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The course of history is never one of smooth progression. Periods
of relative quietness are interrupted by periods of wars and
revolution. This pattern resembles that of a river which, before
flowing into the delta, has to pass countless rapids. The same
holds for the development of the science of medicine. In obstetrics
some of these 'revolutions' or 'rapids' consist of the introduction
of conservative obstetrical treatment by Lucas Johann Boer at the
beginning of the nineteenth century, the discovery of the cause of
puerperal sepsis by Oliver Wendell Holmes and Semmelweiss between
1843 and 1847, the introduction of the principle of asepsis by
Pasteur in 1874, the introduction of prenatal care at the end of
the nine teenth and the beginning of the twentieth century
(Mijnlieff, Treub, De Snoo), the improvement of surgical
techniques, the possibility to treat shock by bloodtransfusion,
and, finally, the acquisition of new means for the effective
therapy of infection. All these developments have led to a sharp
reduction of maternal and perinatal mortality. In this connection
it must be pointed out that such a reduction could never have been
accomplished without the favourable social changes as a result of
which medical and prenatal care could be made universally
available. In recent years there has been another revolutionary
develop ment in obstetrics. Two factors have been responsible for
this: the ap plication of basic sciences in obstetrics, and the
dissolution of the isolation with respect to other clinical
disciplines."
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