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

TANULMÁNYOK - Mádai Lajos: Semmelweis és a statisztikai tudomány (angol nyelvű közlemény)

and enlarged his knowledge on the pathologic-anatomical character of the disease investigated. In addition to performing his difficult and many-sided clinical and teaching responsibilities he thoroughly studied the relevant literature on the aetiology of puerperal fever. The hypotheses concerning the cause of the fever were rather varied and contradictory, according to general belief it was a contagious epidemic having some connection with atmospheric, miasmatic, tellurian, etc. influences, or with troubles in lactation, the effects of the seasons, ventilation, etc. Neither the relevant literature, nor professor Klein, head of the 1st maternity clinic, could provide a reasonable explanation on the pathogène of puerperal fever to Semmelweis, who could not acquiesce in the "fateful epidemic process" against which contemporary medical science stood helpless. Semmelweis's concentrated aetiological researches then reached a point where his rich pathologic-anatomical knowledge, the keen-sighted clinical observations, and his familiarity in the literature demanded the application of another science. That was statistics, and its application a remarkable discovery. The epochmaking discovery grew out from the use of the pragmatic methods. Semmelweis began to study the regular statistical reports of the clinic with great interest. He started from the raw figures of births and deaths in the years 1841—184(5, then computed the maternal mortality rates. He did the same in the relation of the 2nd (midwifery) clinic, too, by which the state of health of the patients in the two neighbouring clinics became comparable. The right evaluation of the figures in the 1st table (so often quoted in works on medical history) was the decisive factor, the "punctum saliens", the first and extremely important perception Semmelweis made in the way of solving the basic questions of his aetiological research. Table 1 Maternal mortality in the maternity clinics of Vienna, 1841—1846* Department of physicians Department of midwives Year Deliveries Mortality Deliveries Mortality number number number number number number percentage number percentage 1841 3 036 237 7.7 2 442 86 3.5 1842 3 287 518 15.8 2 659 202 7.5 1843 3 060 274 8.9 2 739 164 5.9 1844 3 157 260 8.2 2 956 68 2.3 1845 3 492 241 6.8 3 241 GO 2.6 1846 4 010 459 11.4 3 754 105 2.7 Total 20 042 1989 9.92 17 791 691 3.88 * Semmelweis összegyűjtött munkái. Összegyűjt. Győry Tibor. 1908. I. Táblázat