In 1850, Ignaz Semmelweis saved lives with three words: wash your hands | PBS News
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In 1850, Ignaz Semmelweis saved lives with three words: wash your hands
Health
May 15, 2015 3:29 PM EDT
On this date in 1850, a prickly Hungarian obstetrician named Ignaz Semmelweis stepped up to the podium of the Vienna Medical Society's lecture hall. It was a grand and ornately decorated room where some of medicine's greatest discoveries were first announced. The evening of May 15 would hardly be different -- even if those present (and many more who merely read about it) did not acknowledge Semmelweis's marvelous discovery for several decades.
Ignaz Semmelweis, circa 1860. Photo via Wikimedia
What, exactly, was the doctor's advice to his colleagues on that long ago night? It could be summed up in three little words: wash your hands!
At this late date, we all expect our doctors to wash their hands before examining us or performing an operation in order to prevent the spread of infection. Surprisingly, physicians did not begin to acknowledge the lifesaving power of this simple act until 1847
It was then that Dr. Semmelweis began exhorting his fellow physicians at the famed Vienna General Hospital (Allgemeines Krankenhaus) to wash up before examining women about to deliver babies. His plea was far more than aesthetic; it was a matter of life and death and helped to prevent a deadly malady known as "childbed" or puerperal (from the Latin words for child and parent) fever.
In the mid-19th century, about five women in 1,000 died in deliveries performed by midwives or at home. Yet when doctors working in the best maternity hospitals in Europe and America performed deliveries, the maternal death rate was often 10 to 20 times greater. The cause was, invariably, childbed fever. And a miserable end it was: raging fevers, putrid pus emanating from the birth canal, painful abscesses in the abdomen and chest, and an irreversible descent into an absolute hell of sepsis and death -- all within 24 hours of the baby's birth.
The reason seems readily apparent today, if not back then. Medical students and their professors at the elite teaching hospitals of this era typically began their day performing barehanded autopsies on the women who had died the day before of childbed fever. They then proceeded to the wards to examine the laboring women about to deliver their babies.
Dr. Semmelweis was brilliant but had two strikes against him when applying for a position at the Vienna General Hospital in 1846: he was Hungarian and Jewish. Medicine and surgery were considered to be the premier specialties in Vienna but because of his background and religion Semmelweis was relegated to running the less desirable division of obstetrics. Nevertheless, his claim to immortality was the result of an obsession with finding the means to end the childbed fever epidemics that were killing nearly a third of his patients. (The hospital ward run by midwives, without autopsy duties, had far better outcomes with their deliveries).
Every day he heard the heart-rending pleas of women assigned to his care begging to be discharged because they believed these doctors to be the harbingers of death. Fortunately, Dr. Semmelweis was smart enough to listen to his patients.
The obstetrician made the vital connection that puerperal fever was caused by the doctors transferring some type of "morbid poison" from the dissected corpses in the autopsy suite to the women laboring in the delivery room. That morbid poison is now known as the bacteria called Group A hemolytic streptococcus.
Streptococcus pyogenes bacteria, seen through a microscope, the cause of puerperal fever. Photo via Wikimedia
Historians are quick to remind that Semmelweis was not the first physician to make this clinical connection, one that many expectant mothers of the era called "the doctors' plague." For example, the obstetrician Alexander Gordon of Aberdeen, Scotland, suggested in his 1795 Treatise on the Epidemic of Puerperal Fever that midwives and doctors who had recently treated women for puerperal fever spread the malady to other women. More famously, in 1843 Oliver Wendell Holmes, the Harvard anatomist and self-proclaimed "autocrat of the breakfast table," published "The Contagiousness of Puerperal Fever," in which he discerned that the disease was spread by physicians and recommended that actively practicing obstetricians abstain from performing autopsies on women who died of...