Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
V. Life in Buda-Pesth
ANSELM MARTIN 173 mortality was high. According to Semmelweis this incident is of special interest, because in seeking for the causes of the sickness, all the old alleged factors— unfavourable locality, overcrowding, want of cleanliness, and so forth—must be excluded. The structure and furnishings were considered perfect, and the administration endeavoured by cleanliness, ventilation, alternation of the use of the wards, and by the strictest regulations, to prevent the occurrence of puerperal fever. Isolation of sick patients was carried out and the sick puerperae were nursed by an entirely separate staff. The institution was much admired by visitors from Germany and from foreign countries. After expressing his own satisfaction with the hospital, Martin goes on to speak of the duty laid upon such institutions to investigate the causes of puerperal fever. About this sentiment Semmelweis remarks: “The time for further inquiry into the etiology has gone by : the only etiological factor for all cases without exception is the access of a decomposed animal organic material. Now the time has arrived for the utmost endeavours to make this single etiological factor so innocuous that in the whole world, both inside and outside the lying-in hospitals, the disease may be seldom met with. ... As a rule it may be said that treatment is not successful : we must therefore trust to prophylaxis.” Martin mentions as causes of puerperal fever matters that do not stand in any causal relationship to that malady, but he admits that some recognise as a cause of puerperal fever, especially in lying-in hospitals, cadaveric particles adhering to the examining hands of physicians and students after making post-mortem examinations, and that even the cadaveric odour remaining after ordinary washing may imply a putrid atmosphere capable of producing puerperal fever. Even the cadaveric smell of clothing, bedding, etc., may cause infection. Still many authorities in the science of obstetrics deny that this can be a cause of puerperal fever, and Martin, while disavowing partisanship on one or other side, proceeds
