Antall József szerk.: Orvostörténeti közlemények 62-63. (Budapest, 1971)

TANULMÁNYOK - Meigs, J. Wister: Kontagionisták, antikontagionisták és a gyermekágyi láz (angol nyelven)

CONTAGIONISTS, ANTICONTAGIONISTS AND PUERPERAL FEVER J. WI S TER M E I GS Ti /fost accounts of the history of puerperal fever devote a good deal of space to tehe dispute over whether or not the disease was a "contagion". My interest in this controversy arose initially out of the fact that the anticontagionist whose name is known best and whose character is reviled most widely in medical writings was my great-great grandfather, Charles Delucena Meigs ! He was wrong, wrong, wrong in denying the contagiousness of puerperal fever or the possibility that a physician might be a carrier of the agent that caused it. However, there is paradox and even mystery as one studies the many sided story. I Puerperal fever, known also as childbed fever, and in later years as puerperal sepsis or septicemia was the most dreaded killner of women after childbirth. Caused by a streptococcal or other bacterial infection of the female reproductive organs and the adjacent peritoneal cavity, it occurred characteristically in the immediate post-partum period. This disease was dreaded by physicians, patients, and their families not only because it killed but also because it seemed completely capricious in choosing its victims. All too often a woman might deliver with minimal discomfort and no complications, perhaps before the obstetrician had time to reach her house, only to be attacked within a few days, or even hours, by an agonizing and frequently fatal disease. It was the unpredictability of childbed fever that made the spectre of contagion a nightmare to the practising obstetrician. Although he might suspect prolonged and difficult labor as possible contributing factors, there was no practical way for him to guess who might develop or succumb to the disease. Moreover, all available forms of therapy were almost equally bad and remained so throughout the 19th Century and well into the 20th. Thus, if the doctor accepted the possibility that he might carry the disease to his patient despite such hand washing and other hygienic measures as he could employ, how was he to deal with the complicated case? Yet, neither all nor even most of the patients with complications died of puerperal fever. Witness this case report taken from C. D. Meig's notebook: