Pictures from the Past of the Healing Arts / Orvostörténeti Közlemények – Supplementum 18-19. (Budapest, 2000)
Semmelweis's Birthplace - the Home of the Museum
bio us, undecipherable, only the great number of dead was an undoubtful reality' — he noted in his diary. His professor in pathology was Rokitansky. Semmelweis himself looked for an answer in the dissecting-room too. Each morning he conducted post-mortem examinations and the symptoms were always the same: inflammation of the arteries, the lymph vessels, the peritoneum, the pleurisy, the pericardium, and the meninx. On the basis of Skoda's elimination method, he weighed all theories which considered puerperal fever an epidemic. He refused the idea of an epidemic outbreak on account of the different mortality rates between the two clinics. There was no epidemic in the city either. No effect of the seasons could be observed in the occurrence of puerperal fever, an unusual symptom, however, in case of epidemics. Why could then the closing of the clinic stop the 'epidemic' to spread away? No 'injury through force' could be the cause. The other assumed factors (modesty, examination methods, therapy) were the same at both clinics. What could be the local cause at the 1st Clinic then, at the clinic of Professor Klein? After a few months' work Semmelweis had to give up his post as assistant according to the previous agreement, when Dr Breit, his predecessor, returned. He began to learn English and wished to leave for Dublin to study obstetric techniques in a city where puerperal mortality rate was lower. Meanwhile a commission introduced severe restrictions in the clinics in Vienna to eliminate the allegedly rude examinations methods: the number of the medical students was decreased, especially that of the foreign students. And it did result the decreasing of the mortality rate! Dr Breit was not very busy in doing post-mortem examinations by himself, thus the danger of infection came to be smaller. Semmelweis was, however, soon reinstated to his post, because Breit was invited to the chair of midwifery at the University of Tübingen. Then, after so much trouble and worry, in March 1847 Semmelweis set out on a journey to Venice with his friends to relax among the historical monuments of the city. After his return to Vienna, he started to work with renewed energy. Maternal death rate increased rapidly in April 1847 it was again as high as 18%. We know today, as he himself later also realized, that it had been mainly due to his researches. It was the most fatal way a doctor could imagine. He himself caused the death of her labouring patients when hurrying to them immediately after the post-mortem examinations. While he was travelling abroad, his friend Kolletschka , professor of forensic medicine died. During an autopsy his finger had been cut by a medical student's knife. Semmelweis learned it after his return and studied the record made of Kolletschka's post-mortem. He was deeply shocked because he realized that the findings were identical with the symptoms of those who had died in puerperal fever. 'Day and night I was agitated by the report of Kolletschka's death and there was forced upon my mind with irresibile clarity the identity of this disease from which Kolletschka had died, with the other one from which I had seen so many hundreds to die in childbed. ' 19
