Antall József szerk.: Orvostörténeti közlemények 81. (Budapest, 1977)

TANULMÁNYOK - Ehrentheil, O. F.: Oliver Wendell Holmes és Semmelweis Jgnác egy és negyed századról visszatekintve (angol nyelven)

TANULMÁNYOK OLIVER WENDELL HOLMES AND IGNAZ PHILIPP SEMMELWEIS viewed one and a quarter centuries later O. F. EHRENTHEIL " —• We must not reject ancient medicine because it has not attained exactness in every detail, but much rather one has to admire the discoveries leading from deep ignorance to approximate accuracy by rightly and correctly conducted inquiry and not by chance." (Hippocrates [1]) I

t was in 1843 that Dr. Oliver Wendell Holmes [2] published the now famous essay: The Contagiousness of Puerperal Fever. In 1847 Hebra described in an Editorial [3] in the official Journal of the Society of Physicians in Vienna (Austria) the discovery by Ignaz P. Semmelweis that puerperal fever is a pyemia due to conveyed infection from decaying animal organic material. Both men were maligned by prominent obstetricians of the time. But half a century later a discussion arose as to whom the laurels belong of being the discoverer of the cause of Puerperal Fever. About one and a quarter centuries have passed since the time of their signal contributions. Much had been written about their scientific stand in previous years and it is not necessary to repeat all the well known facts, however, I feel that it is of great interest to again compare these two medical men from the vantage point of today without forgetting the scientific, social and political climate of their time and the contrasting personalities of the protagonists. Two facts must be kept in mind: 1) Though the ideas of small animate beings as causes of disease had been expressed by several precursors, bacteriology as a science did not exist before Pasteur and Koch published their works in the eighteenhundred sixties and seventies. 2) The acceptance of the principles of antisepsis - the basic idea being to prevent noxious germs from infecting wounds—was propagated by Joseph Lister in 1867 in response to the bactériologie discoveries. We will see that both the Englich Contagionists including the American Holmes and the Hungarian Semmelweis have employed antiseptic and aseptic methods without knowledge of the existence of microbes 20 years earlier. This fact was passionately emphasized by Franz Bruck [4] who called Semmelweis the founder of antisepsis and asepsis, but the English Contagionists must at least be called the precursors. Most people including the physicians of continental Europe assumed at that time that the epidemics which were ravaging Europe again and again were due to atmospheric-telluric-cosmic influences and the Genius Epidemicus. Today, of course, we know many of the causative infectious agents including bacteria, viruses and mycoplasmas. We know that some epidemics tend to occur in autumn or winter and others in the warmer seasons. The science and practice of obstetrics and the administration of obstetric hospitals in England in the middle of the 19th century were far advanced in comparison to most institutions in continental Europe. Though puerperal fever (P.F.) was not unknown in England it was never so ravaging as it was in the largest obstetrical hospital