Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)

III. Life in Vienna

EVIDENCE FROM CLINICAL WORK 57

In the afternoon a similar visit was made by the assistant along with the students.

In the morning the assistant went round and examined every patient before the professorial visit in order to make his report to the professor.

As time permitted the students made examinations of special cases between the assistant’s first round and the visit of the professor.

Consequently, when a patient with a tedious dilatation stage lasting a whole day or longer was so frequently examined with unclean hands she became infected, and such patients almost without exception died of puerperal fever.

After the introduction of chlorine disinfection and consequently of examination with clean hands, the deplorable mortality among these cases of tedious labour ceased, and delay in the first stage was no more dangerous in the First Clinic than it had always been in the Second Clinic.

In order to make intelligible the import of childbed fever in relation to the infection of the newborn, some of the matter which is contained in Der Begriff, which is treated of later, is stated here in anticipation (Theilweise anticipirte).

In childbed fever the first fact is a resorption of a putrid animal-organic material : in consequence of this resorption there follows a blood-dissolution (Blutentmischung). In cases of prolonged first stage the symptoms might appear during or immediately after labour. This might occur while the circulation of the mother and foetus was still in organic connexion through the placenta, and consequently the foetus became infected and was attacked by a disease identical with that of the mother. . . . The healthy mother could not convey childbed fever to the newborn. This is the explanation of the fact that the newborn never died of puerperal fever while the mother remained well.

We had now also an explanation of former observations with regard to “ street-births.” It was now easy