Inferring and Explaining

62 InferrIng and exPlaInIng e 8 . Changing the approach so that the priest could enter the sick room unobserved made no diference in the mortality rate. “Fortuitous” New Data Not all scientifc data are the product of experi- mental procedures; sometimes, it’s simply good luck. Semmelweis was out of the country at the time of a terrible tragedy at the Vienna General Hospital. Another of Rokitansky and Skoda’s dis- ciples, Jakob Kolletschka, had been accidentally cut by a medical student’s scalpel as they were conducting an autopsy. He developed a massive infection and died a few days later. When Sem- melweis returned soon afer Kolletschka’s death, he studied the pathology report and formed an exciting new hypothesis: Totally shattered, I brooded over the case with intense emotion until suddenly a thought crossed my mind; at once it became clear tome that childbed fever, the fatal sickness of the newborn and the disease of Professor Kolletschka were one and the same, because they all consist pathologically of the same anatomic changes. If, therefore, in the case of Professor Kolletschka a gen- eral sepsis [contamination of the blood] arose from the inoculation of cadaver particles, then puerperal fever must originate from the same source. Now it was only necessary to decide from where and by what means the putrid cadaver particles were introduced to the delivery cases. Te fact of the matter is the transmit- ting source of those cadaver particles was to be found in the hands of the students and attending physicians. 6 Tat one little “ah-ha” moment laid several new bits of data on the table. One was an overlooked diference between the two wards. e 9 . Medical students and their teachers in the First Division regularly conducted autopsies. The midwifery students and their teachers did not. Another had to do with regular medical practice at the time. e 10. Doctors and students would routinely transition from autopsies to gynecological examinations and procedures, including childbirth, with only the most cursory rins- ing of their hands. Added to this, of course, was the information garnered from Kolletschka’s death. e 11 . Details regarding the accident, subse- quent progression of the disease, and ulti- mate death of Kolletschka All this led to a completely new and original the- ory about the cause of childbed fever. t 0 . Childbed fever is caused by the introduc- tion to the blood of cadaver particles. An Experiment and a Treatment Semmelweis was, above all, a good and compas- sionate doctor. His frst responsibilitywas to the patients entrusted to his care. It’s not surprising, therefore, that his instincts upon forming his new hypothesis were all directed at putting this information immediately to work in the inter- ests of his patients. Te reasoning was straight- forward. If childbed fever was being spread by the introduction of cadaver particles from the