Antall József szerk.: Orvostörténeti közlemények 55-56. (Budapest, 1970)

TANULMÁNYOK - Mádai Lajos: Semmelweis és a statisztikai tudomány (angol nyelvű közlemény)

II. Semmelweis started his practical and scientific medical work at the 1st maternity centre, "clinic", of the Allgemeines Krankenhaus in Vienna as a temporary assistant on February 27th 1846, after much study and a broad education. On July 1st of the same year he was appointed assistant for two years, a post he held — with a forced interruption of four months — until the end of March 1849. The Allgemeines Krankenhaus was one of the biggest hospitals of Europe at that time, serving as university hospital as well. The medical students as well as the native and foreign physicians attending a two months course studied obstetrics in the 1st maternity clinic, while the 2nd maternity clinic served the theoretical and practical education of future midwives. Both maternity clinics offered free hospital treatment pending the production of a certificate of poverty ; unmarried girls, poverty-stricken working women were admitted there, with the purpose of providing subjects for teaching and demonstration. For them it was guaranteed that the foundlings' home accepted the infants on condition that for some time the mother had to perform nursing services there. The social position of the patients admitted to the two clinics can be deduced from the demographic statistical data of contemporary Vienna. They show that in 1842 out of 17 855 live infants 8 665 (49.5 per cent) were born out of wedlock, while the corresponding figures for 1847 are 9 730 (50.7 per cent) out of 19 191 (3) In the first part of the 19th century the problem of puerperal fever and growing mortality was getting more and more serious. It occured and endangered the lives of the mothers and their infants mostly in the hospitals. For a long time medical science looked upon puerperal fever as a contagious disease which at times took an unusually high number of victims among the women, when the maternity hospitals were often closed down in order to get rid of the "genius epidemicus" of unknown origin. Between 1664 and 1879 Hitsch recorded not less than 288 childbed fever "epidemics" occuring in the various towns of America and Europe. In the 1st maternity clinic of Vienna nearly every tenth woman died in childbed in the years previous to Semmelweis's arrival (1841—1845). In 1844 deaths registered at the maternity hospitals accounted for 4.9 per cent of the female mortality of Vienna. But this raw figure cannot express the true danger of death due to puerperal fever considering the exceedingly high rate of infantmortality (e.g. 24. 79 per cent in 1844). In my estimation puerperal fever accounted for 14—16 per cent of the deaths among women between 15 and 39 in Vienna at that time (5). At the beginning of his hospital career Semmelweis saw the dramatic events every day, the "mass symptom" of the frequent illness and death of mothers in childbed. In the first three months of his activity (March to May 1846) he had to accept that out of 879 mothers 137 (15.5 per cent) died in puerperal fever in his hospital. With all his energies Semmelweis set to discover the pathogène of this serious disease and the way to prevent it. He carried out his pathologic-anatomical test systematically and incessantly and thus established