Sinclair, Sir William J.: Semmelweis. His Life and his Doctrine (Manchester, 1909)
III. Life in Vienna
58 EVIDENCE FROM CLINICAL WORK to understand why these patients so seldom sickened after admission to the First Clinic : these patients were no longer objects of interest for clinical demonstration, and therefore they were seldom examined after admission, and consequently they escaped contact with hands to which cadaveric material adhered. Similarly, with regard to premature labour. There was seldom occasion for frequent and exact examination. These labours were completed rapidly without further complication, and being rarely of much obstetric interest they escaped examination and consequent infection. Also the reihenweise Erkranken or sickening in rows found an easy explanation. Owing to the large number of patients in the First Clinic there were often several in the labour-room at the same time. Twice daily at the least during the professor’s visit, and again during the assistant’s visit in the afternoon, all these women were examined for the sake of practice by the students in the order in which they lay in bed. They were thus infected in sequence by the unwashed hands of those who came from the dissecting-room. After labour the patients were transferred to the lying-in wards and placed in bed in the same order in which they had been confined. Hence it wras that puerperal fever attacked the patients reihenweise just as they had been infected by frequent examinations during labour. After the introduction of chlorine disinfection the “sickening in rows” ceased to occur. We have seen that as the result of the report of a Commission the number of examinations of patients in labour was much reduced and foreign students were excluded. Following the adoption of these regulations the mortality fell considerably in the end of 1846, but rose again to an alarming extent in April and May 1847. The explanation of these variations is a remarkable testimony to the truth of the doctrine of cadaveric poisoning. “Owing to the circumstances in which I was placed as aspirant for the post of assistant in the First Obstetric Clinic, later as provisional assistant, and finally as actual
