Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
22 ETIOLOGY BEFORE SEMMELWEIS portions of the body, especially those of the sexual system. Under the influence of the doctrine of crasis the opinion was formed according to which the special change in the blood, the increase of fibrin, which occurred to the pregnant woman, had no limit fixed to it, and it might so increase that finally deposits in the form of exudation on the inner and outer surfaces of the uterus were produced spontaneously. From the hyperinotic condition a still further increase might develop, resulting in pyaemia or even in a blood- crasis, a spontaneous “blood-dissolution.” Among the supporters of a theory of spontaneous origin we find, for example, Virchow in 1861 and Barnes in 1875. This condition might also be produced by the direct influence of the external factor, the miasma. The peculiar anatomical condition of the sexual organs brought about by pregnancy and parturition produced a locus minoris resistentiae. This assumed fact explained the frequent occurrence of deposits or secretions from the altered blood, or the influence upon those parts resulting from the miasma, which was taken up from the atmosphere and kept circulating in the blood. It was also taught that the injurious material could find its way into the sexual organs themselves, and there directly produce the lesions contributing to puerperal fever, or completely create the fever after first poisoning the mass of the blood. Besides all this, the opinion was still quite generally entertained that all the anatomical alterations peculiar to puerperal fever arose idiopathically owing to injuries, bad contraction of the uterus, chilling, errors of diet, emotional conditions, and that then the blood-changes such as are present in every form of fever might be secondary results. In the opinions concerning the relationship of the external noxae, of the composition of the blood, of the peculiar anatomical changes in the puerperal sexual organs, and of the pathological-anatomical observations,
