoms (fever, wretchedness, dysorexia) precede the local symptoms or coincide with them". Consequently there is no osteomielytis, sepsis and delirium as its sequence without fever. The developing infection ought to have showed acute symptoms even preceding the signs of derangement, it would have been recognized beyond any doubt by a surgeon on the level of Balassa and by diagnosticians like Bókay ad Wagner, even a hundred years ago. To this it must be added that Wagner was one of the first, perhaps the first, to introduce the thermometer in Hungary (11) Thus there is no datum at our disposal which could support the hypothesis of septic delirium. In conclusion we can adopt the view recently expressed by Professor Imre Zoltán : "It is to be welcomed that the researchers of history strive to arrive at the objective historical truth, but above all that all agree that the human greatness of Semmelweis and the importance of his discovery is not affected by the question whether in his last years he suffered from any disease and if did what that was. The results in medical science in the more than one hundred years that have passed since his death, from the emergence of bacteriology to the birth of antibiotics, all prove the validity of the discovery of Semmelweis, to which thev have added nothing and from which they have taken nothing." (12)