The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells.

  • Wells, Spencer, 1818-1897.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: The prevention of preventable disease : an address to the Glasgow Obstetrical & Gynaecological Society, delivered 24th May, 1893 / by Sir Spencer Wells. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/20 (page 4)
    Puerperal fever, if we follow the nomenclature of diseases drawn up by our College of Physicians, is “ a continued fever, communicable by contagion, occurring in connection with childbirth, and often associated with extensive local lesions, especially of the uterine system.” Dr. Fordyce Barker, who crossed the Atlantic purposely to join in the discussion, accepted this definition as “ absolutely correct,” although its author, Dr. Arthur Farre, thought it might be modified by saying that the fever was “ often communicable by contagion,” implying that sometimes it was not. But however much we may discuss these problems, the main interest with us this afternoon is the question whether this fever is preventable, and how it may be prevented. And here we possess perhaps stronger and more extended evidence than can be procured respecting any other communicable fever. Dr. Duka’s memoir of Semmel- weis, and the history of his wonderful success in the prevention of childbed fever in Vienna, is one of the most effective chapters in medical history. In 1841 a terrible outbreak of childbed fever in the maternity department of the General Hospital of Vienna broke out and lasted for twenty months. Of more than 5,000 parturient women more than 800 died—a terrible mortality of more than 16 per cent. Then came a change. From 1841 to 1846, students and midwives worked in separate departments, and the fatality in the students’ wards was 9, in the midwives’ only 3 per cent. When Semmelweis was striving to discover the cause of this remarkable state of things, he became convinced that the death of a friend, who fell a victim to phlebitis and secondary abscesses after an operation wound, was exactly what he had so often noticed in fatal puerperal cases, and he reasoned that the cause in both cases was “ poison- ing by decomposed particles of a dead body.” , The dissecting students had been satisfied with washing their hands in soap and water, which was clearly insufficient to remove all particles of poisonous matter from the fingers and nails. Accordingly in May, 1847, Semmelweis ordered evex-y student, before examining a pregnant woman, to thoroughly wash his hands with chlorinated lime water'. At that time the percentage of mortality stood at 12 per cent. In six months it was reduced to 3. In the second year of the experiment the death-rate fell to 1‘27 per cent. The practical outcome of the great work of Semmelweis’ life is that puerperal fever can be prevented by “ l’emoval of maternity wards fi'om insanitary surroundings, great cai’e and gentleness in using instruments, scrupulous attention to general cleanliness, and frequent use of antiseptics.” These are the words of Di\ Duka, to whom I am indebted for a few copies of his valuable memoir, which are here on the