Doctors by Sherwin B. Nuland

Author:Sherwin B. Nuland [Nuland, Dr. Sherwin B.]
Language: eng
Format: epub
ISBN: 978-0-307-80789-2
Publisher: Knopf Doubleday Publishing Group
Published: 2011-10-11T16:00:00+00:00

Following the departure of Semmelweis, there had been a return to high mortality figures in Division I. Braun may have been an obstinate ox, but he was no murderer. When he became Chief he acted on a principle enunciated in his book: although cadaver particles were not the cause of childbed fever, no student whose hands smelled of a corpse would be permitted to examine a woman in labor. Thus did he circumvent the reality of the Semmelweis doctrine, and refuse to recognize the true basis of his own improved results.

It is difficult to know what made Ignac Semmelweis begin, finally, to speak out publicly and to write about his work. Perhaps he realized at last that until he himself clearly enunciated his observations and conclusions, broad understanding would never occur. In any event, almost eight years after his return to Hungary, he addressed the Medical Society of Pest-Buda on the topic “The Etiology of Puerperal Fever,” and published his lecture in the Hungarian medical journal Orvosi Hetilap. It was his first written work on the discovery.

Over the next two years Semmelweis wrote letters to prominent obstetricians all over Europe asking their opinions of the theory. The responses he got rarely satisfied him, and caused increasing injury to the pride that had been so badly bruised in Vienna. The acceptance or rejection of the theory had always been deeply interwoven into his view of himself as accepted or rejected, and by 1860 his entire sense of self had apparently become indistinguishable from his theory. All of the frustrations came forth in the book he published in August of that year, The Etiology, the Concept, and the Prevention of Puerperal Fever, his Hauptwerk, his magnum opus, with which he meant to destroy his opposition. The following selection is from the brief introduction, and is characterized by an apparent humility interlarded with self-exalting ideation that suggests a drift toward madness.

I have been made responsible by Fate to reveal the truth which this book contains.… I must no longer think of my own peaceful disposition, but remember the lives that should be saved, depending on whether I or my adversaries win.… The many hours that I have spent in bitterness have not served as a warning; I have survived; my conscience will help me suffer whatever else may be in store for me.

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