Antall József szerk.: Orvostörténeti közlemények 55-56. (Budapest, 1970)
TANULMÁNYOK - Benedek, István: The Illness and Death of Semmelweis (angol nyelvű közlemény)
the upper surface of the 1st head of the right metacarpal there are two small holes. .. at the bottom of the distal end of metacarpal V, and up on its proximal end and on its lateral side respectively one can see a corrupted hole leading into the bone, most probably the result of suppuration." In addition there is an aperture suggesting suppuration on the left metacarpal bone III and IV as well, while the IVth metacarpal bone is missing. If that is the situation the whole contention collapses that all the suppuration started from one centre, from the middle finger of the right hand. Anyhow that might sound a bit suspicious to any thoughtful person: why do the metacarpal bones bear the marks of suppuration, and in addition simultaneously three, or even all the five, why not the phalanxes? According to both recollections, the interview of the widow and Bruck's story, Semmelweis injured the middle finger of his right hand, yet there is no mark of suppuration on the phalanges — is that not strange? (True, half of the phalanges could not be found: they might have even been corroded by the pus.) There is a further discrepancy between the expert opinions: According to Regöly-Mérei "We have found large-scale destruction of the bony tissue on the right scapula which obviously is a concomitant phenomenon of the septical process", but according to Bartucz the right scapula was mouldered by the debris of the bricks. That which of the two expert opinions is correct could be decided only by a new examination of the bones. Till that there is no other choice than to question the conclusive force of the expert opinion. That one scientist believes this and the other that is not defamatory to any of them, only leads one who is interested in the question to try to compare, prove, or disprove the contentions by other data, thus trying to find his way among the contradictions. He may remind himself that already in 1960 Regöly-Mérei pronounced in favour of the toxic delirium, so at the exhumation in 1963 he was already in search of support for his assertion. At the crucial question of the age of the osteomyelitis, which means how much time lapsed after the injury, his reasoning is surprisingly feeble. If he asserted that according to the internationally accepted experience of surgery or palaeo-pathology the average time for the starting of the osteopythe-formation is, say, eight weeks, then it should not occur to the reader who is not an expert on that question to have doubts. But Regöly-Mérei (who, like I, also figured out that if there was any injury then it had to occur in the first part of June) argues : "On the basis of their experiences in surgery Goldhan and Jörns claim that the evolution of sequestration requires about 4—6 weeks. On the bones of Semmelweis cloaca, local osteoporosis and the beginnings of osteophyte-formation can be demonstrated, therefore we may suspect a 6—8 week old osteomyelitits." Consequently the analogical proof for the age of Semmelweis's osteomyelitis is provided not by an internationally and generally accepted theorem but by the experiences of two British surgeons. But what if they were wrong? Or if the bones of Semmelweis were healing differently, perhaps much quicker than those examined by the two Britons? Anyhow they only said 6—8 weeks, which must be the average, sometimes it might be shorter, sometimes longer. On the whole the proof is
