Ignaz Semmelweis
Ignaz Philipp Semmelweis (German: [ˈɪɡnaːts ˈzɛml̩vaɪs]; Hungarian: Semmelweis Ignác Fülöp [ˈsɛmmɛlvɛjs ˈiɡnaːts ˈfyløp]; 1 July 1818 – 13 August 1865) was a Hungarian physician and scientist of German descent, who was an early pioneer of antiseptic procedures, and was described as the "saviour of mothers".[2] Postpartum infection, also known as puerperal fever or childbed fever, consists of any bacterial infection of the reproductive tract following birth, and in the 19th century was common and often fatal. Semmelweis discovered that the incidence of infection could be drastically reduced by requiring healthcare workers in obstetrical clinics to disinfect their hands. In 1847, he proposed hand washing with chlorinated lime solutions at Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards.[3] The maternal mortality rate dropped from 18% to less than 2%, and he published a book of his findings, Etiology, Concept and Prophylaxis of Childbed Fever, in 1861.
"Semmelweis" redirects here. For the films, see Semmelweis (1940 film) and Semmelweis (1952 film).
Ignaz Semmelweis
13 August 1865 (aged 47)
Introducing hand disinfection standards, in obstetrical clinics, from 1847
Vienna General Hospital, Szent Rókus Kórház
5
Despite his research, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community. He could offer no theoretical explanation for his findings of reduced mortality due to hand-washing, and some doctors were offended at the suggestion that they should wash their hands and mocked him for it. In 1865, the increasingly outspoken Semmelweis allegedly suffered a nervous breakdown and was committed to an asylum by his colleagues. In the asylum, he was beaten by the guards. He died 14 days later from a gangrenous wound on his right hand that may have been caused by the beating.
His findings earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory, giving Semmelweis' observations a theoretical explanation, and Joseph Lister, acting on Pasteur's research, practised and operated using hygienic methods, with great success.
Work on cause of childbed fever mortality[edit]
Position at Vienna General Hospital[edit]
Semmelweis was appointed assistant to Professor Johann Klein in the First Obstetrical Clinic of the Vienna General Hospital on 1 July 1846.[9][10][C] A comparable position today in a United States hospital would be "chief resident."[11] His duties were to examine patients each morning in preparation for the professor's rounds, supervise difficult deliveries, teach students of obstetrics, and be "clerk" of records.
Maternity institutions were set up all over Europe to address problems of infanticide of illegitimate children. They were set up as gratis institutions and offered to care for the infants, which made them attractive to poor women, including prostitutes. In return for the free services, the women would be subjects for the training of doctors and midwives.
Two maternity clinics were at the Viennese hospital. The First Clinic had an average maternal mortality rate of about 10% due to puerperal fever. The Second Clinic's rate was considerably lower, averaging less than 4%. This fact was known outside the hospital. The two clinics admitted on alternate days, but women begged to be admitted to the Second Clinic, due to the bad reputation of the First Clinic.[12] Semmelweis described desperate women begging on their knees not to be admitted to the First Clinic.[13] Some women even preferred to give birth in the streets, pretending to have given sudden birth en route to the hospital (a practice known as street births), which meant they would still qualify for the child care benefits without having been admitted to the clinic. Semmelweis was puzzled that puerperal fever was rare among women giving street births. "To me, it appeared logical that patients who experienced street births would become ill at least as frequently as those who delivered in the clinic. [...] What protected those who delivered outside the clinic from these destructive unknown endemic influences?"[14]
Analysis of childbed fever mortality[edit]
Semmelweis was severely troubled that his First Clinic had a much higher mortality rate due to puerperal fever than the Second Clinic. It "made me so miserable that life seemed worthless".[15] The two clinics used almost the same techniques, and Semmelweis started eliminating all possible differences. He excluded "overcrowding" as a cause since the Second Clinic was always more crowded and yet the mortality was lower. He eliminated climate as a cause because the two clinics were in close geographical proximity to each other. He also altered the position that mothers gave birth in, and proposing a priest giving last rites in the clinic was terrifying women after birth and thus causing them to develop the fever.[16]
The only major difference was the individuals who worked there. The First Clinic was the teaching service for medical students, while the Second Clinic had been selected in 1841 for the instruction of midwives only.