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

TANULMÁNYOK - Regöly-Mérei, Gyula: The Pathological Reconstruction of Semmelweis's Disease on the Basis of the Catamnestic Analysis and Palaeopathological Examination (angol nyelvű közlemény)

of acute inflammation. The earlier mentioned symptoms can also be in connection with the latter. The opinion prevailing in pathological anatomy in the second half of the last century was expressed by Scheuthauer (60) who also wrote that the ruined nerve-fibres, the decomposition of the myelin sheath, swollen axis-cylinders and "luminous vesicles" in the nuclei are distinct signs of inflammation. Leubschner, too, deals in this sense with the "detached adipose tissue" and other histological symptoms. Scheuthauer has also described that the varying dilatation and sagging in respect to the lumen of the vessels as well as the presence of hyaline and adiposis occur in the case of arteriosclerosis. (60). Changes pointing to syphilis (e.g. Heubner's syphilitic endarteritis of the cerebral vessels) were not mentioned in the histological report. Cerebral atrophy as well as the symptoms as described in the neurohistological finding are, in my view, due to arteriosclerosis. Arteriosclerosis explains outright the change in Semmelweis's personality which ensued in the last four years of his life and also accounts for headaches, insomnia, irascibility, absent-mindedness, changes of mood and premature ageing. The section of the autopsy report concerned with the septic process contains the following. On the middle finger of the right hand, on the area of the 1st and Und phalanx there was a gangrenous inflammation, the last interphalangeal joint opened and its cartilage decayed. Above the left rib there was an ichoroid abscess, which, causing osteitis of the six lower ribs, spread into the chest and caused an abscess bordered by the pleura visceralis, pleura costalis and the pericardium. On the surface of the left kidney an "aggregátum" of the size of a man's fist and consisting of striped pus foci was visible. It is beyond doubt that the latter two changes correspond to the septic metastasis of the abscess caused by the panaritium articulare and ostitis. However, one can have one's doubts about the defect as large as a silver coin with hollowed out edge above the right elbow, as well as similar signs on the left arm, right knee and ankle and the crackling tumescence on the left index finger. All these symptoms distinctly show that violence had been used and are, thus, the result of injuries and not of septic metastasis. Benedek (7) was of the opinion that the injuries are due to Semmelweis having been fastened with straps and put in a strait-jacket. In our view Benedek's statement is absolutely justified from the aspect of pathological anatomy. VI. THE PALAEOPATHOLOGICAL EXAMINATION Since our book published in 1965 (53a and b) contains a minute account on the X-ray, macroscopic and histological examinations, here and now I shall only briefly sum up the results of my palaeopathological examinations. The 6 Orvostörténeti Közlemények 55—56.