SEMMELWEISS – A TRUE SAVIOUR OF WOMEN
The story of Ignaz Philip Semmelweiss (1818-1865), who is one of the great martyrs in the history of medicine, is a sad tale, because, although he did so much to improve childbirth, today very few know of him or the great work he did.
The birth of a child is a source of great joy to the happy parents, and with modern technology there is little risk to the mother’s health. However, in the 19th century it was a very different story. Many mothers died within a week or two of giving birth from a disease called `childbed’ or puerperal fever. This condition, which includes a high temperature, pain in the lower abdomen, swelling of the pelvic tissues, abscesses, peritonitis, septicaemia, delirium and finally heart failure, was common in women delivered in hospitals. Those delivered at home fared much better, and as most of the well-off invariably give birth at home, it was the poorer people of the communities who were at most risk.
In 1846, working as First Assistant in the Maternity Hospital in Vienna, Ignaz Semmelweiss, noticed a huge difference between the high numbers of deaths from childbed fever in the hospital’s two maternity wards. In ward 1, 18.9% of newly delivered mothers died, and in ward 2 the figure was much lower at 3.9%. This puzzled the doctor, and as the first ward became notorious for its death-rate, women could be seen in tears begging not to be placed in the dreaded ward.
The doctors in charge of the hospital, like others throughout Europe, were convinced that the fever was caused through infectious moisture in the air and did nothing about it. Semmelweiss, however, could not accept this theory. If it was in the air, then why weren’t both wards affected equally?
\further investigation carried out by Semmelweiss discovered that Ward 1
was run by medical students who entered the ward directly from the
dissecting rooms still wearing the same blood splattered coats in which they
had performed their autopsies, and not bothering to wash their hands,
proceed to examine their patients. Ward 2 was run by female midwives
who paid particular attention of cleanliness.
One day, while Semmelweiss was still trying to explain the contrast,
his friend Kolletschka, Professor of Medical Jurisprudence, fell ill and died of
a dissection wound to the hand, and when he went back to the hospital,
more sad news awaited him. One of his colleagues, a pathologist had fallen
ill and died, after pricking his finger whilst doing the autopsy on someone
who had died from childbed fever. Semmelweiss noted that the symptoms
closely resembled those of puerperal fever, and he was convinced that the
cause of both were somehow connected, and concluded that something,
which Semmelweiss called, `putrid particles’, were being transferred from
the bodies in the dissecting rooms into the wound – the small cut in his
friend’s hand and the large wound left after the placenta separates from the
uterus following childbirth.
The young Semmelweiss should have been delighted with his discovery
but instead he was riddled with guilt. He too had dissected many bodies,
primarily to find out why so many women had died after childbirth, and he
too, unknowingly, could have passed on the fever to many unsuspecting
Semmelweiss acted quickly, and in May 1847, ordered every student to
wash their hands and cleaning their instruments not with just soap, but with
a solution of lime chloride before entering Ward 1. The results were
dramatic. Within a year, the mortality rate in the ward had fallen to just over
3%, and the following year, it had reached 1.27%. By the end of 1848, out
of 3,356 having their babies at the hospital, only 45 died.
When Semmelweiss published his findings, he thought everyone would be
pleased, but his suggestions were ridiculed and ignored, but despite the
danger to his future career, he refused to be silenced, and in an ensuing
row, he called opponents `murderers’.
His working colleagues never forgave him and, Semmelweiss being a
sensitive man became disgusted at the persecution that followed. He
suddenly left his post and Vienna. It was thought that washing hands in
chloride water was silly and was soon abandoned. Within a month of him
leaving, twenty women died of childbirth fever.
He moved to Budapest and continued to practice obstetrics, where, in
1855, he became professor of obstetrics at the University, and spent most
of his spare time writing a book that he thought would finally support his
claims. The Cause, Concept and Prophylaxis of Childbed Fever was
published in 1861, but having been conceived through a medical dispute, it
did not convince the profession. Sadly, Semmelweiss became depressed
and angry, and speculation grew that he had developed a mental condition
brought on by possibly syphilis or even Alzheimer’s. On 1st August 1865, at
the age of 47, he was admitted to a mental asylum, and just 12 days later
he died. When he entered the asylum he had a sore finger from a knife-slip
during one of his last operations, and the wound had become infected, and
he died of streptococcal blood poisoning, a septic wound on the finger, or
possibly after being beaten by his guards – ironically he had become a
victim of the very disease he had fought so hard to prevent. During a
meeting of the Academy of Medicine in Paris, in 1879, Semmelweiss was
finally exonerated. An eminent gynaecologist began to mock the
Hungarian’s theory about the contagious disease, when he was suddenly
interrupted by the great French scientist, Louis Pasteur who, mounting the
platform and began to draw a series of small circles, joined together by a
chain, on the blackboard.
`There you are!’ exclaimed Pasteur. `The streptococcus bacterium, that’s
what they look like’. It was later found that Semmelweiss methods were well
in advance of Joseph Lister’s antiseptic surgery.
According to the great medical historian, Fielding H Garrison,
Semmelweiss is now regarded as `one of medicine’s martyrs, and one of its
far-shining names’. A statute of Semmelweiss can be seen in front of Szent
Rokus Hospital. Budapest and another at the University of Tehran, both
silent reminders to a dedicated man to whom every mother today owes a