Antall József szerk.: Orvostörténeti közlemények 62-63. (Budapest, 1971)
TANULMÁNYOK - Meigs, J. Wister: Kontagionisták, antikontagionisták és a gyermekágyi láz (angol nyelven)
the pulse became perceptible, but she had frequent fainting fits during which it stopped. We gave vol. julep, brandy toddy and warm bread and milk." The notes continue through June 23rd. Mrs. S. almost died during the first night but improved thereafter. The last note was added as follows: l 'Aug. 12, 1840 She has had a fine child about a year and a half since. Dr. F. Bache [Benjamin Franklin Bache, a grandson of Benjamin Franklin] delivered her. He was obliged to separate the placenta with his fingers — the whole hand in utero. CDM" [20]. Perhaps, you can now see that the practice of obstetrics in the 10th century was a different story from the situation today in a well-equipped medical center. If you can picture yourself in the position of either Mrs. S. or her physician, it should be clear that worry about puerperal fever could add a further emotional burden to an already appalling situation. C. D. Meigs responded to the fear of contagion first by denying that the disease was a contagion and second by promoting scrupulous care and cleanliness in the practice of obstetrics [23]. He has been universally and rightly criticized for the denials. His obstinately persistent rejection of communicability of childbed fever in the face of evidence accepted by his contemporaries is reason enough for Meigs to be the all-time winner of the anticontagionist Derby. The story is more complicated. Was it simply the availability of Meigs as an obvious whipping boy that would explain some of the elaborate criticisms? Why did Henry Viets, in 1964, after joining the chorus of critics of Meigs the anticontagionist, add the arresting statement that among the serious defects of the latter's 1838 text on obstetrics was the omission of a section on pre-natal care? [8]. It would have been even more surprising if Meigs had included a chapter on an aspect of obstetricial practice that did not begin until 60 or 70 years later. C. D. Meigs was only one of many anticontagionists blamed by medical writers for situations in which evidence was either lacking or unclear. For example, epidemics of puerperal fever in the late 19th century have been attributed to anticontagionists who had died years previously [8, 10, 14, 32]. These allegations sound plausible, but an epidemic at the Boston Lying-in Hospital will illustrate some difficulties. Here is the pertinent chronology. In the late 1860s Pasteur described bacteria and by 1879 he had identified the streptococcus as a causative organism in discharges from patients with puerperal fever [20]. In the same year the Boston Lying-in Hospital had the first of a series of epidemics of puerperal fever. The peak was in 1882 when 0% of patients died after delivery. In that year sixteen of seventeen maternal deaths were due to septicemia. Some sixty years later, in 1943, Fritz Irving, Chief of the Boston Lying-in Hospital, commemorated the centenary of Oliver Wendell Holmes' great essay on "The Contagiousness of Puerperal Fever", After noting that epidemic puerperal fever continued for at least forty years after the writings of Holmes and Semmelweis, Irving commented: "In America, the reactionary influence of Meigs and Hodge ... continued to cost the lives of countless women. There was more respect in those days for academic authority, there were fewer professors, and they
