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

TANULMÁNYOK - Regöly-Mérei, Gyula: The Pathological Reconstruction of Semmelweis's Disease on the Basis of the Catamnestic Analysis and Palaeopathological Examination (angol nyelvű közlemény)

III. THE CATAMNESIS 1, The period of the "Aetiologie" and the "Open Letters" More than ten years had passed since the discovery. Semmelweis at last wrote his book. In the Preface he explains what the delay was due to: "Zu dieser Abneigung gegen jede Polemik kommt noch hinzu eine mir angeborene Abneigung gegen alles, was schreiben heisst" (63), His thesis was published first in Hungarian, in the Orvosi Hetilap (Medical Weekly) in serial parts, in 1858 (62), These years are already subject to the catamnestic analysis for views can often be encountered according to which Semmelweis was "mentally deranged" in some way or other at that time. For example, Schürer von Waldheim (61) gives mental disorder as the motive for Semmelweis leaving Vienna (1850), the true reasons of which we got to know through the recent research of Erna Lesky (34); from the investigations of 5. Fekete it appeared that Semmelweis had to go home, for his family in Buda was hard up because the so called "Kossuth-banknotes" became devaluated due to the failure of the War of Independence. In the view of Dawson (17) symptoms of mental disorder were already noticeable in 1857. According to others (14) the "hackneyed repetitions" in the book and the Open Letters also point to paralysis. In the opinion of Gortvay and Zoltán (23) the repetitions were a conscious way of debating, characteristic of Semmelweis, In addition, — as /. Hirschler, a contemporary of Semmelweis wrote (Autographisches Fragment) — Semmelweis used to send his manuscripts to press at once without previously collating the chapters. The book of Semmelweis presents a wealth of data demonstrating the author's splendid logic and excellent capacity of association. It contains two decisive observations from the aspect of pathological anatomy. Semmelweis and not Rokitansky recognized that the changes of Kolletschka's corpse were identical with the ones usual in the case of deceased by puerperal fever. Regarding the connection between thrombosis and puerperal fever Semmelweis (63) was right while his debating partner Virchow (73) was mistaken. According to Virchow, after confinement physiological thrombosis occurs due to the defective contraction of the vessels of the uterus and the cause of puerperal fever is due, among others, to weather conditions.L, Máday (37) mentions that in Semmelweis's works analysis of parallel changes, long-range dynamic series and many-sided grouping are already dealt with. In view of the aforesaid there is no reason whatever to assume that Semmelweis's mind was deranged at the time he wrote his book. There remains, however, another question, the peculiar way of using fractions, a somewhat startling phenomenon indeed. For example: "Wenn wir die Frage stellen, von wie viel Wöchnerinnen ist in einzelnen Epochen des Wiener Gebärhauses Eine gestor-