Ignaz Semmelweis (1818-1865)
Ignaz Semmelweis (born Semmelweis Ignác Fülöp in Buda, Hungary on 1st July, 1818) lived and worked before germ theory was popularised by Louis Pasteur. Things might have been a little easier for him if he had been born 10-20 years later.While employed as a senior assistant to the professor of obstetrics in the Vienna General Hospital, the Mortality was significantly higher in the clinic where he taught medical students, compared to the second clinic where only midwives trained. So obvious was the difference that women preferred to be delivered in the second clinic. Semmelweis realised that the explanation had something to do with the movement of medical students between autopsies and the obstetric clinic, proposing “cadaverous particles” as the likely cause of infection. The final straw was the death of his friend and colleague Jakob Kolletschka who died from septicaemia after being pricked by a student’s scalpel. Semmelweis introduced removal of his proposed cadaverous particles with chloride of lime solution between the autopsy room and the delivery bed and documented an almost ten-fold reduction in mortality.
You would have thought that an improvement of care of this magnitude would have met with widespread acclaim. Unfortunately it was not. His discovery was greeted with indifference, disbelief, opposition and ridicule. Semmelweis’ increasingly angry protests did not help his position. When an opportunity for promotion arose, he was passed over in favour of colleague. He returned to Pest, Hungary and was able to show once again an impressive reduction in mortality from childbed fever on the introduction of his method. Rather late in the day Semmelweis began to publish his findings papers, monographs and books. These stirred up further opposition from prominent authorities such as Simpson in the UK, and Virchow in Germany. His key work, Etiology, Concept and Prophylaxis of Childbed Fever, was finally published only four years before he died.
Faced with the opposition of some of the leading specialists of his day, is is not surprising that Semmelweiss slipped into a rapid decline. After a period of erratic and increasingly irritable behaviour, he finally had a nervous breakdown in 1865. Speculation includes causes such as Alzheimer’s Disease and neurosyphilis (an occupational hazard of obstetricians in those days). He was committed to an asylum and, in a final twist of fate, died from septicaemia following injuries probably incurred during or shortly after his admission.
In retrospect it is easy to understand his frustration that a purely empiric demonstration of efficacy was not enough to win over his medical colleagues. It would take another generation to build a firmer foundation for a mechanistic understanding of the disease process Semmelweiss sought to prevent. Yet you have to admire his ability to make that leap of imagination that enabled him to understand the basis of a causal relationship between something he couldn’t see and its disease-causing effects. His use of the term “Etiology” in the title of his book shows his colours as a forerunner of the hygiene movement. His intuitive grasp of disease causation makes you wonder what he might have achieved if he had within his reach the laboratory tools we now command.
The house where Ignaz Semmelweiss was born is now a museum of the history of medicine. It aims to put him in his rightful place as one of those who developed methods we use today. It can be found underneath the southern ramparts of Buda Castle, overlooking the Danube. A tram will get you close to the museum, but the walk along the west bank of the river is a pleasant alternative.
Ignaz Semmelweis (born Semmelweis Ignác Fülöp in Buda, Hungary on 1st July, 1818) lived and worked before germ theory was popularised by Louis Pasteur. Things might have been a little easier for him if he had been born 10-20 years later.While employed as a senior assistant to the professor of obstetrics in the Vienna General Hospital, the Mortality was significantly higher in the clinic where he taught medical students, compared to the second clinic where only midwives trained. So obvious was the difference that women preferred to be delivered in the second clinic. Semmelweis realised that the explanation had something to do with the movement of medical students between autopsies and the obstetric clinic, proposing “cadaverous particles” as the likely cause of infection. The final straw was the death of his friend and colleague Jakob Kolletschka who died from septicaemia after being pricked by a student’s scalpel. Semmelweis introduced removal of his proposed cadaverous particles with chloride of lime solution between the autopsy room and the delivery bed and documented an almost ten-fold reduction in mortality.
You would have thought that an improvement of care of this magnitude would have met with widespread acclaim. Unfortunately it was not. His discovery was greeted with indifference, disbelief, opposition and ridicule. Semmelweis’ increasingly angry protests did not help his position. When an opportunity for promotion arose, he was passed over in favour of colleague. He returned to Pest, Hungary and was able to show once again an impressive reduction in mortality from childbed fever on the introduction of his method. Rather late in the day Semmelweis began to publish his findings papers, monographs and books. These stirred up further opposition from prominent authorities such as Simpson in the UK, and Virchow in Germany. His key work, Etiology, Concept and Prophylaxis of Childbed Fever, was finally published only four years before he died.
Faced with the opposition of some of the leading specialists of his day, is is not surprising that Semmelweiss slipped into a rapid decline. After a period of erratic and increasingly irritable behaviour, he finally had a nervous breakdown in 1865. Speculation includes causes such as Alzheimer’s Disease and neurosyphilis (an occupational hazard of obstetricians in those days). He was committed to an asylum and, in a final twist of fate, died from septicaemia following injuries probably incurred during or shortly after his admission.
In retrospect it is easy to understand his frustration that a purely empiric demonstration of efficacy was not enough to win over his medical colleagues. It would take another generation to build a firmer foundation for a mechanistic understanding of the disease process Semmelweiss sought to prevent. Yet you have to admire his ability to make that leap of imagination that enabled him to understand the basis of a causal relationship between something he couldn’t see and its disease-causing effects. His use of the term “Etiology” in the title of his book shows his colours as a forerunner of the hygiene movement. His intuitive grasp of disease causation makes you wonder what he might have achieved if he had within his reach the laboratory tools we now command.
The house where Ignaz Semmelweiss was born is now a museum of the history of medicine. It aims to put him in his rightful place as one of those who developed methods we use today. It can be found underneath the southern ramparts of Buda Castle, overlooking the Danube. A tram will get you close to the museum, but the walk along the west bank of the river is a pleasant alternative.
