Ignaz Semmelweis (1818 – 1865)
Sometimes you discover something and can’t persuade the powers that be that you have made a major breakthrough. This was the fate that befell the latest inductee into our illustrious Hall of Fame, the Hungarian obstetrician, Ignaz Semmelweis.
Our hero studied Law at the University of Vienna in 1837 but switched to medicine the following year and after gaining his doctorate in 1844, decided to specialise in obstetrics. He took up his first appointment in 1846 as an assistant in the Vienna General Hospital’s maternity ward. There were two wards, A which was the preserve of doctors and trainees, and B which was staffed by midwives only. In the mid 19th century giving birth was a precarious business, often proving fatal to either the mother or the baby or, in some cases, both.
Clinic A had a phenomenally high mortality rate – about 10%, mainly as a result of puerperal fever, whereas the mortality rate in Clinic B was a still shocking but lower 2%. Women who came to the hospital – they were mainly from the lower classes – tried as best they could to avoid Clinic A because of its fearsome reputation. Many preferred to give birth in the streets where the mortality rate was considerably lower. Why was that, Semmelweis wondered?
The duties of the doctors at the hospital were many and varied. They would routinely examine diseased corpses in the mortuary, carrying out autopsies to determine cause of death or dissections to further their knowledge of the human anatomy, before moving on to the maternity ward. Whilst we now tend to regard, or at least hope, that medics are as close to the Platonic paradigm of cleanliness but in Semmelweiss’ time it was rare for a medic to wash their hands between dealing with patients. He noted the discrepancy between mortality rates where doctors were involved and where midwives, who did not handle dead bodies, were in attendance and concluded that some form of cadaverous material picked up from the stiffs was contributing to the high incidence of puerperal fever.
Acting upon these observations and hypotheses, Ignaz decided that he and his colleagues should was their hands in a solution of chlorinated lime, principally to remove the whiff of putrefying flesh, after handling dead bodies. The results were astonishing with fatality rates plummeting and after the experiment had been carried out for a while, deaths were a thing of the past. Concluding that he was on to something, although he could not provide a rational explanation as to why it worked as he knew nothing about germs, Semmelweiss began to promulgate his views. This led to great outburst of hand-wringing but not hand-washing amongst the medical profession, many of whom were outraged by the suggestion that their hands could be unclean. They were gentlemen, after all.
In revolutionary Vienna, Semmelweiss was seen as a trouble maker and was soon dismissed from his post. Surprise, surprise, the abandonment of the hand washing policy saw mortality rates rise to their pre-Ignatian levels. Frustrated, Semmelweiss wrote increasingly furious letters and articles to the medical community, accusing them of cold-hearted murder. Accounts of his discovery were printed in journals such as the Lancet. Semmelweiss repeated his successes whilst working in hospitals in Budapest in the 1850s and in 1861 published his theory and statistical demonstrations in a book called The Etiology, Concept and Prophylaxis of Childbed Fever. It was not well received.
Worse still, he became an obsessive on the subject at a time when he started to develop signs of the onset of what might have been Alzheimer’s. Even his wife thought he was verging on insanity and in 1865 he was lured into a mental asylum in Vienna . Realising he had been trapped, Semmelweiss tried to make good his escape, but was detained, put in a straightjacket and given a good hiding by the warders for good measure. Two weeks later he died from his injuries which had gone gangrenous.
It was only when Louis Pasteur was able to provide a theoretical explanation of the causal link between germs and disease that Semmelweiss began to be regarded as the genius that he was and was able to claim his place as a pioneer of antiseptic policy. For this, Ignaz, you are a worthy inductee to our Hall of Fame.
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