Day 857: How Ignaz Semmelweis Changed The Medical World And Never Lived To Know It

originally published May 6, 2014

Does the name Ignaz Semmelweis mean anything to you?

My readers whose boot-prints lay along the medical mud-path (or in the frightening swamp of germophobia) will shout an esteemed “YES!”, probably with the reverence my musician friends would reserve for a Les Paul or a Robert Moog. Dr. Semmelweis’s work has probably saved millions upon millions of lives, which is particularly impressive considering he was virtually laughed out of the medical profession.

Many of history’s great geniuses have toiled in anonymity, but it’s a thing of spectacular bamboozlement when someone with the foresight to establish something that is accepted as a subconscious standard decades later was actually lambasted by his peers for thinking outside the box. Louis Pasteur is revered and regarded, with his name showing up on the sides of milk cartons, juice boxes, butter bars and syrup jars for his work in germ theory. But Dr. Semmelweis?

The poor guy doesn’t even pass the spell-check feature of Microsoft Word. And without him, Pasteur might never have uncovered all those secrets of the micro-universe between the filthy ridges of our fingertips.

Dr. Semmelweis (who, according to the photos I could find, may never have had a full head of hair) was born in the Buda part of Budapest, in what was then a part of the Austrian Empire. He earned his doctorate degree in 1844 and decided to specialize in obstetrics. He was assigned to the First Obstetrical Clinic of the Vienna General Hospital, serving under Professor Johann Klein, a man whose contributions to the field of medicine appear to have been little more than squat. I mention this only because his dickishness plays into this story a little later.

There were two maternity clinics at the hospital. They were open on alternate days, meaning it was a coin-toss whether you’d end up in #1 or #2 when your water broke. There was a substantial difference between the two clinics; clinic #1 had an average mortality rate among mothers of about 10% due to puerperal fever, which is an unpleasant infection of the reproductive organs. The mortality rate in clinic #2 was only about 4%. That’s a big leap.

Women would show up on clinic #1 days and literally drop to their knees, begging for admission to the other clinic. Some would give birth on the street, claiming they were on their way to the hospital, just so they didn’t have to deliver their baby in that clinic. Dr. Semmelweis was baffled by this – why was one clinic killing off so many young mothers? The only real difference he could see was in the staff: clinic #1 was where medical students would do their rounds and learn, while clinic #2 was strictly for instructing midwives.

Keep in mind, these clinics were mainly for the low-income ladies (including prostitutes) in Vienna. These women didn’t have a lot of options – if they were giving birth, they’d be taking their chances. Then one day, Dr. Semmelweis’s friend, Dr. Jakob Kolletschka, was accidentally nicked with a med student’s scalpel during a post mortem examination, the ensuing infection killing him. His autopsy revealed a number of similarities to the deaths of the women. Dr. Semmelweis put the pieces together. Med students were examining cadavers then wandering into the obstetrics clinic and fondling live lady-parts.

Maybe they should just wash their goddamn hands in between.

The medical world was still a ways off from figuring out germ theory (that’s where Pasteur stepped up). When Dr. Semmelweis suggested that the med students wash their hands in a solution of chlorinated lime, he didn’t know what was being transferred from the corpses to the birth-mothers, he only knew that the solution would kill the smell. What he didn’t realize is that it was also killing the germs, and within a few months the mommy-mortality rate in clinic #1 dropped from 11.4% down to zero.

You’d think the guy would be hailed as a hero. Instead, he became a laughing-stock.

The medical profession in the 1840’s was unfathomably primitive by today’s standards. Doctors still believed that puerperal fever – like any disease – was a singular issue with each particular patient, not a communicable condition. The concept of contagion hadn’t been figured out yet. The idea of “four humors” guiding the body’s inner functionality, and that blood-letting was a legitimate way to treat all sorts of conditions, was still a thing. Suggesting that some sort of particles (let alone microorganisms) could be transmitted from one body to the next was outrageous.

By 1848, Dr. Semmelweis had expanded his theory into insisting that all medical instruments get scrubbed in between patients. It was a radical notion, and it pissed off the medical community thoroughly. Doctors didn’t believe they should have to wash their hands; they were gentlemen of good breeding. It didn’t help that Dr. Semmelweis never published a paper on his discoveries – his students preached the hand-washing gospel all over the continent but Dr. Semmelweis was quiet.

Around this time a political revolution was taking place against the Hapsburgs who were in charge of the Austrian Empire. Dr. Johann Klein, a conservative Austrian, didn’t trust the Hungarian-born Semmelweis, and coupled with the good doctor’s endless prattling about hand-washing, it was a no-brainer for Klein to hand Semmelweis’s job over to Carl Braun, another doctor. Dr. Semmelweiss left Vienna for a position in Budapest, and the mortality rates in the Vienna hospital rocketed upward during the 1850’s. No one thought to ask why.

When Dr. Semmelweis showed up at St. Rochus Hospital, childbed fever was a rampant problem. After implementing the same hand-washing procedures he’d used in Vienna, he all but eliminated the problem. Unfortunately, Dr. Ede Florian Birly, the professor running the show at St. Rochus, also refused to accept Dr. Semmelweis’s ideas. When he died in 1854, Dr. Semmelweiss applied for the job, but Dr. Birly’s colleagues instead decided to give it to… shit, Carl Braun again. That guy had a knack for showing up and messing with Dr. Semmelweis’s career whenever he could. Luckily, Braun didn’t speak Hungarian so Semmelweis got the gig.

By the early 1860’s, Dr. Semmelweis was losing it. He wrote a book that once again resulted in a collective scoff by the medical community. He became depressed and absentminded, writing furious open letters to the obstetrics community, calling his critics ignoramuses and even irresponsible murderers. He started drinking and frequenting prostitutes (much to the displeasure of his wife), and his behavior in public was downright embarrassing. In the summer of 1865, his colleagues had had enough.

Dr. Janos Balassa, one of Hungary’s top doctors, signed the papers to have Dr. Semmelweiss committed. No one knows what was really wrong with the guy – it might have been exhaustion, depression, nearly 20 years of accrued frustration or maybe even the early stages of Alzheimer’s. But within a few minutes after Dr. Semmelweiss showed up at the asylum (he was invited under the guise of being given a tour), the doctor tried to make a break for it. He was beaten by the guards.

Here’s where shit gets tragically ironic. Dr. Semmelweis died within two weeks from a gangrenous wound, most likely caused by the beating. A wound that was not cleaned properly because no one friggin’ listened to the guy or paid attention to his consistent results. He was 47 years old.

Louis Pasteur’s work on germ theory, which began during the final years of Dr. Semmelweis’s life, would later validate everything Semmelweis stood for. Now the guy has a hospital, a women’s clinic and a university named after him – but back when he was changing the world, he was little more than a punchline. Something to remember next time you scrub up.

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