The medical pioneer Ignaz Philipp Semmelweis was one of mankind's great benefactors. He earned the epithet "saviour or mothers" for his discovery of the cause or "childbed fever", the septicemia which had plagued European maternity hospitals for many decades. He also opened a new era in medical science when he introduced antiseptic prophylaxis in obstetrics and surgery.
He was born on July 1,1818 in Buda, Hungary, a section of Budapest then almost entirely inhabited by German Hungarians, i. e. Danube Swabians. Ignaz was the fourth of the eight children of Therese, nee Müller, and her husband Joseph Semmelweis a prosperous wholesale merchant.
Although Ignaz had no particular liking or aptitude for the legal profession, he enrolled at the University of Pest law school. After two years at Pest he moved to Vienna to complete his law studies at the prestigious University of Vienna. The law books made dull reading and he detested the legal jargon. After attending a few trials he became convinced that the law was a sham, and that he was too honest and truthful to become a lawyer.
To collect his thoughts he went for a walk and chanced upon a group of students waiting to DC admitted to a medical facility of the university. Ignaz struck up a conversation with a friendly medical student who invited him to attend a lecture to be given by a renowned professor of anatomy. The professor positioned himself beside an operating table under a skylight in the middle of the room. When a white sheet was yanked off an object on the table it revealed the cadaver of a middle-aged male. Semmelweis was somewhat taken aback by this unexpected revelation, but he swallowed hard and was determined to stay, come what may.
With the scalpel glinting in his hand the professor began with the dissection of the cadaver. He opened with a few deft strokes of the scalpel, removed several organs, sectioned them expertly and explained their function. Semmelweis was entranced by the scientific and dignified manner of the presentation. The clarity and universality of the medical terms appealed to him. Time flew and he was a bit disappointed when the professor had finished.
Ignaz had made up his mind to become a physician. He rushed to the university medical office just before it closed for the day and enrolled as a medical student for the years 1836/37. With unbridled enthusiasm he sailed through medical school, passing both the written and verbal exams m March 1844.
Through the recommendation of his professors he obtained a position as provisional assistant to the head of obstetrics department at the Vienna General Hospital. This huge medical complex occupied a whole city block and was the largest and most comprehensive medical facility in the world at that time. In addition to the usual facilities it was also a renowned teaching hospital. It was opened in l7~ by Emperor Joseph II. At the instigation of his mother Empress Maria Theresia, who had borne 16 children herself, two wings of the hospital were maternity wards which provided free obstetrical services to indigent women and single mothers. The wings were known as the First and Second Divisions. They differed only in that the First Division provided practical experience for supervised medical students and the Second Division was devoted to the training of midwives.
Under its original director Dr. Lucas Boer, the First Division had won international acclaim in controlling a disease commonly known as "childbed fever". During Semmelweis' tenure at the hospital the First Division was headed by Dr. Johann Klein a pretentious authoritarian who allowed no deviation from his prescribed regimen, even though puerperal fever in his ward had reached epidemic proportions. in the worst month 40% of the patients had died of this disease. To help alleviate the situation Semmelweis tried to introduce some prophylactic procedures but was overruled by Dr. Klein who did not take kindly to suggestions from an assistant whom he considered to be his intellectual and social inferior. Semmelweis worked day and night in the lab to find an answer, but to no avail. The key to the mystery still eluded him.
When a colleague who had cut his finger while doing an autopsy on a septic case died, a post-mortem examination revealed that he - although a man - had died of the same disease that had killed so many women. Semmelweis who Had earlier believed that the disease had affected only new mothers Had a brainstorm at the funeral of this friend. He was certain that he had found the cause of puerperal fever. He theorized that septicemia was a form of blood poisoning caused by bacterium entering the birth passages of recently delivered mothers. He correctly concluded that the offending micro- organisms were conveyed to the unfortunate mothers by the very doctors who attended them.
According to Dr. Klein's syllabus medical students were required to perform autopsies and dissect septic material. They presumably washed their hands with soap and water which, however, did not kill the bacteria and when they entered the obstetrical ward to examine new mothers they literally carried death on their hands!
It was now clear why the death rate in the Second Division had always been so much lower than in the First - the midwives did not perform autopsies, and Dr. Boer had not allowed students to examine new mothers but had them practice on a so-called "phantom", a model of the female anatomy.
With the grudging consent of Dr. Klein Semmelweis introduced stringent hygienic measures to eradicate the disease. After experimenting with all the then known disinfectants he settled on chloride of lime as being the most effective. Before entering the ward every doctor and student had to wash up in a solution of chloride of lime. To make sure it was thorough Semmelweis introduced the use of a hand brush, a scrubbing-up procedure still practiced in hospitals around the world. All instruments had to be sterilized. Windows which had been closed for months because of Dr. Klein's fear of "miasma" bad air) were opened again and the ward got a thorough cleaning.
To Semmelweis' great satisfaction his antiseptic measures quickly produced positive results. In May of 1847 mortality in the ward still stood at 12.5%. But in June, the first full month that Semmelweis measures were in effect it had Sunk to 2,7%. In July it was only 1.7% and in August there were no deaths in the First Division.
Semmelweis invariably sided with the underdog. In 1848, the year revolutions broke out all over Europe, he enthusiastically joined the people of Vienna to protest against the oppressive laws then in effect. The revolution was put down by the military but because of his participation he became a marked man in ruling circles. When he applied for the position of obstetrical professor at the university, a position for which he was eminently qualified, he was rejected on the grounds that he was a disloyal subject. In 1849 when his contract with the General Hospital had run out, Dr. Klein made sure it was not renewed.
Disillusioned and angry, Semmelweis packed his instruments and personal belongings and went back to Budapest. Through the intercession of the kindly Dr. Florian Birly, a Danube Swabian from Hodschag in the rich agricultural county of Batschka, he obtained a position in the obstetrical department of St. Rochus Hospital. at that time the most renowned medical facility in east-central Europe. It didn't take long for Dr. Semmelweis' hygienic procedures to produce the desired results. The mortality rate dropped to almost nil and Dr. Birly was so ecstatic that he pressured the Hungarian Ministry of Health to direct all hospitals under its jurisdiction to implement Dr. Semmelweis principles of prophylaxis. This resulted in Hungarian hospitals having the lowest mortality rate in all of Europe. Semmelweis stature rose to new heights, but in the rest of Europe he was either ridiculed or ignored.
After Dr. Birly died Semmelweis became head of St. Rochus for a short time. When the Chair of Theoretical and Practical Obstetrics at the University of Pest became vacant, Semmelweis applied for it. Although by far the most qualified candidate for the position, some of his friends thought he would not get it because of his part in the revolution. So they petitioned Emperor Franz Josef to use his influence to install Dr. Ignaz Philipp Semmelweis as a professor at the University. Consequently he was named to the Chair of Obstetrics with an annual salary of 1300 Gulden to be increased every decade by 300 Gulden. Ignaz was overjoyed. Not only was he politically rehabilitated, he also received a salary that would give him a comfortable living for the rest of his life.
In 1857, at age 39, the balding professor fell in love with a vivacious 17 year old girl named Maria Weidenhöfer. When the couple announced their engagement the girl's mother was less than pleased on account of their age difference. However, when she saw how happy they were together she relented and gave them her blessing. She was no doubt more than a little flattered that her daughter would marry a respectable and renowned university professor. The couple wed on July 7, 1857 and eventually had five children.
Ten years after Semmelweis' discovery a medical conference took place in Paris in which eminent doctors expounded theories about the cause of septicimia which Semmelweis had long ago proven to be false. His use of chloride of lime was ridiculed as "belonging in a factory, not in a hospital".
A full account of the Paris conference was published in the Budapest newspapers. When Semmelweis learned how eminent obstetricians had maligned and ridiculed his work he was furious. He lashed out at what he called his "tormentors" with a vehemence that surprised his friends and shocked his enemies.
When his battle with entrenched conservatism got him nowhere, Semmelweis spent two years gathering data about his findings which he published in 1861 in a 384 page book entitled "Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers" (The Etiology, the Concept, and Prephylaxis of Puerperal Fever). It was a learned, scientifically detailed account of the disease and measures he introduced to control it. Even today it is still considered to be a classic of medical literature. However, probably due to his encroaching mental illness, he used the book to hurl further accusations at those who did not agree with him and thereby dulled the positive impact the book might have had in his lifetime.
Years of controversy had gradually eroded Semmelweis' mental stability. Carelessness with the scalpel - he had cut his finger while doing a dissection in front of the last class he taught at Pest, prompted the Board of Governors to suspend his activities at the University.
His wife, too, came to the sad conclusion that his mental condition was such that he had to be institutionalized. At an opportune moment when he was composed she suggested they visit a former colleague who was now the head of a mental hospital in Döbling, Austria, to which he agreed. While the women exchanged niceties over coffee, the friend suggested they visit his hospital.
Once safely inside the friend turned Semmelweis over to an assistant. When Semmelweis realized that he could not leave he became very abusive and had to be physically restrained. His mental condition worsened in the hospital and he also became physically ill. The cut on his finger festered, his temperature rose, he suffered from shaking chills, and he became weaker and weaker. Never one to yield, Semmelweis fought off the inevitable with every fiber in his body. Just as he had lost many a battle before, he lost this one too. Before the sun rose in the early hours of August 13, 1865, just two weeks after being hospitalized, the "Saviour of Mothers" was dead.
Fate had never been kind to Semmelweis The cause of his death was originally listed as "mania", but an autopsy revealed that he had died from the effects of septicemia. Ironically, the disease which he was determined to wipe out claimed him as one of its last victims.
In a simple ceremony, attended only by relatives and friends, Semmelweis was buried in the churchyard at Döbling. There, under an ancient weeping willow tree, in the silence of the grave, the misunderstood and often embattled champion of medical progress found peace at last