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)

VIII. ORIGIN AND TIME OF THE HAND INJURY The question at issue is not merely a matter of interest from a medico-historical aspect for if the origin of the purulent process coincides with the nursing in the mental hospital the opinion of Haranghy, Nyirő and Regöly-Mérei has to be ruled out a priori. Two views prevail: 1. the injury was caused in the mental hospital 2. the suppurative process started in the second half or middle of June 1865 as a result of a surgical injury. Gyógyászat published in 1906 (36) the reminiscences of Béla Machik he has told already a few times. Accordingly, he was an assistant-physician at the mental ward in Vienna where Semmelweis had been nursed. Riedel, the chief-physician was on his holiday at the time Semmelweis was hospitalized there and when he returned from his leave and was informed that his one-time schoolmate Semmelweis was lying ill in his department he visited the latter at once. According to Machik's narrative Semmelweis was in a confused state of mind, smacked Riedel's face and was therefore fastened with straps. When he had been released there were already gangrenous symptoms on his right hand. Benedek (7) is, rightly sceptical about the historical fidelity of the narrative because Riedel was older than Semmelweis and thus they couldn't have been fellow-students. According to the heading of the autopsy report Semmelweis was hospitalized in Mildner'

s and not in Riedels mental ward. Although Machik's story does not seem to be authentic it does not exclude the possibility that the septic process was the result of injuries he suffered in the lunatic asylum. The osteomyelitis on the right hand — in view of its pathological character could have developed 6—8 weeks ago and this in itself suffices to rule out the possiblity that it originated in the mental hospital. The injuries on the lower left limb and on the right elbow are due to violence but originated far later than the former one. Of the injuries the one on the right elbow with a hollowed out edge, a purulent, ulcerous inflammation extending to the periosteum is the oldest one but on the basis of the descriptions even that cannot date back to an earlier date than one-two maximum three weeks, The other injuries were covered with crust and are, obviously, of an even more recent origin. The autopsy report is rather incomplete. No mention is made of haematoma, peripheral oedemas, inflammatory symptoms, condition of the tissues etc. Owing to the laconic wording of the autopsy report the deformation on the left index-finger is difficult to explain. Reference is merely made to a crackling tumescence but the condition of the soft part and the bone is not mentioned, thus it can be the trace of a fracture or an inflammation caused by an anaerob microorganism.