Ignaz Philipp Semmelweis, or in his
native Hungarian spelling Ignác Fülöp Semmelweis, was born on
July 1, 1818 in
Buda,
Hungary (then part of the
Austrian Empire, and now
Budapest, the
capital of Hungary). After having studied
medicine at the
University of
Pest he went to
Vienna to further advance his learning, where he received his doctor's degree in 1844.
Vienna General Hospital
Semmelweis then began to work as an
assistant at the
obstetric clinic of the
Vienna General Hospital. The Hospital had two
wards for
pregnant women, one for the
poor and another for the more well-to-do.
The ward for the poor was the
territory of
midwives, who had always performed this duty for
pregnant women before medicine became advanced enough for real
doctors to enter into the picture. The doctors only focused on the ward for the richer women, however, and left the poor ward up to the midwives.
At this time in
history the practice of
true medicine was starting to emerge, and the Vienna General Hospital was one of the places where the
discipline was taken seriously. The hospital was a
proponent of
research and wanted to find the
causes for illnesses using a
scholarly approach. This meant, however, that autopsies were regularly carried out to find out what the
patient had died of and what effects
illness had had on the body.
Puerperal fever
When Semmelweis came to work at the Hospital, the
death rate due to
puerperal fever in the rich ward was significantly higher - in the order of ten times as high - than in the poor ward. Semmelweis began studying this
phenomenon and eventually came up with an answer.
In 1840 the new head of the
obstetrics clinic wanted the students at the
clinic to get hands-on experience, and under
supervision the students started helping during deliveries. However, one of the other duties of the students was to perform autopsies on deceased patients for
educational purposes.
When death rates in the rich ward began to increase the students were told to perform autopsies on every
death in the ward to find out why so many deaths were occurring. Sadly, this
measure was in part responsible for keeping that death rate high.
Scientific study
Semmelweis embarked on what was for the time a very thorough
investigation and it is this in part which has in recent times given Semmelweis the
recognition he deserved, but in his own lifetime never got. His investigation is probably the first true scientifically conducted
study. Semmelweis set up different
hypotheses for his problem and then tried to either
prove or
disprove each
hypothesis in turn. He included
variables such as
temperature,
fresh versus
stagnant air,
cleanliness of bedclothes, and even the color of the rooms in his study. And one by one he disproved each hypothesis he came up with.
This situation continued for some time, until Semmelweis focused on the fact that the only true difference in the two wards was the staff. What Semmelweis discovered was that the students and doctors would often go from the
autopsy chamber to the
delivery ward without
washing hands, changing
aprons or otherwise cleaning themselves up. He hypothesized that the deaths due to
puerperal fever had something to do with these autopsies, and that the
affliction was somehow carried over from the
dead bodies to the
women by the doctors and
students themselves. This was of course a highly
controversial hypothesis, putting the blame at the feet of the doctors.
Semmelweis tried to find
proof for his hypothesis and instituted a rigid
protocol for students (who were the ones that were doing autopsies most often). They were instructed to
wash their hands thoroughly, and then to
rinse their
hands with
chloride of
lime, before entering the delivery ward. In the months following the institution of this protocol, the death rate in the rich ward steadily
dropped until it was equal and even somewhat below that in the poor ward. This, for Semmelweis, was the proof that his hypothesis was
correct.
His
superiors, however, thought his hypothesis was highly
insulting and untrue besides. Of course, if they did not
disagree, they had to face the fact that they had themselves been the main reason for such a high death rate among the women who had
given birth in the rich ward. Semmelweis was fired and went back to
Budapest.
Differing ends
At this point my sources start to diverge. One states Semmelweis became
abusive at home, whereupon his
wife and brother-in-law
conspired to have him admitted to a
psychiatric asylum in
Vienna. Discovering the betrayal he tried to
escape and was caught and severely beaten. He died a few weeks later.
Others state that he was a
manic depressive and was admitted to an
asylum for that reason on
August 1, 1865. According to this version a
cut on his right hand, contracted during a
gynealogical operation, was noted during his
admittance. He died on
August 13, 1865, in
Vienna,
Austria,
suffering from
septicaemia.
Recognition
Whatever the circumstances of his
death, Ignaz Semmelweis never got the
credit he deserved in his own
lifetime. In later years however his work was noted and he is now somewhat revered as a hero far in advance of his own time. It wasn't until 30 years later that his
ideas concerning
cleanliness were implemented in
western hospitals on a wide scale, mostly due to the work of people like
Louis Pasteur and his colleagues, who in 1879 demonstrated that the
cause of
puerperal fever was usually
streptococcus.
Semmelweis was, however, not the first to note that puerperal fever had something to do with
hygiene, particularly after working with
corpses.
Alexander Gordon (1752-1799) of
Aberdeen,
Scotland, was probably the first to tie the two together, and
Oliver Wendell Holmes published an
essay in 1842 stating much the same. It was Semmelweis, though, who finally, through
scientific study, provided the
proof for this
theory, even if in his own time it was not recognized as such.
And this
aspect of Semmelweis brings me to why I, as a
Civil Engineer to be, came to know about Dr. Ignaz Semmelweis. One of my courses, "
research methodology", started out with a screening of a
documentary about Semmelweis to illustrate what proper
scientific research is and how it was first done by Semmelweis.
This is the reason he should be entered into
the annals of history.
Puerperal fever is caused by conveyance to the pregnant woman of putrid particles
derived from living organisms, through the agency of the examining fingers.......
Consequently must I make my confession that God only knows the number of women whom
I have consigned prematurely to the grave.
-- Ignaz Semmelweis --
Sources:
http://www.sinc.sunysb.edu/Class/bio101/lifelines/34.html -- Semmelweis
http://www.umanitoba.ca/outreach/manitoba_womens_health/hist1b.htm -- Puerperal fever and Gordon, Holmes and Semmelweis
http://www.britannica.com/eb/article?eu=68445 -- Semmelweis
Unknown documentary I saw years ago
September 10, 2001