Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VI. Publication or "Die Aetiologie"
224 PROPHYLAXIS to completely isolate patients who may be a danger to the others; in this way can overfilling possibly become the cause of the production of a decomposed matter, and thus indirectly overfilling may lead to the conveyance of decomposed matter from one individual to another. But when, in spite of overfilling, the necessary degree of cleanliness is observed so that no decomposed matter is produced . . . under such conditions it is a matter of indifference to the lying-in hospital patient whether the hospital is overfilled or not ” (p. 213). This opinion is elaborated and supported by a great mass of statistics which occupy the greater portion of the chapter. The only point of any importance which is not mere repetition is the discussion of puerperal miasma. The argument amounts to this, that when the air of a lying-in room is so loaded with exhalations from the skin of the patients, from secretion of milk and from the lochia, and from the emanations from the new-born, in the absence of ventilation, it may form a decomposed matter and become itself the conveyer of decomposed matter to the genitals, and thereby the producer of puerperal fever. “When this is the meaning attached to puerperal miasma I agree in accepting it. Anything else over and above this as puerperal miasma does not exist. On this import of puerperal miasma is based the due employment of means of ventilation, and the practice of isolation of affected cases.” Prophylaxis. Inasmuch as the only cause of puerperal fever is the bringing to the individual of a decomposed animal organic material from without or the production of such deleterious matter within the individual, the task of prophylaxis of puerperal fever must consist in preventing the access of decomposed material from without, the arrest of the development of such material within the organism, and the removal as quickly as possible from
