Ignaz Semmelweis

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Ignaz Semmelweis bigraphy, stories - Doctor of obstetrics who advocated handwashing.

Ignaz Semmelweis : biography

July 1, 1818 – August 13, 1865

Ignaz Philipp Semmelweis (July 1, 1818 – August 13, 1865) (born Ignác Fülöp Semmelweis) was a Hungarian physician of German extraction now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%. Semmelweis proposed the practice of washing with chlorinated lime solutions in 1847 while working in Vienna General Hospital’s First Obstetrical Clinic, where doctors’ wards had three times the mortality of midwives’ wards. He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.

Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis’s observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community. Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis’s practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist’s research, practiced and operated, using hygienic methods, with great success. In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed.

Discovery of cadaverous poisoning

Semmelweis was appointed assistant to Professor Johann Klein in the First Obstetrical Clinic of the Vienna General Hospital on July 1, 1846.{{#tag:ref|Details: On July 1, 1844 Semmelweis became a trainee physician’s assistant at the Vienna maternity clinic (in German, Aspirant Assistentarztes an der Wiener Geburtshilflichen Klinik) and on July 1, 1846 he was appointed an ordinary physician’s assistant (in German, ordentlicher Assistentarzt). However, on October 20, 1846 his predecessor Dr. Franz Breit (an obstetrician) unexpectedly returned, and Semmelweis was demoted. By March 20, 1847, Dr. Breit was appointed professor in Tübingen and Semmelweis resumed the Assistentarzt position.|group = "Note"}} A comparable position today in a US hospital would be "chief resident." His duties were to examine patients each morning in preparation for the professor’s rounds, supervise difficult deliveries, teach students of obstetrics and be ‘clerk’ of records.

Maternity institutions were set up all over Europe to address problems of infanticide of illegitimate children. They were set up as gratis institutions and offered to care for the infants, which made them attractive to underprivileged women, including prostitutes. In return for the free services, the women would be subjects for the training of doctors and midwives. There were two maternity clinics at the Viennese hospital. The First Clinic had an average maternal mortality rate due to puerperal fever of about 10% (actual rates fluctuated wildly). The Second Clinic’s rate was considerably lower, averaging less than 4%. This fact was known outside the hospital. The two clinics admitted on alternate days but women begged to be admitted to the Second Clinic, due to the bad reputation of the First Clinic. Semmelweis described desperate women begging on their knees not to be admitted to the First Clinic. Some women even preferred to give birth in the streets, pretending to have given sudden birth en route to the hospital (a practice known as street births), which meant they would still qualify for the child care benefits without having been admitted to the clinic. Semmelweis was puzzled that puerperal fever was rare among women giving street births. "To me, it appeared logical that patients who experienced street births would become ill at least as frequently as those who delivered in the clinic. […] What protected those who delivered outside the clinic from these destructive unknown endemic influences?"