Antall József szerk.: Orvostörténeti közlemények 62-63. (Budapest, 1971)
TANULMÁNYOK - Meigs, J. Wister: Kontagionisták, antikontagionisták és a gyermekágyi láz (angol nyelven)
years, the corrected four year maternal death rate becomes 2.54%.* Browne's failure to quote this information from the Board reports should be considered in relation to his praise of Atthil for his attitude about contagion. Browne said: "Atthil ,.. was fully aware of the important changes in medicine . . . In 1869 he had attended the famous meeting of the Obstetrical Society at which Kennedy's paper on zymotic diseases was discussed, [Kennedy was also a strong contagionist [27], There he had supported Semmelweiss' views, and although he did not completely agree with Kennedy's ideas, he admired him. Atthil was the first to insist upon the nurses and students washing their hands in carbolic soap, and rinsing them in basins containing a solution of carbolic acid [5e], These are a few examples, from many available, to support the argument that historians of puerperal fever, and especially more modern ones, have leaned beyond the evidence in being critical of anticontagionists and in praising contagionists. As a main support I have purposely used Dublin's history, because the biases can be seen more clearly in relation to records of actual performance. But why should there have been what looks like a pretty strong bias? And further, are there better explanations than the „reactionary influence of anticontagionists" for the puerperal fever epidemics of the 1850-1900 period. It may be easier to appreciate the powerful emotions that might cause such a bias if one understands that there were logical causes for the epidemics. These causes were described clearly by some of the writers in the early 1900s. Lea pointed out in a 1910 text on Puerperal Infection [16] that: . . the introduction of chloroform has been accompanied by a distinct increase in puerperal mortality. Before this time, operations were undertaken rarely and with reluctance, but with the general introduction of anaesthesia, they were performed with increasing frequency, and a distinct increase in mortality can be traced to this fact. Thus, whilst in 1847 to 1856 the mortality did not exceed 1.8 per 1000 in England and Wales, in spite of the absence of antiseptics, in the years 1875 to 1884 this had increased to 2.4 per 100, and has as yet shown few signs of diminution." Table I shows that the Rotunda's epidemic period followed immediately the time of introduction of chloroform. In addition, McClintock's and Denham's Masterships were marked by increasing numbers of examinations of women in labor by students [15]. The Rotunda history affirms the concomitant increase in operative obstetrics. Consider the emotions surrounding the use of chloroform. All at once the dreaded pains of childbirth could be largely eliminated. The enthusiasm for anaesthesia was so great among both doctors and patients that the risks were usually minimized and sometimes completely ignored. It took * We should like to add that statistical figures have always provided opportunities for some misunderstanding, among others it was a general practice with hospitals to transfer agonising persons to other departments, with a view to improve the statistical figures of the department concerned. (The Editor.) 5 Orvostörténeti Közlemények 62—63
