| 冯琦,唐金陵.欧洲产褥热流行调查与控制:被忽略的流行病学先驱塞麦尔维斯[J].Chinese journal of Epidemiology,2017,38(8):1136-1139 |
| 欧洲产褥热流行调查与控制:被忽略的流行病学先驱塞麦尔维斯 |
| Study on the 19th century puerperal fever epidemic:Semmelweis-an often neglected pioneer epidemiologist |
| Received:April 10, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.08.028 |
| KeyWord: 产褥热 消毒 塞麦尔维斯 流行病学 |
| English Key Word: Puerperal fever Disinfection Semmelweis Epidemiology |
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| Abstract: |
| 19世纪，产褥热在欧洲突然流行，导致无数产妇死亡，人们束手无策。1846年，维也纳总医院年轻的产科医生塞麦尔维斯，经过比较分析和偶然事件的启发，认为可能是医生进行病理解剖后直接去产房接生将所谓"死尸因子"带给了产妇，引起产褥热。他进而提出用漂白液洗手，很快将产妇死亡率从10.65%降至1.98%。塞麦尔维斯的工作强烈提示了病因细菌说的可能性。1854年约翰·；斯诺对伦敦霍乱暴发原因的调查，也是后来巴斯德、李斯特和科赫研究的重要铺垫，开创了流行病学调查、预防控制和无菌术的先河，预示了微生物学的诞生。塞麦尔维斯是医学史上重要的革命性人物。但是，他的理论与当时的医学信条相悖，被医学主流嘲讽和排挤，最后精神失常，47岁去世。有时进步是先驱者的血泪之殇，其中的故事警钟长鸣。时间是公正的，轰轰烈烈的也许是场闹剧，而孤寂的可能是未来的主角。谨以此文缅怀这位伟大的流行病学先驱。 |
| English Abstract: |
| Puerperal fever was a major cause of maternal death in Europe in the 19th century. Many efforts were made to investigate the cause of the epidemic but failed. In 1846, Semmelweis, a young obstetrician in Vienna General Hospital, started his historical investigation. His breakthrough was largely due to his doctor friend's accidental injury during autopsy and his consequential death. Semmelweis found the pathological findings in his friend's post mortem examination were very similar to puerperal fever. He postulated his friend's death might be caused by "cadaverous particles" from cadavers and further inferred that puerperal fever might also be caused by the cadaverous particles that doctors brought to the delivering women after autopsy classes. He advocated hand-washing with chlorinated lime solution to wash off those particles, which rapidly reduced the maternal mortality in his department by 80% (from 10.65% to 1.98%). However, what his unprecedented work brought him was only denial, mockery and career setback rather than support, honor and compliments. Under substantial psychological pressure, he had a mental breakdown and died in a psychiatry asylum at the age of 47. He was a pioneer in epidemiological investigations before John Snow and in aseptic techniques before Joseph Lister, but his work is still often neglected. |
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