Ignaz Semmelweis : biography
When Semmelweis’s term was about to expire Carl Braun also applied for the position of assistant in the First Clinic, possibly at Klein’s own invitation. Semmelweis and Braun were the only two applicants for the post. Semmelweis’s predecessor, Breit, had been granted a two-year extension. Semmelweis’s application for an extension was supported by Josef Škoda and Carl von Rokitansky and by most of the medical faculty, but Klein chose Braun for the position. Semmelweis was obliged to leave the obstetrical clinic when his term expired on March 20, 1849.
The day his term expired, Semmelweis petitioned the Viennese authorities to be made docent of obstetrics. A docent was a private lecturer who taught students and who had access to some university facilities. At first, because of Klein’s opposition, Semmelweis’s petition was denied. He reapplied, but had to wait until October 10, 1850 (more than 18 months) before finally being appointed docent of theoretical obstetrics. The terms refused him access to cadavers and limited him to teaching students by using leather-fabricated mannequins only. A few days after being notified of his appointment, Semmelweis left Vienna abruptly and returned to Pest. It appears that he left without so much as saying good-bye to his former friends and colleagues, a move that may have offended them. According to his own account, he left Vienna because he was "unable to endure further frustrations in dealing with the Viennese medical establishment".
Life in Budapest
During 1848–1849 some troops from the Habsburg-ruled Austrian Empire thwarted the Hungarian independence movement, executed or imprisoned its leaders and in the process destroyed parts of Pest. It seems likely that Semmelweis, upon arriving from the Habsburg Vienna in 1850, was not warmly welcomed in Pest.
On May 20, 1851 Semmelweis took the relatively insignificant, unpaid, honorary head-physician position of the obstetric ward of Pest’s small St. Rochus Hospital. He held that position for six years, until June 1857. Childbed fever was rampant at the clinic; at a visit in 1850, just after returning to Pest, Semmelweis found one fresh corpse, another patient in severe agony, and four others seriously ill with the disease. After taking over in 1851, Semmelweis virtually eliminated the disease. During 1851–1855 only 8 patients died from childbed fever out of 933 births (0.85%).
Despite the impressive results, Semmelweis’s ideas were not accepted by the other obstetricians in Budapest. The professor of obstetrics at the University of Pest, Ede Flórián Birly, never adopted Semmelweis’s methods. He continued to believe that puerperal fever was due to uncleanliness of the bowel. Therefore, extensive purging was the preferred treatment.
After Birly died in 1854, Semmelweis applied for the position. So did Carl Braun — Semmelweis’s nemesis and successor as Johann Klein’s assistant in Vienna — and Braun received more votes from his Hungarian colleagues than Semmelweis did. Semmelweis was eventually appointed in 1855, but only because the Viennese authorities overruled the wishes of the Hungarians, as Braun did not speak Hungarian. As professor of obstetrics, Semmelweis instituted chlorine washings at the University of Pest maternity clinic. Once again, the results were impressive.
Semmelweis declined an offer in 1857 to become professor of obstetrics at the University of Zurich. The same year, Semmelweis married Maria Weidenhoffer (1837–1910), nineteen years his junior and the daughter of a successful merchant in Pest. They had five children: a son who died shortly after birth, a daughter who died at the age of 4 months, another son who committed suicide at age 23 (possibly due to gambling debts), another daughter who would remain unmarried, and a third daughter who would have children of her own.
Response by the medical community
One of the first to respond to Semmelweis’s 1848 communications was James Young Simpson who wrote a stinging letter. Simpson surmised that the English obstetrical literature must be totally unknown in Vienna, or Semmelweis would have known that the English had long regarded childbed fever as contagious and would have employed chlorine washing to protect against it.