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)
When interviewed in 1900, Mrs. Semmelweis told the interviewer that her husband "had scratched the middle finger of the right hand during the treatment of a patient. He got an infection which he treated himself for a long time by soaking it in water every night. .." Operative injuries are reported by: Wiener Medizinische Presse (August 20th 1805), Hegar (on the basis of Hirschler's narrative 26), Schürer von Waldheim (gynaecological operation, 61), Fleischer (operation 22) , J. Bruck (operation performed on a newborn, 15). In his necrology Markusovszky only wrote that Semmelweis's death was caused by pyaemia ( 39). Therefore, the gangrenous inflammation of the right index-finger and the osteomyelitis of the metacarpal bones is in causal connection with the injury suffered during surgery. As a result of the injury first subcutan panaritium, then a bone process originated, and osteomyelitis developed. The bone process (sequester, osteophyta-formation) that developed 0—8 weeks prior to his death, and/or the soft part inflammation preceding it (when the resorption of the bacterium toxins started already) chronologically coincides with the time mentioned by Mrs. Semmelweis (middle of June 1805). Compresses and bathing the injured organ was in agreement with the treatment of starting panaritium at that time. Unguentum cinereum was also used. Incision was only taken recourse to in case of fluctuation (16). Thus, the treatment in Pest was adequate to the contemporary practice. Panaritium osseale and articulare caused by a gangrenous abscess, the start of a sepsis, are proved by the autopsy report whereas osteomyelitis is confirmed by the palaeopathological examination, therefore — particularly in view of the contemporary books on surgery by Bardelehen (5),Pitha and Billroth (46) — it is incomprehensible why the necessary operation was not performed in the Vienna mental hospital although the fatal pyaemia developed so-to-speak under their very eyes. Semmelweis met his death from pyaemia, which he recognized. IX. THE QUESTION OF THE ACUTE INFECTIOUS-TOXIC REACTION TYPE In the opinion of Schaffer the pathological substance of Semmelweis's disease was the following; "Nachdem Hyperämie der Meningen, Hyperämie und Atrophie des Gehirns festgestellt wurde, müssen wir uns die psychiatrische Erfahrung vor Augen halten, dass in solchen Fällen als Initialsymptome melancholisch-hypochondrische Depression, katatone Erscheinungen, sowie Delirien und Krämpfe auftreten können. An eine akute exogene Geistesstörung müssen wir um so mehr denken, als die erwähnten Symptome mit der septikämischen Erkrankung zusammenfallen. Wir meinen deshalb, dass die Annahme einer symptomatologischen, sekundären und nicht primären, genuinen Psychose im Falle von Semmelweis gerechtfertigt erscheint" (57). Hence, Schaffer very definitely indicated the essence of the pathological process too,
