Ignaz Semmelweis

Ignaz Philipp Semmelweis (originally Ignác Fülöp Semmelweis) (July 1, 1818 - August 13, 1865) was the Hungarian-Austrian physician who demonstrated that puerperal fever (also known as "childbed fever") was contagious and that its incidence could be drastically reduced by enforcing appropriate hand-washing behavior by medical care-givers. He made this discovery in 1847 while head of the Maternity Department of the Vienna Lying-in Hospital.

Rejection by the medical establishment

Despite this dramatic result, Semmelweis refused to communicate his method officially to the learned circles of Vienna, nor was he eager to explain it on paper. Ferdinand von Hebra finally wrote two articles in his behalf but although foreign physicians and the leading members of the Viennese school were impressed by Semmelweis' apparent discovery the papers failed to generate widespread support. His observations went against the current scientific opinion of the time, which blamed diseases (among other quite odd causes) on an imbalance of the basic "humours" in the body. It was also argued that even if his findings were correct, washing one's hands each time before treating a pregnant woman, as Semmelweis advised, would be too much work. Nor were doctors eager to admit that they had caused so many deaths; indeed, they tended to claim that their profession was one divinely blessed and thus their hands could not be dirty.

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During 1848 Semmelweis widened the scope of his washing protocol to include all instruments coming in contact with patients in labor and he statistically documented success in virtually eliminating puerperal fever from the hospital ward, leading Skoda to attempt to create an official commission to investigate the results. The commission proposal was ultimately rejected by the Ministry of Education due to a political conflict in the university and government bureaucracies. Semmelweis was an active liberal, but a conservative movement gained power in 1848 and in 1849 he was fired from his position. Skoda delivered an address on the subject in the Imperial and Royal Academy of Sciences in October of 1849, but Semmelweis had neglected to correct his friends' papers to make known their mistakes in describing his work. Semmelweis was finally persuaded to present his findings personally in 1850 with some success. However, Semmelweis abruptly left Vienna later that year to return to Pest, apparently due to financial difficulties, without notifying even his closest friends. This hasty decision ruined his chances to overcome the Viennese sceptics.

Related Topics:
1848 - Imperial and Royal Academy of Sciences

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In Hungary, Semmelweis took charge of the maternity ward of Pest's St. Rochus Hospital from 1851 to 1857. His hand- and equipment-washing protocols reduced the mortality rate from puerperal fever to 0.85% there, and his ideas were soon accepted throughout Hungary. He married, had five children, and built a large private practice. He became chair of theoretical and practical midwifery at the University of Pest in July 1855. Semmelweis turned down an offer in 1857 to chair obstetrics in Zurich. Vienna remained quite hostile to him, however.

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In 1861 Semmelweis finally published his discovery in a book, Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers. A number of unfavorable foreign reviews of the book prompted Semmelweis to lash out against his critics in series of open letters written in 1861-1862, which did little to advance his ideas. At a conference of German physicians and natural scientists, most of the speakers rejected his doctrine. One of them was Rudolf Virchow.

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The establishment's failure to recognize his findings earlier led to the tragic and unnecessary death of thousands of young mothers, but he was ultimately vindicated. This case is sometimes put forward as an example of a situation where scientific progress was slowed down by the inertia of established professionals.

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