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

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

In 1855 Semmelweis was appointed professor of obstetrics in the faculty of medicine of Pest. His best results were achieved in his first year, in 1855/56, when only two women died in puerperal fever out of 514, that is 0.39 per cent. In the following two academic years the rate in the maternity department increased to 2.90 and 4.05 per cent respectively. The detailed and thorough clinical investigation of the case revealed the pathogenic effects of contaminated bedcloth. Semmelweis's comparative statistical method has historical value, too, it was him who first used it in medical statistics. He compared the maternity statistical figures and trends of Vienna with those of Paris, London, and Dublin. The relevant statistical figures of Paris supported his thesis on the cause of the difference between the mortality rates of the two maternity clinics of Vienna. In the period 1835—1848 the mortality rate was 4.55 per cent in the Dubois university hospital, whereas between 1828—1848 it was only slightly lower (4.18 per cent) in the Maternité, where the training of midwives took place. But according to Oslander there the midwives, too, had pathologico-anatomical exercises like the medical students, that is why there was no difference in the rate. By comparing the maternity homes of Paris and Dublin with those of Vienna Semmelweis challenged the view which accepted the epidemic nature of puerperal fever. The mortalities of the compared hospitals showed a substantial difference through a long period, for instance the rate was always worse in the Paris Maternité than in Dublin. The more favourable mortality rates of the English and Irish maternity hospitals as compared to those of Paris and Vienna were not due to the differences in the climate but to their different character. The London and Dublin hospitals appearing in the comparison were independent maternity hospitals and did not have any relationship with other hospital departments, e.g. chirurgy, or prosectorship, consequently the number of contact infections was much smaller. It also contributed to the better rate that puerperal fever was regarded as a serious contagious disease by the English physicians, who, in order to prevent it, implemented some radical measures against it. The correctness of Semmelweis's aetiological theory was further supported by the results of the statistical observations of the Medical Association of St. Petersburg, presented in 1801 at the congress on the problems of puerperal fever. In St. Petersburg between 1845—1800 the rate of mortality due to puerperal fever was the highest at the maternity department of the Medical Training College (9.04 per cent), while in the Midwives' Training School it was only 2.96 per cent, and in the City Maternity Centre it was still lower, only 1.55 per cent. But the rate was the best in the group of those women who gave birth at home: 0.00 per cent. I cannot agree with the opinion of István Benedek on his evaluation of the method of international comparative statistics, set forth in his monograph Semmelweis és kora (Semmelweis and His Time); "... It, too, turns out, what we have also suspected, how unsafe the basis is on which Semmelweis's whole stock of statistical arguments rests. If he collected the