Semmelweis, Ignaz Philipp: Die Ätiologie, der Begriff und die Prophylaxe des Kindbettfiebers. Pest u. a., 1861.
(The book in which Semmelweis presented his discovery that...)
The book in which Semmelweis presented his discovery that setting the standards of hand disinfection leads to much lower mortality rates with mothers who just gave birth
Ignaz Philipp Semmelweis was a physician who specialized in obstetrics. He is known for implementing hand disinfection standards, which was a pioneering move when it comes to antiseptic procedures. His discoveries significantly decreased mortality rates due to puerperal fever with mother who just gave births. However, despite obvious success, his work wasn’t widely acknowledged due to political turmoil.
Background
Ethnicity:
German origin of his family can be traced back to the 17th century.
Ignaz Phillip Semmelweis was born in Buda, Hungary, one of the two parts of today’s capital of Hungary, Budapest. He was born in an old commercial part of the city called Taban as the fifth child of his parents József Semmelweis and Teréz Müller. His father was of German origin and worked as a successful housekeeper in Buda.
Education
Little Ignaz grew up in a huge family since his parents had ten children in total. He loved playing with his siblings but he was also dedicated to learning. He enrolled at the Catholic Gymnasium to get his elementary education and then finished schooling at the University of Pest in 1837. His father wanted him to become a military advocate that would serve the Austrian bureaucracy, so Semmelweis moved to Vienna in 1837 to fulfill his wish.
However, as soon as he arrived, he realized he is attracted to medicine. He decided to follow his dream and get into a medical school. It is not known if his father approved this, but no sources claim that he opposed either. After finishing his first year of studies, he returned to Hungary in 1839 to continue studying at the local university. However, the school didn’t have appropriate conditions so he decided to travel back to Vienna in 1841 and enroll the Second Vienna Medical School. This school will be among the leading centers of bedside medicine.
Semmelweis loved medicine and went to many seminars voluntarily, including the ones led by his teachers Josef Skoda, Karl von Rokitansky and Ferdinand von Hebra. He finally completed his dissertation in 1844 and enrolled a course in practical midwifery again to receive a Magister degree in the subject. He also spent more than fourteen months (1844-1846) learning diagnostic and statistical methods along Skoda, making sure he also gets some surgical training. It seemed that he was finally ready to work, so he applied for the position at the First Obstetrical Clinic in The Vienna General Hospital.
Career
The Vienna General Hospital, where Semmelweis got the job as an assistant to Professor Johann Klein in the First Obstetrical Clinic, was the teaching institution of the University. He started working on the position in the summer of 1846, which was a great success for him (if we compare the position of assistant to hospitals in the United States today, he would be “chief resident”). His duties included examining the patients before the professor’s rounds, teaching students and take care of the records.
At the time, maternity clinics were set up offering gratis services of caring for the infants for all women, including underprivileged and prostitutes. In return, they would accept to be subjects in the training courses of midwives and doctors. At The Vienna General Hospital, two of those clinics were set up. However, The First Clinic had a much higher average mortality rate than the Second Clinic. This quickly spread to public and women started avoiding the First Clinic, begging to be admitted to the Second and often even giving birth on the streets rather than in the hospital facilities. Semmelweis noticed that puerperal fever, the main reason of death with women giving births, was considerably lower in cases of street births. It was very puzzling for him, as it sounded quite illogical for the mortality rate to be lower if you give birth on the street than if you do it in the clinic.
Semmelweis started observing and trying to eliminate any possible causes for higher mortality rate at the First Clinic. He was thorough, so he made sure to observe everything, including the religious practices of the patients. He finally found that the only significant difference was that the First Clinic was used for teaching medical students, and the other for teaching midwives. As the students were also dissecting dead bodies, Semmelweis concluded that it was they who transferred the infection from the mothers who had died to the healthy mothers in the maternity ward. In May 1847, Semmelweis ordered all students and staff to use the new system of prophylaxis. He instructed them to wash their hands in a solution of chlorinated lime whenever they would go from the autopsy to patient examination. Although there were many protests and few people believed that the reason for such high mortality rates was simply cleanliness, Semmelweis was persuasive. In Just a month, he managed to decline the puerperal fever death rate to around 2 percent.
Despite his method being a great success, Semmelweis didn’t want to communicate it officially or write a paper about it. It was his teacher Hebra that wrote two articles strongly recommending the method to be used as a preventive but the articles didn’t receive great support. Skoda noticed that the success of Semmelweis’ new method was obvious and tried to create an official commission to investigate the results. However, it was the time of great turmoil in Austria in 1848. Semmelweis participated in the liberal revolution, and when the liberals were defeated, the conservatives rejected the proposal.
Not only that, he was fired from his position at the clinic in 1849 and was turned down when he applied to be a teacher of midwifery in the university. He realized that the only way to spread his idea was to communicate it, which was exactly what he did in 1850 in the successful lecture “The Origin of Puerperal Fever” he held at the Medical Society of Vienna under the presidency of Rokitansky. The same year he was offered the position of the teacher at the University but under the condition that he could teach obstetrics only on a mannequin. Semmelweis believed this was a humiliation and left Vienna without even noticing his close friends.
He decided to return to Pest where he worked at the St. Rochus Hospital for the next six years. When an epidemic broke out in the obstetrics department, Semmelweis was put in charge and managed to reduce the mortality rate significantly in a short period of time. During this period, the mortality rated in Pest were under 1 percent, while in Vienna and Prague they were still higher than 10 percent. He became a professor at the University of Pest in 1855 while developing his private practice. The Hungarian government accepted his methods and ordered all districts to implement Semmelweis’ prophylactic methods.
However, Vienna was more than hostile towards him. The editor of the Wiener Medizinische Wochenschrift had even written an article calling for people to stop this great nonsense of washing hands in chlorine. When Semmelweis published a book in 1861 where he discovered his findings, the book was largely unaccepted. The book was called Die Atiologie, der Begriff und die Prophylaxis des Kindbettfiebers and was written in German. However, given that Semmelweis wasn’t a favorite of Austrian authorities and he managed to lose the support of his friends when he left Vienna without telling them, foreign reviews of the book were not good.
Semmelweis had trouble accepting this and started writing letters to some reputable European obstetricians, calling them irresponsible murderers. The indifference of his colleagues towards the number of death occurring enraged him. He succumbed to depression with occasional attacks of rage. Everyone, including his wife, believed he was sick. In 1865, he was tricked by his alleged friend Hebra, who falsely lured him to visit one of his “new institutes”. Instead, they committed him to an asylum in Vienna. He died there two weeks later after getting beaten by the guards. The official cause of death the autopsy offered was blood poisoning.
(The book in which Semmelweis presented his discovery that...)
1861
Religion
Semmelweis' elementary school was a Catholi Gymnasium im today's Budapest.
Politics
Semmelweis took part in the liberal revolution that broke out throughout Europe in 1848. After the conservatives stopped the revolution and defeated the liberals, Semmelweis experienced many problems, including issues with spreading his idea of new system of prophylaxis and getting fired from the Vienna General Hospital.
Views
Although Semmelweis wanted to be in the world of internal medicine, after getting turned down, he turned to the obstetrics. He was a devoted worker and was ahead of his time in the means that he was looking for ways to improve and perfect the medicine in general. He wasn't burdened by conservative ways of society in the Austrian Empire in the 19th century.
When he realized that his hand disinfection standards were working, he fought strongly for them. He even believed to be the 'savior of mothers'. However, he didn't manage to pass the brilliant discoveries he made due to several factors. There were some misunderstandings of Viennese and foreign physicians which could lead to an inadequate assessment of a particular procedure. Political feuds didn't help Semmelweis, especially when the liberals who he showed affection for were defeated in 1848 and his abrupt leaving of Vienna, which was the arena he fought for his cause, further damaged his chances of being acknowledged. He was accepted in Hungary who was at the time scientifically backward country with a far less reputable university, which was not enough to help him promulgate his ideas. He additionally hampered himself with his enraged letters to respected obstetricians and his violent behavior.
Quotations:
"When I look back upon the past, I can only dispel the sadness which falls upon me by gazing into that happy future when the infection will be banished . . . The conviction that such a time must inevitably sooner or later arrive will cheer my dying hour."
Personality
Semmelweis was diligent and had a great love for medicine. He pursued his career in this field despite his father wanted him to become a military advocate. He was strict but fair to the students he taught. When he forced them to implement his new hand disinfection standards, he did so with a good reason - to save lives. After getting criticized and his idea getting repeatedly rejected by the conservative colleagues and public, he succumbed to mental problems, which manifested with occasional episodes of rage, leading in the end to him being placed in an asylum.
Interests
Writing
Philosophers & Thinkers
Carl Menger
Politicians
Count Kolowrat, Count Ficquelmont
Writers
Johann Wolfgang von Goethe
Artists
Joseph Matthäus Aigner
Connections
Semmelweis married Maria Weidenhoffer in 1857. She was a daughter of a Pest merchant and 19 years younger than Semmelweis. Together they had five children, among which only one daughter who will have children of her own.