Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
ETIOLOGY BEFORE SEMMELWEIS 23 we find manifold modifications and variations among the various authors. The differences of opinion arose essentially from this circumstance that one author would attach more weight to one factor, another to some other factor, and then enunciate as an “authority” some half-digested theory, which was sure to be accepted in some quarter, usually in his own school or university. At this later period, only two points are worthy of special attention : (1) the relations of puerperal fever to the various acute infectious diseases, and (2) the relations in which it stood to the old pyaemia of the surgeons. Whilst in Germany and France the contagiousness of puerperal fever was the subject of much controversy, and was as a rule rejected, it was universally accepted in England. As a result of much observation, even in private practice, the conclusion was reached that scarlet fever, measles, smallpox, erysipelas, pseudo-erysipelas, even typhus and typhoid fever, stood in intimate relationship to childbed fever. It was believed that the virus of each of these diseases could produce puerperal fever in the peculiarly sensitive lying-in woman. The usual notion of this relationship was that the poison of these diseases could, owing to the peculiar quality of the blood and tissues of the puerpera, as on another soil, produce quite different phenomena from those produced under ordinary circumstances in the woman in normal conditions of health exposed to infection. The further conclusion was not far to seek, that for puerperal fever, generally speaking, there existed a specific virus, and many identified this virus with that of erysipelas or pseudo-erysipelas. The relation of puerperal fever to pyaemia of the old surgeons, or surgical fever, offers for our consideration quite peculiar phases. Hegar says that Cruveilhier was the first to compare the puerpera to a wounded person who had become affected by a miasm arising in a hospital, and that Eisemann next referred to the injury to the inner surface of the uterus, and its importance as the point of entrance of the miasm or contagium, the
