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SEMMELWEIS, Ignaz Philipp (1818-1865)

Die Aetiologie. Der Begriff und die Prophylaxis des Kindbettfiebers.
Pest, Wien & Leipzig, C. H. Hartleben’s Verlags-Expedition, 1861.

First edition. In the whole history of medicine we find, arguably, a record of only two discoveries of the highest importance in producing direct and immediate blessings to the human race by the saving of life and the prevention of suffering. These were the discoveries of Edward Jenner and Ignaz Phillip Semmelweis. Semmelweis studied at the University of Vienna under Hebra, Skoda and Rokitansky. At the age of 29 he was appointed assistant in the maternity department, division 1, of the Allgemeines Krankenhaus in Vienna. Division 1 was used for the instruction of doctors and division 2 for midwives. Division 1 was notorious for its higher mortality and pregnant women begged in tears not to be admitted there. The medical students went to divsion 1 directly from the dissecting room and morgue. They often made vaginal examinations of the women in labour with hands unclean or improperly cleaned. Semmelweis himself made a careful study by autopsy of all the fatal cases of puerperal fever and sought an explanation of the frightful mortality and ways of controlling it. On his return from a short holiday, he found his friend and associate, Dr Kolletschka, dead of an infection which has resulted from a cut of a finger received in a postmortem examination. Semmelweiss recognized the changes in the body of his friend as those of childbed fever and he immediately established in his own mind the similarity of the infectious processes. He determined to teach that childbed fever is a pyemia resulting from the introduction of decomposed organic matter into the uterus during childbirth. Completely unaware of the contributions of Oliver Wendell Holmes in this same field, Semmelweis prescribed the washing of the physician’s hands in calcium chloride solution before the examination of childbed cases. The result was that infant mortality was reduced by five-sixths. Semmelweis’ book covers in detail his conception of childbed fever and gives a thorough investigation to the attitude of his proponents and opponents. The style is wordy and repetitious; the argument flows back and forth without professing to any logcial point; the author is egoistic and bellicose. He faced great ridicule and opposition from colleagues and was forced to move from Vienna to Pest. His lack of talent as a writer also impeded the understanding of his theories. His biographer, W. J. Sinclair, remarked that “if he could have written like Oliver Wendell Holmes, his 'Aetiology' would have conquered Europe in 12 months”. Worn down by the continued bitter controversy aroused by his findings, Semmelweis suffered a mental breakdown in the summer of 1865, and died later in the same year – of generalized sepsis from a surgically infected finger – shortly after being committed to an asylum.

Collation: Pp vi, 543, (1) errata.

Binding: Contemporary dark-brown half calf, gilt ruled spine with gilt title, marbled boards. Bound without the printed wrappers.

References: Garrison-Morton 6277; Grolier, One Hundred Books famous in Medicine 72; Printing and the Mind of Man 316; Norman 1926; Heirs of Hippocrates 1851; Lilly Library, Notable Medical Books, 219; Cutter & Vietz, A Short History of Midwifery, pp 137-43; Radcliffe, Milestones in Midwifery, pp 75 ff.; Gortvay & Zoltan, Semmelweis, Life and Work; English translation in Medical Classics, 1941, 5, pp 350-773; The original reprinted in Budapest, 1970. Waller 8830.

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