Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
44 ELIMINATION OF FACTORS The explanation that the more premature the birth the less developed was that puerperal condition which predisposes to puerperal illness was not convincing, for the puerperal condition is not essential to the production of puerperal fever, and puerperal fever may originate during labour and even during pregnancy. The better health conditions of puerperae after premature labour in the Second Division was also in harmony with the better health condition of puerperae after labour at full term in this Division. Distribution of infected cases in the wards. The patients as a rule sickened in child-bed in an irregular manner: one woman would become the victim of puerperal fever while several women in the neighbouring beds, to right and left, remained well; but occasionally the patients in whole rows of beds in a ward sickened about the same time without a single normal puerpera between them. How was this circumstance to be explained? In the Second Division patients who became ill were always scattered, never in rows? The explanation which appeared at the time sufficient was that puerperal fever is at times a contagious disease, and the occurrence of cases in rows (reihenweise) was declared to arise out of the spread of the contagion from bed to bed. The authorities did not remain indifferent to the dis- quietening appearance of a higher mortality in the First Clinic compared with the Second, and various Commissions wTere from time to time appointed to inquire into the causes of the difference in mortality and to come to some conclusions as to whether a larger proportion of the lying-in women might or might not be saved in the First Clinic. In the hope of saving a larger number all puerperal fever cases were at once transferred to the General Hospital where they came under the treatment of different physicians, but they died there also with few exceptions. By these Commissions, largely composed of non
