The Pesth Fool

THE CRY AND THE COVENANT (469 pp.)--Morton Thompson--Doubleday ($3.50).

One hot day in August 1865, a bald, middle-aged man lunged through the streets of Budapest thrusting circulars into the hands of startled pedestrians. "Young men and women! You are in mortal danger!" they read. "The peril of childbed fever menaces your life! Beware of doctors, for they will kill you! Remember! When you enter labor unless everything that touches you is washed with soap and water and then chlorine solution, you will die and your child with you! . . . Your friend, Ignaz Philipp Semmelweis."

Forty-seven-year-old Dr. Semmelweis, professor of obstetrics at the Pesth Lying-in Hospital, knew that he was going mad. He had broken down in tears at a medical meeting; he had begun talking to himself in public places; his wife had already made arrangements to send him to an asylum. His circulars were a pathetic attempt to make the world understand the source of childbed fever before madness destroyed him. When all of them were distributed, he flung himself into the last gesture of his life. Rushing to the dissecting room of Pesth University, he slashed his fingers with a knife, plunged them "into the corrupt and rotting darkness" of a corpse. It was his final demonstration of a great discovery: six days later Ignaz Semmelweis died of childbed fever.

Author Morton Thompson (Joe, the Wounded Tennis Player) dignifies his novelized life of Semmelweis by steering clear of the soupy fantasies that make a lot of biographical fiction worthless. The Cry and the Covenant was read for errors by a leading Manhattan gynecologist, who found none. Even the inevitably idyllic love affair (at 38 Semmelweis married a girl of 18) is anchored firmly in fact. "An editor suggested that I have him fall in love sooner," reports Author Thompson. "I said, 'What do you want me to do--make him fall in love with an eleven-year-old girl?' "

Wounded Modesty. A Budapest grocer's son, hearty, robust Semmelweis went to Vienna in 1836 to study law but soon transferred to medicine. Six years later, as a provisional assistant in the Vienna Lying-in Hospital, he witnessed the horrors that were to haunt his life and give it purpose. One out of every three women who entered the First Division ward died of childbed fever; most victims' babies died too. In other parts of the world the story was even grimmer. At Jena over a four-year period, the death toll among infection victims was 100%. Among "causes" of the fever, doctors who had never heard of the germ theory listed wounded modesty, cosmic-telluric influences, fear, bad ventilation, climate and a feeling of guilt.

Dr. Semmelweis was skeptical. His first clue to the real cause was statistics showing that mortality in the First Division ward was much higher than in the others. His second clue--the death of a fellow doctor--paid off. The doctor had cut his finger while dissecting a corpse; a post mortem convinced Semmelweis that his friend had died of childbed fever. "He saw himself dissecting ... He felt his fingers wet with the pus and the fluids of putrefaction. He saw those hands, partly wiped, entering the bodies of living women. The contagion passed from his fingers to the living tissues, to wounded tissues. He saw the women fever. He heard them scream. He saw them die." Finally Semmelweis knew the reason why more mothers in the First Division ward died: students fresh from the dissecting room were allowed to examine them.

Steaming Caldron. "Wash your hands!" became the cry of Semmelweis' life. The medical world replied by nicknaming him the Pesth Fool and easing him out of his assistantship. The remaining years of his life were marked by almost incredible persecution. As director of obstetrics in the miserable, tenth-rate Pesth General Hospital, Semmelweis, working day & night to oversee his prophylaxis, finally managed to cut childbed fever mortality to zero. But his assistants sneered at him and his superiors refused to give him or his theories any credit. When his book, The Etiology, the Concept, and the Prophylaxis of Childbed Fever, met with derision, his mind snapped.

The Cry and the Covenant is a steaming caldron of 19th Century medical horror that sometimes bubbles over in such phrases as "The love in him wrung its hands in defeat." But more often its galloping, impassioned style exactly conveys the sight and smell of wards full of dying women, the outraged conservatism of doctors who bitterly resisted aseptic surgery, the heartbreak of seeing a lifesaving discovery rejected.

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