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)

The difference between the personalities of Semmelweis and Holmes is striking. The former hated to write but Holmes, "the Autocrat at the Breakfast Table" (Title of one of his non medical books) loved it : in poetry, in essays, in novels, and autobiographical sketches. Sinclair said [8c]: "If Semmelweis could have written like Holmes his Aetiologie would have conquered Europe in twelve months'". Semmelweis wished that his doctrine should be known. He asked his friend F. H. C. Routh of London and Franz H. v. Arneth to write to several outstanding professors of obstetrics and directors of lying-in-hospitals to propagate his findings and views. The first answer which he received came from Dr. James Y. Simpson. Simpson was a famous professor of obstetrics in Edinburgh who had introduced anesthesia in obstetrical practice. Simpson answered Arneth's letter immediately stating that it is too bad that the Viennese physicians do not know that the English regard P.F. as a contagious disease and that it can be carried on hands and clothes of doctors or midwives from sick patients and from the dissecting room to healthy parturient women. The English used ablutions of the hands with a solution of chloride of lime. He wrote that he knew that the conditions in the obstetrical hospitals in Germany and Austria in regard to cleanliness were much worse than in England. Semmelweis regarded this letter as an insult and did not further reply. Unfortunately Simpson's letter is lost and we know of its content only from the book "Aetiologie" published by Semmelweis in 1861. If we examine those points of the letter which Semmelweis alluded to we have to say that Simpson's observations about the lack of cleanliness in European hospitals in general were probably correct. There still remained the question of whether P.F. should be called a contagious disease. We will discuss this important point later. Both Semmelweis and Simpson said that it is certainly a transferable disease. I wanted to show here that the tragedy of Semmelweis is not only due to the hostile environment that surrounded him, but also due to his own hypersensitivity. The sharp rejections and oppositions to his doctrine were interpreted by him as personal affronts. This, together with his personality and behavior produced one of the saddest martyr chapters in medical history. Among the most prominent obstetricians opposing Semmelweis' doctrine were Franz Kiwisch von Rotterau [25] Professor of obstetrics in Würzburg (Germany) and Friedrich W. Scanzoni von Lichtenfels of Prague and later of Würzburg. [26] Semmelweis remained silent for years hoping that the truth, as he saw it, would finally be recognized. However, even his own superior, the chief of the clinic Professor Johann Klein remained skeptical of his assistant's ideas and regarded the improvement of the morbidity and mortality as having been caused by changes in the Genius Epidemicus and in the atmospheric-telluric-cosmic conditions. Klein apparently hated the assertive manner of his assistant and did not prolong Semmelweis' appointment though prolongation was customary. By losing his job as assistant to Klein Semmelweis had also lost any possibility to continue his work. He applied for the "venia legendi" (the right to teach) at the Medical School of the University but was rejected at first : he applied again and won the right to teach students at the manikin, a leather model of the female pelvis and a leather doll used in teaching obstetrics. Just after this advancement in October 1850 Semmelweis suddenly left Vienna and moved to Budapest. He explained this move ten years later by declaring he had been