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Ignaz Semmelweis

Ignaz Semmelweis
Micro-organisms that cause infectious disease are called pathogens
Ignaz Semmelweis (1818-1865) was a Hungarian doctor who is nowadays recognised as a discoverer of the role of unseen micro-organisms in infection, and an early advocate of antiseptic procedures, including chemical disinfectants. As such, he addressed problems that existed in hospitals at the time, and established some principles that still need to be adhered to today.

At that time many women died at childbirth (of a condition known as "childbed fever"), and whilst working in Vienna General Hospital (in Austria), Semmelweis noted that there was a greater death rate in one section than another. The section with the worse record was visited by (male) doctors who regularly attended post-mortems (autopsies) of dead patients, whereas the other section was staffed by (female) nurses - midwives - who did not attend post-mortems.

The hospital kept records of numbers of patients, together with data concerning deaths. Interestingly there was little difference between the two sections before the division into male and female staffing.

When one of his colleagues died from an infection after accidentally cutting himself during a post-mortem, Semmelweis came up with the theory that infectious particles of some sort caused these diseases, and made the link with the differences described above. He advocated greater hygiene and the use of a bleach-like chemical solution for hand washing, and impressed this on all the staff working under him. In this way he achieved a noticeable reduction in deaths amongst hospital patients The same scale of improvement was repeated in other hospitals to which he later moved.

He eventually published his findings in a book in 1861 (see below) and a later a series of pamphlets or open letters, and embarked on a campaign to persuade others in the medical profession to adopt these procedures. However his approach was far from diplomatic, so he was not very successful in persuading others to follow his example.

His recommendations were not accepted by other doctors at the time, principally because at the time there was no evidence for the existence of disease-causing micro-organisms (bacteria, viruses, etc).

He made some professional enemies. Some considered that childbed fever was simply passed from mother to mother within the hospital - "contagion" - but refused to consider the possibility of poor hygiene amongst doctors, seeing it as an issue of social class. At the time there were many unscientific notions about the cause of disease, and some aspects of medical training were distinctly unhygienic.

When his health failed he was sent to a mental institution where he died soon after admission, possibly as a result of the rough physical treatment he received there. There is no evidence to support the statement in one recent textbook that he died from an infection picked up from a patient during an operation. In fact they are probably confusing him with his friend Jakob Kolletschka (mentioned above)

There is now a Semmelweis University, as well as several hospital clinics and museums named after him.

Developments after Semmelweis

A short time after the death of Semmelweis, Louis Pasteur showed the existence of bacteria and their role in some forms of disease, which came to be known as the germ theory. Robert Koch reinforced the cause and effect relationship between bacteria and disease. Joseph Lister introduced other forms of administering chemical compounds to reduce the spread of disease in operating theatres.

Much later Alexander Fleming, in conjunction with Howard Florey and Ernst Chase (and others) introduced a different class of chemical control using antibiotics which resulted in another level of reduction in disease. However this is more closely targetted on the bacteria causing disease and also paradoxically more subject to failure than antiseptic chemicals.

At about the same time other physicians had made links between surgical procedures and the spread of disease, but possibly they were less systematic in their use of antiseptic chemicals, and had less clear-cut information on which to base their theories. In 1843 in the USA, Oliver Wendell Holmes (senior) came to similar conclusions about childbed fever. This formed the basis of a storyline in a recent (fiction) book The Bone Garden by Tess Gerritsen.

Web links

Ignaz Semmelweis From Wikipedia, the free encyclopedia

Terms to explain

Read the wikipedia article (above) then try to explain the following:
savior of mothers
puerperal fever
obstetrical clinics
chlorinated lime solutions
Etiology, Concept and Prophylaxis of Childbed Fever.

Ignaz Semmelweis - Saviour of mothers - good readable article with data - and background to how science works.

Semmelweis and the aetiology of puerperal sepsis 160 years on: an historical review - a very comprehensive review with interesting graphics and quite a lot of detail about the comings and goings in the hospital in Vienna.

A 7-minute YouTube clip from BBC4

Some books

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