Antall József szerk.: Orvostörténeti közlemények 81. (Budapest, 1977)

TANULMÁNYOK - Ehrentheil, O. F.: Oliver Wendell Holmes és Semmelweis Jgnác egy és negyed századról visszatekintve (angol nyelven)

of the European continent : the Obstetrical University Clinic in Vienna. In England the doctrine of the contagiousness of P.F. was then the prominent view. The following incomplete enumeration serves to remind the reader of the theoretical and practical achievements of the so called English Contagionists before 1850. Charles White (1773) of Manchester identified P.F. with surgical fever; Denman (1788) suspected that P.F. was sometimes transmitted by physicians and midwives; Gordon (1795) and Armstrong (1814) noticed that further cases of P.F. were prone to occur when the obstetrician or midwife were treating a case of P.F. Róberton (1831) emphasized the danger to parturient women when the obstetrician attended autopsies of P.F. cases ; Lee and Róberton, Nunnely, Copland (1833), Paley (1839) commented on the identity of P.F. and erysipelas, which had been suggested by Pouteau in 1760 [5]. Holmes gave special honor to Dr. Alexander Gordon of Aberdeen. Gordon had published a report in 1795 [6] in which he stated that "the cause of puerperal fever . . . was a specific contagion or infection altogether unconnected with noxious constitution of the atmosphere.'' He described that the disease (P.F.) was sticking to some physicians and nurses while there were no cases of P.F. among the patients of other physicians or nurses in the town. He admitted: "// is a disagreeable declaration for me to mention that I myself was the means of carrying the infection to a great number of women". Dr. Holmes righthy expressed his admiration for the scientific acumen and the personal honesty of these English practitioners. They reported cases of their own practice where contagion was apparently brought to previously healthy parturient women by doctors and nurses attending other patients with phlegmonous or erysipelous disorders, and/or women with P.F. and/or performing post mortem examinations. They suggested thorough "ablutions", changing of clothes, and even temporary withdrawal from practicing if a physician or nurse had two patients with P.F. [5, 6] An especially impressive success story is trje report of Robert Collins, master of the Rotunda Hospital in Dublin [7] who experienced a great number of P.F. cases between November 1827 and February 1829. In that February all the rooms of the Rotunda were filled with nascent chlorine gas for 48 hours with all openings sealed. The floors and woodwork were covered with chloride of lime in the form of a paste and after 48 hours they were washed with fresh lime. Woodwork, walls and ceilings were painted. Blankets and other bedding were scoured and then treated with dry heat in a stove at 120 to 130 degrees Fahrenheit. By such measures Collins was able to control the epidemic. For the rest of this mastership from February 1829 until November 1835 he had no further cases of P.F. and the mortality of childbirth from all causes was reduced to 0.53% among 10,785 deliveries. Sir William J. Sinclair [8] gives an explanation for the advanced status of British obstetrics as compared to obstetrics in continental Europe, namely that the progress in England was due to the fact that male doctors were practicing obstetrics in England while midwives played a secondary role. In continental Europe it was the other way around. There the midwives practiced obstetrics almost exclusively, while physicians were primarily called for infanticidal operations. In mid 19th century the midwives played their role according to the status of women in general and of midwives in particular, female physicians did not exist; the midwives were expected to transmit