Ignaz Semmelweis


Ignaz Semmelweis : biography

July 1, 1818 – August 13, 1865

Semmelweis’s views were much more favorably received in England than on the continent, but he was more often cited than understood. The English consistently regarded Semmelweis as having supported their theory of contagion. A typical example was W. Tyler Smith, who claimed that Semmelweis "made out very conclusively" that "miasms derived from the dissecting room will excite puerperal disease."

In 1856, Semmelweis’s assistant Josef Fleischer reported the successful results of handwashings at St. Rochus and Pest maternity institutions in the Viennese Medical Weekly (Wiener Medizinische Wochenschrift). The editor remarked sarcastically that it was time people stopped being misled about the theory of chlorine washings.

In 1858 Semmelweis finally published his own account of his work in an essay entitled, "The Etiology of Childbed Fever". Two years later he published a second essay, "The Difference in Opinion between Myself and the English Physicians regarding Childbed Fever".{{#tag:ref|The article was originally published as: Ignaz Philipp Semmelweis, "A gyermekágyi láz fölötti véleménykülönbség köztem s az angol orvosok közt" Orvosi hetilap 4 (1860), 849–851, 873-76, 889–893, 913–915.|group = "Note"}} In 1861, Semmelweis finally published his main work Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers (German for The Etiology, Concept and Prophylaxis of Childbed Fever).

In his 1861 book, Semmelweis lamented the slow adoption of his ideas: "Most medical lecture halls continue to resound with lectures on epidemic childbed fever and with discourses against my theories. […] The medical literature for the last twelve years continues to swell with reports of puerperal epidemics, and in 1854 in Vienna, the birthplace of my theory, 400 maternity patients died from childbed fever. In published medical works my teachings are either ignored or attacked. The medical faculty at Würzburg awarded a prize to a monograph written in 1859 in which my teachings were rejected".

In Berlin, the professor of obstetrics, Joseph Hermann Schmidt, approved of obstetrical students having ready access to morgues in which they could spend time while waiting for the labor process.

In a textbook, Carl Braun, Semmelweis’s successor as assistant in the first clinic, identified 30 causes of childbed fever; only the 28th of these was cadaverous infection. Other causes included conception and pregnancy, uremia, pressure exerted on adjacent organs by the shrinking uterus, emotional traumata, mistakes in diet, chilling, and atmospheric epidemic influences. The impact of Braun’s views are clearly visible in the rising mortality rates in the 1850s.

Ede Flórián Birly, Semmelweis’s predecessor as Professor of Obstetrics at the University of Pest, never accepted Semmelweis’s teachings; he continued to believe that puerperal fever was due to uncleanliness of the bowel.

August Breisky, an obstetrician in Prague, rejected Semmelweis’s book as "naive" and he referred to it as "the Koran of puerperal theology". Breisky objected that Semmelweis had not proved that puerperal fever and pyemia are identical, and he insisted that other factors beyond decaying organic matter certainly had to be included in the etiology of the disease.

Carl Edvard Marius Levy, head of the Copenhagen maternity hospital and an outspoken critic of Semmelweis’s ideas, had reservations concerning the unspecific nature of cadaverous particles and that the supposed quantities were unreasonably small. "If Dr. Semmelweis had limited his opinion regarding infections from corpses to puerperal corpses, I would have been less disposed to denial than I am. […] And, with due respect for the cleanliness of the Viennese students, it seems improbable that enough infective matter or vapor could be secluded around the fingernails to kill a patient." In fact, Robert Koch later used precisely this fact to prove that various infecting materials contained living organisms which could reproduce in the human body, i.e. since the poison could be neither chemical nor physical in operation, it must be biological.