Antall József szerk.: Orvostörténeti közlemények 97-99. (Budapest, 1982)

TANULMÁNYOK - Codell Carter, K: Semmelweis esetleges hatása Kari Mayrhoferra és a tizenkilencedik századi etiológiai elméletek kidolgozóira (angol nyelven)

sympathetic expositors have passed over this development with relative indifference.

8 Third, it remains to be determined to what extent, if at all, Semmelweis influenced those who so brilliantly used the same etiological strategy to explain and to control other infectious diseases. In this paper I wish to give some attention to this third area. Even if one grants that Semmelweis adopted an original method, one could still object that his use of that method was anticipatory but without significant influence—that the method had to be rediscovered by others at a later date. One could object that neither Semmelweis nor his successors realized the magnitude of the research tool he had stumbled upon. I believe that these observations may be substantially correct. Cases of simultaneous (or nearly simultaneous) independent discovery seem to be the rule rather than the exception in the history of science.

9 It is certainly possible that Semmelweis, who appears never to have realized that his strategy had application outside his work no puerperal fever, "stumbled upon" this particular approach and that it was then adopted independently by researchers investigating other diseases. However, even if this proves to be true, so far as I can see it would not diminish the significance of the Aetiology in the slightest degree. Fundamental linguistic and methodological innovations, like the adoption of etiological characterizations, are never gratuitous. In any case, Semmelweis was the harbinger of a revolution that swept medicine and that severed it from its twothousand year history. If other people discovered the same strategy independently, this simply underscores the need for an explanation. Why, after all, in the middle of the nineteenth century, probably for the first time in the history of medicine, would various physicians, acting independently of one another, suddenly become interested in necessary causes? Presumably this change would have to be explained sociologically

—perhaps in terms of the social role of the physician.

10 On the other hand, there is a possibility that Semmelweis's work did, in fact, provide a more significant model for his successors than has generally been recognized. In his Geschichte der Geburtshilfe in Wien, I. Fischer briefly discussed the life of Karl Mayrhofer (1837-1882).

11 At the beginning of his career, Mayrhofer was an assistant in the first obstetrical clinic in Vienna

—the same clinic in which Semmelweis had done his work. While there, he published three essays on childbed fever.

12 In the essays Mayrhofer reported identifying specific microorganisms, which he called vibrions, in the secretions and tissues of over one hundred puerperal fever victims. He also reported 8 I have discussed Lesky's comments about Semmelweis's etiological innovations in an earlier paper, Carter, op. cit., note 3 above, pp. 71 f. Gortvay and Zoltán pass over this aspect of Semmelweis's work with the comment, "he had naturally come to the conclusion that the identical pathological symptoms must have identical causes." Gortvay and Zoltán, op. cit., note 6 above. This was not a natural inference, but a radical innovation of the first order. None of these authors see any difference between the etiological doctrines advanced in the May 1850 lecture and those announced earlier. 9 The phenomenon of simultaneous discovery has received some philosophical attention recently. See, for example, Thomas S. Kuhn, The Essential Tension, Chicago, The University of Chicago Press, 1977, pp. 69-72, 101-104, and 166-174. 10 I have argued for this possibility in "On the Decline of Bloodletting in Nineteenth Century Medicine," forthcoming in Journal of Psychoanalytic Anthropology. 11 I. Fischer, Geschichte der Geburtshilfe in Wien, Vienna and Leipzig, Vogel, 1909, pp. 352-354. 12 Karl Mayrhofer, "Ueber das Vorkommen von Vibrionen bei Wöchnerinnen," Wochenblatt der Zeitschrift der k. k. Gesellschaft der Aerzte in Wien, 1863, 19: 17-20; „Untersuchungen über Aetiologie der Puerperalprocesse," Zeitschrift der k. k. Gesellschaft der Aerzte in Wien, 1863, 19 : 28-39; and „Zur Frage nach der Aetiologie der Puerperalprocesse," Monatsschrift für Geburtskunde und Frauenkrankheiten, 1865, 25 : 112-134.