The Ignaz effect

ignaz_semmel at work.jpg Next time you go into a hospital and come out alive this is the gentleman you should thank: Ignaz Semmelweis (1818-1865), a nineteenth century Hungarian doctor.

He discovered there was one cause to the unusually high rates of women dying from “childbed fever” or blood poisoning following childbirth—dirty hands.

At the Vienna hospital in which he worked, one maternity clinic had a 10% fatality rate following childbrith, another was less than 4%. Semmelweis wondered why.

Then a close friend was accidently cut by a student’s scalpel while performing a postmortem examination and died. A postmortem revealed the death was caused by a similar condition to the one that was killing mothers in the maternity ward.

Semmelweis saw the connection and concluded that it was contact with corpses that somehow was fatal to these women and to his friend. This was confirmed when he discovered that the ward with a 10% fatality was attended by medical students who had performed postmortems, while the ward with a 4% mortality was not.

Semmelweis began requiring hospital staff to wash their hands in chlorinated lime between autopsy work and examination of patients. The immediate result was a ten-fold drop in fatalities.

The response of the medical establishment was opposition to Semmelweis’ conclusions and recommendations. Their was no scientific theory to back up Semmelweis’ findings. The germ theory of disease was decades away from discovery.

When his term expired Semmelweis was not reappointed by the hospital. He left Vienna for Budapest humiliated and took up a relatively insignificant, unpaid position at a small hospital. Childbed fever was rampant there, under his supervision the hospital introduced hand washing and the disease was virtually eliminated.

His dramatic successes continued to be ridiculed and rejected by the medical establishment in Vienna and Budapest.

From 1861, he suffered from severe depression and became obsessed with the topic of childbed fever in every conversation. In 1865 his family lured him to a mental institution. When he tried to leave he was severely beaten by guards, put in a straightjacket, and locked in a dark cell. He died two weeks later from extensive internal injuries. The autopsy revealed blood poisoning—the same condition he had attempted to eliminate in maternity wards.

Semmelweis’ methods finally gained acceptance years after his death, when Louis Pasteur developed the germ theory of disease which provided the explanation for Semmelweis’ findings.

I wonder how many people are alive today because of his pioneering work?

The next post will have some reflections on what we can learn from Ignaz Semmelweis.