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

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

III. The history of statistics saw important theoretical and methodological problems concerning the emergence and evolution of medical statistics. The place and importance of Semmelweis in the emergence of medical statistics and his impact on the development of that branch of science calls for a special study. The study of the works of Semmelweis raises the question of the impulses that affected his statistical conceptions and methods, apart from the characteristic features of his own imaginativeness. Presumably he was not too well versed in contemporary statistical literature during his medical studies, as that discipline was then taught only in the faculties and academies of law. Erna Lesky mentiones that Semmelweis got acquainted with the use of "statistical-numerical" tables, which played some role in the aetiological research method of "diagnosis per exclusionem", while he was on probation under professor Skoda. The latter was interested in statistics owing to the inspiration of a French physician, Louis, whose works contained the numerical findings of his successive investigations in pharmacodynamics (18). The statistical observations of Louis (1787—1872) were restricted only to a very small number of cases (from 17 to 123). His followers, Pelletain, Villerme, Lelut, D'Espine, Chateauneuf, Renaudin, too, drew generalising conclusions from a small number of cases, e.g. 17 instances of typhoid, 60 pneumonias — as it was pointed out by Róbert Horváth. In 1835 the French Academy took sides in the scientific debate evoked by the conclusions of the first representatives of medical statistics. The Academy was on the opinion that diagnoses were not suitable for observation in large numbers due to their individual nature. That erroneous view — submitted to the Académie des Sciences by Double — was soon refuted by science on the basis of the law of averages, to which the aetiological researches of Semmelweis served as a valuable contribution. Yet the negativ approach of the Academy was right considering that the physicians mentioned drew their bold conclusions from a small number of diagnoses, without critical sense. In spite of the negative appraisement and the severe critism of Huber, Westergaard considered the medical statistical observations of Villerme, Boudin, Parent-Duchatelet to be an important episode in the history of statistics, especially regarding some questions of detail: health conditions among soldiers and sailors serving in the tropics, diseases of workers in tobacco factories, etc. He attached a special value to the work of Louis, who had influence on William Farr, the prominent English medico-statistician, the man who elaborated the first classification of diseases (20), Semmelweis greatly excelled the primitive methods of French medical statistics in his scientific activities. That was undoubtedly facilitated by the fortunate situation that the maternity clinics of Vienna with their 0 to 7 thousands of parturitions presented a mass phenomenon which permitted the working of the law of averages, their measurement, and to draw scientific conclusions. But the historical significance of Semmelweis was not only the result of his