Antall József szerk.: Orvostörténeti közlemények 55-56. (Budapest, 1970)
TANULMÁNYOK - Mádai Lajos: Semmelweis és a statisztikai tudomány (angol nyelvű közlemény)
resulted from several factors: 1. due to the high mortality the number of the students was reduced from 42 to 20 by the ministerial committee which thought that the cause of the "epidemic" was the harsh treatment practised by the students during examinations; 2. Doctor Breit' s post as assistant was extended by two years, so the activity of Semmelweis was interrupted; 3, in that period Semmelweis continued his pathologico-anatomical tests but did not examine the women in childbed; and finally the pathologico-anatomical exercises of the students became rare and as a result the frequency of contact infections decreased. When Breit was appointed professor at Tübingen in March 1847, Semmelweis returned to his post of assitant in the first maternity clinic. After his return there was another sudden increase in the death rate. It was in that period (April to May 1847) that Semmelweis discovered the pathogen of puerperal fever: in the course of dissections the hands of the medical students became infected and as a consequence they transferred the pathogenic materials on the mothers, which resulted in sepsis. The "Kolletschkaexperience", so often referred to by medical historians, was only the concluding step of his manifold aetiological research. Semmelweis in his analysis recognized the identical nature of the pathologico-anatomical diagnoses, the influencing factor of the mortality rate, the interrelation. The discovery and use of the effective way of prophylaxis: chlorigated solution, cut down the death rate to 2.4 per cent in June, 1.2 in July, and 1.9 in August. Semmelweis kept a close watch on the statistical figures of the hospital. After the first favourable results in the autumn of 1847 the mortality rate again increased (September—November: 5.2, 4.0, 4.5 per cent respectively). The investigation of that phenomenon lead Semmelweis to further discoveries, namely that any supporating, ichorous process (dispersed medullary cancer, carious knee-joint, etc.) can bring about puerperal fever if chlorination is ignored, that puerperal fever is not an independent disease but one form of pyaemia, so theoretically it is not different from an infection during an operation. Due to the application of prevention the mortality rate of the 1st maternity clinic fell to 1,25 per cent in 1848, While only in April 1847, out of 312 mothers 57 died in puerperal fever, in 1848 during the whole year only 45 died out of 3556 mothers in childbed. In 1850 Semmelweis returned to Hungary to work in Pest, where he greatly contributed to the development of Hungarian public health. It was here that he continued his fight for the acceptence of his theory and practice until his tragic death. Although he published only a few statistical data on his activity in Pest in his Aetiology, these figures clearly show that statistics remained a controlling force in Semmelweis's medical conscience, he indeed looked upon statistics as being "in the service of collective conscience (13) During his activity in the Rókus Hospital as head physician (1850—1854), the mortality rate of births was only 0,89 per cent, while in the 1st maternity clinic in Vienna, the former scene of his activities, 400 mothers (9.10 per cent) died in 1854 owing to the neglect of prevention.
