The Doctors' Plague by Sherwin B. Nuland

Author:Sherwin B. Nuland
Language: eng
Format: epub
Publisher: W. W. Norton & Company

VI

Having discovered the nature of puerperal fever, having devised a way to prevent it, and having accomplished these feats of clinical science in a logical, lucid way consistent with the principles of inductive reasoning and the new discipline of pathological anatomy—having done all of this, Semmelweis might have been expected to sally forth into the medical literature with a full description of his contribution. And he might also have been expected to conduct controlled experiments to confirm in the laboratory the theory he had devised in the clinic. He did neither.

The most obvious sort of experiment that suggests itself is a relatively simple one, in which the slightly traumatized genital canals of perhaps a dozen rabbits would be rubbed forcefully with a rod or brush contaminated with infected fluid taken from a woman dead of puerperal fever. Another dozen would undergo the same procedure, except that the contaminated rod or brush would be soaked in a chlorine solution. A third group would also be treated similarly, but with a rod or brush free of contaminated fluid. The proof would consist of the observation that all or almost all of the first group would die, with autopsy findings consistent with puerperal fever; none of the second group would die; few, perhaps none, of the third group would die. But Semmelweis attempted nothing of such a nature.

There was, in fact, one feeble attempt at experimental confirmation, but the results hardly advanced the Semmelweis cause. Unable to hold out against the urgings of Skoda (whose own experience in laboratories was limited), he halfheartedly enlisted the aid of his friend Georg Maria Lautner, a young lecturer at Rokitansky’s institute. The two reluctant researchers carried out a series of nine poorly planned experiments between March and August of 1847. In the first seven, the protocol consisted of inserting a brush into the vagina and uterus of an immediate postpartum rabbit, the brush having been soaked in one or another liquid obtained from a cadaver. In the other two, the fluid was injected into the genital canal with a syringe.

In the first three experiments, the material used to saturate the brush was turbid discharge from the abdomens of women dead of puerperal fever. All three animals died, with autopsy findings precisely those found in the cadavers. The other six studies used a variety of fluids taken from several sources, as follows: blood from a man dead of malnutrition, and then chest fluid followed by peritoneal fluid from a man dead of tuberculosis (rabbit remained healthy); peritoneal fluid from the same source as in experiment 4 (rabbit remained healthy); infected chest fluid from a man dead of undescribed cause, followed by peritoneal fluid from a man dead of typhus (rabbit died with findings that were indeterminate but definitely not those of puerperal fever); pus from an abscess between the ribs of a man dead of cholera (rabbit remained healthy); undescribed fluid, injected by syringe into the genital canal of the same rabbit used in experiment 4 (rabbit

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