Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
EXPLANATION OF PHENOMENA 55 became professor of midwifery in 1789, after his return with obstetric spolia opima from Great Britain : he introduced the English methods of practice which he had learned, chiefly from Denman, founded on the principles of cleanliness and patience. From first to last, Boer’s mortality from puerperal fever was comparatively insignificant. During the thirty-three years of Boer’s incumbency until his dismissal in 1822, the patients amounted to 65,000, and of these 850 died, that is equal to an average annual mortality of i'3 per cent. In 1822 the last year of Boer’s tenure of office, the mortality was o'8 per cent. Boer had absolutely refused to teach midwife-pupils by practice upon the cadaver, and his want of subordination was made a pretext for his removal. His successor, Professor Klein, was more complaisant: he demonstrated on the cadaver, and during his first year of office, 1823, the mortality rose to 7'8 per cent., and since then it had never been eradicated : it usually remained high; sometimes it was appalling. The only difference between Boer the master and Klein the weak disciple was the introduction of cadaveric poison. In 1846 the mortality was 8 per cent. In 1847, during which chlorine disinfection was introduced, the mortality was 3 per cent., and in the year 1848, during the whole of which the chlorine disinfection was diligently practised, the mortality sank to i'28 per cent. Well might Semmelweis say that his Table XVII. (/.Etiologie, p.62), from which these figures are quoted, is “an irrefragable proof of my opinion that puerperal fever originates in the carrying over (Uebertragung) of decomposed animal- organic matter. At the time when the system of teaching restricted the opportunities of conveying infection the health of the patients was favourable; when the Vienna School adopted the anatomical basis of instruction the unfavourable health condition of the lying-in women began . . .” A review of the past of the lying-in hospital also shewed that the less the amount of teaching carried on
