Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
VII. Last Illness and Death
306 OBSTETRICAL SOCIETY OF LONDON supply to the child cut off. She is in an enfeebled nervous condition . . . She is, therefore, in the exact condition for a series of changes which must necessarily be febrile in character . . . We must accept the fact that there are a considerable number of women who are hereditarily predisposed to particular diseases including puerperal fever . . . ... I presume there is no such thing ... as a case of delivery which is not followed by some slight febrile state, for that state is necessitated by the changed physiological conditions, by the increased tension of the vessels . . . There is always this simple surgical fever . . . Barring that natural febrile state which follows upon confinement . . . there is no such disease as specific puerperal fever. . . . The presence of organic germs and bacteria is a mere matter of coincidence . . . Antiseptics, that is, bodies which prevent putrefaction, . . . antiseptics do not act by destroying germs or organic forms, but by interfering with the poisonous action of the septinous material which produces the fatal disease. Dr. Robert Barnes, Obstetric Physician of St. George’s Hospital, said he would divide the cases of puerperal fever into two great classes : (i) Heterogenetic, the direct result of infection or contagion produced by some zymotic poison, as scarlet fever, erysipelas, measles, or typhoid. All those things we see and know and cannot for a moment dispute them; (2) Autogenic, in which the conditions of the fever exist or arise in the patient’s system, with which infection or contagion from without has nothing to do. Such cases are manifest to every one . . . How is it that lying-in women are specially prone to scarlet fever? . . . How is it that the protection of a previous attack all of a sudden breaks down under the trial of child-birth? ... “I have seen cases traced to scarlatinal poison in which the usual symptoms of scarlet fever were absent: no particular sore throat, no swelling
