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)

statement that he has discovered in 1847 the only and always true cause of P.F. sounds pretentious to our modern and humble approach to scientific statements. There exists no absolute truth in science. Sir Karl Popper [36] has shown that the only laws that are scientifically valid are those where the possibility exists that they could be refuted sometime in the future. In this case Semmelweis' apodictic statement of the "eternal truth" declaring that decaying animal-organic substances only produce P.F. was weakened by Doleris [37] who vaginally injected parturient animals shortly after delivery with pure cultures of streptococci and produced P.F. A pure culture of streptococci is not a decomposing substance and does not even belong to the animal kingdom. It is a sad observation that even in England where the doctrine of contagiousness of P.F. was taught, this disease was not completely eradicated. Between the years 1847 and 1880 no less than 164,446 deaths were registered in England as the result of septic puerperal disease. (Alloway [38]. Strict rules of anti- and asepsis were observed only after the great discoveries of Pasteur, Koch and their pupils had revolutionized medicine and after Lister based on these bactériologie discoveries published his methods to prevent infections of surgical wounds, and revolutionized surgery. Franz Bruck [4] was certainly right when he emphasized that the principles of anti- and asepsis were published by Semmelweis about 20 years earlier than by Lister. However the real acceptance followed Lister's publication because the new science of bacteriology could explain the success of Lister's methods. Pasteur and Lister had to fight for their ideas like Holmes and Semmelweis did a quarter of a century earlier. R. J. Dubos [39] describes a typical encounter in his book "Pasteur":* . . . puerperal fever was then causing immense numbers of deaths in maternity wards. Despite the visionary teachings of Semmelweis in Vienna and Oliver Wendell Holmes in Boston, physicians did not regard the disease as contagious, but rather explained it in terms of some mysterious metabolic disorder. Pasteur had observed in the uterus, in the peritoneal cavity, and in blood clots of deceased women a microorganism occurring "in rounded granules arranged in the form of chains or strings of beads'''' and he became convinced that it was the most frequent cause of infection among women in confinement. In March 1879 there took place in the Paris Academy of Medicine a discussion on the cause of puerperal fever. One of the academicians, Hervieux, had engaged in an eloquent discourse, during which he spoke in sneering terms of the role of microorganisms in disease;

... In 1879 the germ theory was not yet universally accepted in medical circles. Hervieux had contrasted the true "miasm or puerperal fever" with "those microorganisms which are widely distributed in nature, and which after all appear fairly inoffensive, since we constantly live in their midst without being thereby disturbed.'''' Irritated by the vague reference to the "puerperal miasm''' Pasteur interrupted the speaker from his place in the audience and retorted with vigor: "The cause of the epidemic is nothing of the kind: It is the doctor and his staff who carry the * Copyright 1950 by Little, Brown & Co. and reprinted with permission of publisher and author.