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)

Of the many causes premature ageing can be due to, two possiblities shall be discussed: paralysis progressiva and arteriosclerosis. On the basis of the analysis of the neurohistological examination Haranghy (24, 25a and b

) considers arteriosclerosis an established fact. In Semmelweis's catamnesis there are no direct symptoms pointing to arteriosclerosis, except for headaches which however, might also have been hypertensive headaches. This question will be treated more fully in connection with the results of the post-mortem examination and the neurohistological finding. e) The catamnestic analysis a) Data pointing to signs characteristic of paralysis progressiva such as depression (inferiority complex, self-accusation), expansiveness (megalomania), mania (fits, delirium, raptus) or dementia (amnesia, quick decrease of the intellect or hebetude, amnesic asphasia, apraxia, incapacity of orientation in space and time) could not be met with. He had no dysarthria (for he delivered lectures at the University) and his handwriting does not point to dysgraphia. b) Tabes dorsalis : No mention was made of symptoms of optical and acoustic. Hypotonia of the muscles (genu recurvatum), ataxia, lancinating pains (e.g. crise gastrique) would not have passed unnoticed by his colleagues and family members and the same refers to ataxic gait. All these signs would have aroused the interest of his entourage. Dysuria and defecation disorders had not been mentioned by his wife in the interview (1900). c) Headache, insomnia, absent-mindedness and irritability could have been the result of arteriosclerosis. 4. The last weeks Fleischer, a contemporary of Semmelweis wrote the following: "In the last weeks of his life this clear and profound mind started to get muddled, his unusual peculiar private life, forgetfulness and absent-mindedness as well as childish behaviour puzzled his family and all those who were familiar with his nature and customs at the University, medical visits and faculty meetings" (22). Fleischer's statements are absolutely authentic for he belonged to the immediate entourage of Semmelweis. "The mental disorder" he continues (22) "worsened in the second half of July" ; this is in agreement with the statement of Mrs. Semmelweis who noticed the first alarming symptoms of troubles of the nervous system on July 13th 1865. He was not to be contradicted, wanted to visit patients at night, became bulimic, used obscene words, was moved without any reason and his migrain worsened. Previously Mrs. Semmelweis only noticed the restlessness of her husband: "He used to get up at night, and drafted the letters, answers to the attacks, walking up and down in the bedroom" (Interview in 1906). The attacks date frcm the peried of the Open Letters. It is, however, not striking that a physician and a discoverer at that gets excited because of savage onslaughts made against him and is preoccupied with them day and night. The more striking are the events that took place in July I h 65, showing increasing pa-