There were two sets of wards in the maternity department. The one set
may be called Clinique A, and the other Clinique B. For many years,
the mortality had been the same in each. In 1841 a change was made:
Clinique A was assigned to the teaching of students, and Clinique B to
the teaching of midwives: and, so soon as this change had been made,
the mortality in Clinique B became less, but the mortality in Clinique
A did not. Commissions of inquiry were held, and in vain. It was
suggested that the foreign students were somehow to blame, nobody knew
why; and many of them were sent away. Still the deaths went on. Women
admitted to Clinique A would go down on their knees and pray to be
allowed to go home; almost every day the bell was heard ringing in the
wards, for the administration of the Sacrament to a dying woman.
People talked about atmospheric influences, and overcrowding, and the
tainted air of old wards, and the power of the mind over the body: and
Semmelweis set to work.
He observed that cases of protracted labour in Clinique A died, almost
all of them; but not in Clinique B. He observed also that cases of
premature labour, nearly all of them, did well, whichever Clinique
they were in; so did those women who were delivered before they came
to the hospital, and were admitted after delivery. He observed also
that a row of patients, lying side by side, would all be attacked at
once in Clinique A; which never happened in Clinique B. He tried
everything: he altered the details of treatment; he used various
subterfuges to prevent one of the professors from examining serious
cases; he enforced this or that rule in Clinique A, because it was the
custom in Clinique B; he slaved away at the notes of the cases--and at
last the truth came to him, by the death of one of his friends from a
dissection-wound. He says, "My friend's fatal symptoms unveiled to my
mind an identity with those which I had so often noticed at the
deathbeds of puerperal cases." He saw now that the students, coming
straight from the dissecting-rooms, had infected the patients during
examination.
Public-domain text, read in full here on John Shaqi.
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