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Semmelweis and his friends would trembling care and sympathy wherever
take the trouble to read British obstetric literature they would see that Englishmen had long been aware of the contagious character of puerperal disease and had employed chlorine disinfection for its prevention.
From the above it will be seen that Professor Simpson confused the English theory of the specific contagiousness of puerperal fever a disease communicated by the sick puerperant to the healthy one, or transmitted by the physician who has confined a woman suffering from the malady with the Semmelweis doctrine of its causation by the absorption of putrid matter from a living organism or cadaver, producing a pyemic blood-dissolution.
It will be recalled that these English opinions were copied and adopted in 1843 by Oliver Wendell Holmes, in his immortal essay, "The Contagiousness of Puerperal Fever." Yet in Siebold's standard History of Obstetrics there is no mention of Dr. Holmes. Such accidents seem liable to occur: Baker Brown actually wrote an historical sketch of Ovariotomy without referring to Ephraim McDowell. It is true Holmes did not devote much time to puerperal sepsis. He wrote his one essay on the subject, and set it adrift in a quarterly medical magazine which suspended publication within a year. But the man and his work could not perish especially as the eminent Professor Meigs denounced him with the same virulence that he opposed Simpson's use of chloroform in labor. There is no passage in medical literature more frequently quoted than Holmes' concluding appeal: "The woman about to become a mother, or with new-born infant upon her bosom, should should be be the object of
she bears her tender burden, or stretches her aching limbs. The very outcast of the streets has pity upon her sister in degradation, when the seal of promised maternity is impressed upon her. The remorseless vengeance of the law, brought down. upon its victims by a machinery as sure as destiny, is arrested in its fall at a word which reveals her transient claim for mercy. The solemn prayer of the liturgy singles out her sorrows from the multiplied trials of life, to plead for her in the hour of peril. God forbid that any member of the profession to which she trusts her life, doubly precious at that eventful period, should hazard it negligently, unadvisedly, or selfishly."
A closer examination of the subject convinced Simpson that the English and the Semmelweis etiology were not identical, and since he was J. Y. Simpson, he acknowledged his mistake. From that time on, aided by his wellknown assistant, Matthews Duncan, he preached the truth regarding puerperal sepsis, and it was due chiefly to the efforts of his school that British obstetrics outstripped and long outranked the continental tokology.
About this period, an honor was conferred upon Semmelweis. Dr. Karl Haller, an influential man, a director and senior physician of the General Hospital, suggested that Semmelweis be invited to address the Vienna Medical Society on his experience with puerperal fever. The motion was adopted, but Semmelweis voted in the negative. In truth, he had never spoken to an audience, and the mere thought of it gave him stage-frightan evil which a solution of chlorine could not remove. Finally he was prevailed upon to appear, and he pro
duced an excellent impression. The discussion that followed was certainly pleasing to Semmelweis. Rokitansky, who presided, spoke in his favor; brave Chiari-son-in-law of Kleinvoiced his approval; Helm and Arneth called the young discoverer a benefactor, while Skoda, Hebra, and Haller applauded.
It was a great triumph for the humble assistant, but it aroused his enemies to action. Rosas cursed him; Klein frowned heavily when he met him; Scanzoni-the snake of midwifery who rattled his fangs also at Simpson-poured venom at him; Bamberger attacked him; Kiwisch insulted him; Lumpe laughed at him; Seyfert spat at him.
By this time Semmelweis's assistantship had expired, and he applied for an extension of two years more, like his predecessor in the First Clinic and his colleague in the Second Clinic had successfully done. But the authorities were against Semmelweis. It was not forgotten that he had served in the Academic Legion. The stupid Klein took his revenge; his pursed-up lips meant, “I want to be rid of you." Semmelwies then petitioned to be appointed Privat-Dozent of Midwifery. After a rather long wait-from March, 1849, till October, 1850-he received the position, but with galling restrictions; he could not grant certificates of attendance like other dozenten, and he could not demonstrate on the cadaver, only on the manikin. Semmelweis was an emotional man. He was a scientist, but with the artistic temperament. He was terribly enraged, and made up his mind to shake the dust of Vienna from his feet. He acted unreasonably, and did not call upon Rokitansky; he did not bid farewell to Hebra; he did not shake hands
with Skoda. He simply packed up his belongings, and started for Budapest. Ignaz Semmelweis is a type that Tragedy loves to mark as her own: intense, tense, impractical, uncompromising. Too unworldly to look after his personal interests, too honest to make terms with popular falsehood, he was predestined for the road of bitterness, and the crown of thorns awaited him.
Twelve years ago, as a pleasant youth of nineteen, Semmelweis had left Budapest to enter the University of Vienna. Now he came back to his birthplace, immortal but unsuccessful. His home-coming was not a happy
His parents were dead; his brothers, who had taken their share in the revolution of 1848, were refugees; there remained to him only one brother, who was a parson, and one sister, who was married.
The sight of houses and landmarks intimately known in former days. brought back a thousand recollections of boyhood, and he could not but smile that so many trivial and even silly incidents should crowd upon his memory. After all, he was not sorry to leave Vienna, and he whistled a snatch from Petöfi, but stopped in amazement to look at the majestic Suspension Bridge which had been completed the year before by the English engineers, Tiernay and Adam Clark. Then he strolled reminiscently thru the street where his father had kept a shop.
Semmelweis felt a subtle sympathy for his country, which, like himself, had been conquered by the powers of darkness: stabbed by Windischgratz, hanged by Haynau, knouted by Nicholas. Only a year before Semmelweis returned to Budapest, Louis Batthyani, the distinguished Hungarian patriot, had been caught there, courtmartialed, and shot. The prison-odor
still clung to Balassa, the professor of surgery. Semmelweis did not really escape Vienna: all over Hungary's capital the superfluous men known as state-agents eavesdropped and peeped; spies-nasty, sneaky, crawling, slimy creatures, forever pilloried by the grim pen of Maxim Gorky.
The Hungarian Academy of Sciences was closed by pleasure of the law, and the Medical Society of Pest could not meet unless a policeman was present. Semmelweis sighed-what else was there to do? He claimed he did not know how to write, so he could not find solace in the ink-bottle. But he seemed to experiment on the value of doing nothing. He who had been indefatigable became the apostle of apathy, the lord of laziness, a very prince of procrastination.
But such a state of affairs could not last long: Professor Klein did not send Semmelweis money to live upon. Semmelweies had his choice: either make an honest living as a respectable member of organized society, or join a roving gypsy-band and pitch a tent and swing a kettle on any hillside-in which occupation he would have been as comfortable as a frog in acetic acid. When Rogers saw Lord Brougham ride off one morning, he remarked, "There go Solon, Lycurgus, Demosthenes, Archimedes, Sir Isaac Newton, Lord Chesterfield, and a great many more all in one post-chaise." A similar compliment could not be paid to Semmelweis. He was not a versatile man. He knew his branch of medicine, and nothing more. In fact, he was a man of one idea-but it was a great idea.
Semmelweis now petitioned to be appointed director of the Obstetric Division of the St. Rochus Hospital, a cheerful institution, with windows sug
gestively overlooking the cemetery. His application was successful, and as soon as he entered he introduced chlorine disinfection. The mortality at the hospital decreased so swiftly and surely that the fame of Dr. Semmelweis spread thruout Budapest. It boomed too his private practice; his office now contained more than one patient at a time.
Thus matters went on for about five years; then Hofrath Birly, the incumbent of the chair of midwifery in the university, was elegised by his friends, and wreaths were placed upon his coffin. A professorship-fortunately -is not hereditary, and the question arose: Who will succeed old Birly?
1855, Ignaz Semmelweis was appointed Professor of Theoretical and Practical Midwifery in the University of Pest.
It is pleasant to record that, in July, so he is accustomed to being afraid and going home without having done it and then longing for it in secret, and finally, goaded to desperation, of making a bolt for it. That is the history of his daily emotional life."
There is no tonic in any Pharmacopeia equal to the elixir of success. Success it is iron, mother's salve, digitalis, capsicum plaster, catarrh snuff, Godfrey's cordial, Hoffman's anodyne, Seidlitz powder, brandy and hasheesh all in one. Success purifies the blood, it draws the tip of the chin in, it throws back the shoulders, it straightens the spinal column, it gives color to the cheeks, and brings lustre to the eye. The Herr Imperial Royal Professor Semmelweis walked with a jaunty air. He was enthusiastic, and determined to make Budapest the medical Mecca of the world.
When an affectionate bachelor finds himself living on Easy Street, he is apt to speculate in the matrimonial market, especially if a sweet girl like Marie Weidenhofer-overlooking his lack of manners and admiring his wealth of character-seems to be fond of him. Ignaz was a bald-headed professor of thirty-eight; Marie was a charming fräulein of eighteen, but they now promised to love each other as long as they lived, and never to quarrel, or cause each other jealousy. How it happened that a shy man like Semmelweis took advantage of the psychological moment is more than we can presume to explain. The best we can do is to quote from Lillian Bell, who exposes all the secrets of sex: "Proposing," claims this lady, "requires a sort of plunge; a burst of courage; a bravery which must be pumped up for the occasion, and that sort of thing your shy man is used to. He cannot even ask a girl to take a walk with him without perspiring under his hatband,
It is fortunate that Semmelweis could now find consolation at home, for the school-year 1857-8 was a frightful one: four per centum of the women in his Lying-in Hospital died from puerperal fever. fever. How Carl Braun and Scanzoni would jeer at him! What was the cause of this dreadful slaughter? When Semmelweis had first assumed charge of the obstetric clinic, he found that the women lay "upon filthy sheets which actually stank of decomposed blood and lochia." Enraged at the circumstance, he pulled the unclean linen from the beds, gathered it into a pile, and rushed to von Tandler, the official in charge. "Smell!" shouted Semmelweis, shoving the foul bundle under his nose. After this practical appeal to the olfactory organ of the Statthaltereirath, the laundry contractor was requested to wash the soiled linen. before returning it. So the Lying-in Hospital now had clean sheets, chlorine disinfection of course was employed, and yet here was a mortality of 4 per cent. What evil agency was at work, destroying lives with an invisible hand? Semmelweis did not sleep till he discovered the cause: a careless nurse. Either some students had bribed her to disobey the professor, or she herself had no interest in his hobby, because she made it a rule never to go to the trouble of changing sheets, even in the bed in which a patient died from puerperal fever. An expensive idiosyncrasy: it cost 18 out of 449 lying-in women their lives. Semmelweis discharged the culprit
whose treachery had brought about the four per centum mortality. A nurse trained in his own prophylaxis-it was enough to make a man go mad. Semmelweis indeed had reason to be unhappy. His Doctrine made little headway. He could not lift the boulder of prejudice that lay in the path of medical progress.
Primerose and Riolan attacked Harvey's discovery, but denial of the circulation of the blood never injured anyone's health. Regardless of what men thought, the heart forced the ruddy life-fluid into the mighty aorta, which spread it all over the body, where it came to great venous trunks and emptied into the auricle, flowing into the lower ventricle, whose systole pumped it into the lungs, whence it passed a vast meshwork of capillaries, gave up its carbon dioxide in exchange for oxygen, turning from dark purple to bright scarlet, entered the pulmonary veins, which carried it back to its starting-point, and thus completed the circuit-just as it does to-day when we know all about it. Many did not accept Newton's law of gravitation, but this stupidity was not followed by symptoms of pyemia. Dr. Ohm was considered unbalanced, but failure to comprehend the unit of electrical resistance did not result in phlebitis. Galvani was ridiculed as the frog's dancing-master, but inability to appreciate the value of galvinism never caused lymphangitis. Cuvier vanquished Lamarck and Hilaire, scoffed at the idea of fossil man, and pitched the bones out of the window in a rage. Scientific progress was thus hindered, and the doctrine of Evolution delayed for a generation, but no man died from metastases because he failed to greet the monkeys in the zoological garden as his long-lost cousins.
But to hold erroneous views on the etiology of puerperal fever meant that thousands of wrongly-trained practitioners and midwives went yearly forth to spread disease and death; it meant that countless hosts of mothers were wantonly massacred in statesupported murder-dens. "To be laid on the confinement bed," said Fritsch,
was the same as to be delivered to the hangman."
As late as 1860-3, Achilles Rose was a student at the University of Jena, and he records that during that period. no lying-in woman left the institution alive. "All died," he writes, "from puerperal fever. Disinfection of the hands, insisted upon by Semmelweis, had not received any consideration, even by such an eminent man as Professor Schultze."
But an intellectual giant-besides whom the eminent Prof. Schultze was insignificant-saw no good in Semmelweis. To claim that Virchow is one of the greatest sons of Hippocrates is unnecessary, because it is undisputed. But there was this difference between the Greek and the German: the latter had limitations. His opposition to Semmelweis was by no means his only sin. When William Detmold opened an intracranial abscess, Virchow's Archiv had a paragraph about the "American swindle." When Haeckel desired that Evolution be included in the curricula of the public schools, Virchow took the contrary view-with vehemence. Virchow claimed there was an essential difference between the skull of primitive man and the ape, arguing that no human being had an orbital stricture as pronounced as is found in the Pithecanthropus. The words were hardly out of his mouth when Nehring found a skull of a Brazilian Indian in the