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)

was observed to have suppurative ulcers on her leg (Nov. 1847). Semmelweis therefore extended his doctrine and emphasized that the poison of P.F. is not only coming from poisonous material conveyed from cadavers or other patients with P.F. but can be transmitted from decaying animal-organic substances in general. This was his second discovery. Unfortunately, Semmelweis hated writing and his discovery was propagated not by himself, but by his friend Ferdinand Hebra who was then editor-in-chief of the official Journal of the Society of Physicians in Vienna (Zeitschrift der K.K. Gesellschaft der Aerzte zu Wien). In an unsigned editorial [3a] carrying the provocative title : Very important experiences about the Etiology of the Puerperal Fever which is epidemic in our obstetrical hospitals he described Semmelweis' findings and theories and said that the editors felt it was their duty to announce this doctrine to the physicians at large with the urgent request to prove or disprove Semmelweis' views due to the importance to the welfare of mankind. In this first announcement the main points of Semmelweis' doctrine were covered: P.F. is not a contagious disease because it is not conveyed by a specific contagium. Any decaying animal-organic substance brought to a wound can produce a pyemic condition. To regard P.F. as a pyemia was Semmelweis' third discovery. The Danish physician P. A. Schleisner [20] recognized that malignant P.F. and the disease process called purulent infection or pyemia are identical processes except for modifications due to the special conditions of the Puerperium. Schleisner however, did not discuss how and why the pyemia developed. The danger of bringing any decaying animal organic matter to the wounded female organs, the absorption of this matter, and subsequent pyemia were in their connection definitely Semmelweis'' discoveries. We have seen that several precursors have come to similar conclusions in their thinking about the pathology of P.F. and practical methods for its prevention. In Hebra's editorial there is no mention of the achievment of the English Contagionists who observed the conveyance of the disease through the hands and clothes of attending physicians and midwives nor was there any reference to the prophylactic measures used by them. Hebra [3b] wrote a second editorial (again unsigned) where more statistics were given and where supportive letters by Michaelis of Kiel, Germany and Tilanus of Amsterdam were mentioned. Semmelweis was a pupil of Skoda, the famous internist and chairman of the Department of Lung Diseases in the Viennese Medical School. From him Semmelweis learned scientific methodology, the use of statistics in medicine, and especially how to arrive at a solution of (diagnostic) problems by exclusions (diagnosis per exclusionem). In the excellent biography of Semmelweis by Gortvay and Zoltán [19e] the authors emphasize that Semmelweis' discoveries were not chance discoveries but the triumph of logical thought. Skoda was convinced of the importance of Semmelweis' findings. He gave a talk to the Austrian Academy of Science on Oct. 18, 1849 about these findings. A report of this talk appeared later in the Journal of the Society of Physicians in Vienna [21]. Finally Semmelweis himself gave a talk in the Society of Physicians in Vienna May 15, 1850. The highlights of the talk were reported in the protocol of the society [22]. It can be read in English translation [23]. However Semmelweis himself detested writing. This aversion precluded the publication of his ideas for many years.