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PROGRESS IN OBSTETRICS: OLIVER WENDELL HOLMES AND CHILDBIRTH FEVER
The incidents connected with childbirth had existed unchanged for centuries before Christ was born and changed little for centuries after. Women at this interesting time were attended by other women. In well-organized societies a select group of midwives took over this function but apparently they interfered little, being content to await the arrival of the child. Women in labor suffered, occasionally died, but in general went successfully through the ordeal as the so-called lower animals do.
It was only three hundred years ago that epidemic childbirth fever assumed importance. Then as people crowded more and more into cities, lying-in hospitals were established. The proximity of many patients, the growing feeling of midwives and accoucheurs that they could assist nature, and hence their more frequent examinations, brought it about that when one woman was infected, and the disease was transmitted to others. Of course nothing was known about bacteria and infection in those days, but more and more doctors were noting the rising number of deaths of mothers following childbirth. Until the middle of the last century the great scourge of childbirth was this puerperal fever, or childbirth fever. At times whole droves of healthy young women would enter a lying-in hospital, deliver, and shortly come down with a fever, and die. The worst of it was that the higher the standing of the doctors the more likely was this to occur. Dr. Oliver Wendell Holmes, of Boston, in one of the most brilliant and valuable papers in medical history, on the contagiousness of puerperal fever, showed that this deadly scourge was carried from one case to another by the attending obstetrician. Childbirth fever is almost unknown now.
This was undoubtedly the outstanding incident of Holmes’ medical career and he had a brilliant one. A member of one of the old “Brahmin” families of New England, he had of course an education at Harvard and Harvard Medical School and, following this, he went to France where medical training was better than that which could be had in America in those days. Here he learned “not to take authority when I can have facts; not to guess when I can know; and not to think that a man must take physic because he is sick.”
For thirty-five years he was professor at Harvard Medical School, covering so many subjects that he said his chair was really a settee. To this day these lectures are legendary. Such a training of such a mind led directly to “intensive studies of recorded cases” and “processes of medical logic from which definite conclusions could be drawn.” The result was his demonstration that puerperal fever was carried from patient to patient by doctors and nurses. A few years later Semmelweiss in Europe independently reached the same conclusions, and then Pasteur entirely cleared the mystery by his demonstration of bacteria as the agents of infection.
It is well that Americans should be reminded again what a man Oliver Wendell Holmes, Sr., was. People, including Holmes himself, have reservations about the versatile man. Holmes himself said, “Do not linger by the enchanted fields of literature – the great practitioners are generally those who concentrate all their powers on their business.” However, Dr. Holmes did not thus concentrate. Did his literary success dim his medical fame If he had not written The Autocrat, “The Chambered Nautilus,” and the beautiful hymn “Lord of All being, Throned Afar,” perhaps he would have received greater acclaim as the savior of countless young mothers and one of the outstanding leaders in medical advancement.
*8/276/5*