"The Engines of Our Ingenuity"
No. 622: Ignaz Philipp Semmelweis
Today, we meet an unrewarded hero of medicine. The University of Houston's College of Engineering presents this series about the machines that make our civilization run, and the people whose ingenuity created them.
In 1847 Dr. Ignaz Semmelweis's close friend, Jakob Kolletschka, cuts his finger while he's doing an autopsy. Kolletschka soon dies of symptoms like those of puerperal fever.
That gets Semmelweis's attention. Puerperal fever is killing 13 percent of the women who give birth in his hospital. The death rate is driving him nuts. He can't figure it out. A nearby obstetric hospital, run by midwives, loses only two percent of its patients to fever.
No one has connected germs with disease yet. The first hint of that connection will come from England six years later. Lister won't show us how to kill germs for another 18 years.
Semmelweis is a Hungarian doctor teaching medicine in Vienna. He notices that students move between the dissection room and the delivery room without washing their hands. On a hunch, he sets up a policy. Doctors must wash their hands in a chlorine solution when they leave the cadavers. Mortality from puerperal fever promptly drops to two percent.
Now things grow strange. Instead of reporting his success at a meeting, Semmelweis says nothing. Finally, a friend publishes two papers on the method. By now, Semmelweis has started washing medical instruments as well as hands.
As outside interest grows, we begin to understand Semmelweis's silence. The hospital director feels his leadership has been criticized. He's furious. He blocks Semmelweis's promotion. The situation gets worse. Viennese doctors turn on this Hungarian immigrant.
Finally, he goes back to Budapest. There he brings his methods to a far more primitive hospital. He cuts death by puerperal fever to less than one percent. He does more. He systematically isolates causes of death. He autopsies victims. He sets up control groups. He studies statistics.
Finally, in 1861, he writes a book on his methods. The establishment gives it poor reviews. Semmelweis grows angry and polemical. He hurts his own cause with rage and frustration.
In 1865 he suffers a mental breakdown. Friends commit him to a mental institution. There -- as though to close the circle on his brief 47-year life -- he cuts his finger. In days, he dies of the very infection that killed his friend Kolletschka and from which he's saved thousands of mothers.
That same year Joseph Lister begins spraying a carbolic acid solution during surgery to kill germs. In the end, it's Lister who gives our unhappy hero his due. He says, "Without Semmelweis, my achievements would be nothing."
I'm John Lienhard, at the University of Houston, where we're interested in the way inventive minds work.
Risse, G.B., Semmelweis, Ignaz Philipp. Dictionary of Scientific Biography (C.C. Gilespie, ed.).
New York: Charles Scribner's Sons, 1970-1980.
See also the Encyclopaedia Britannica article on Semmelweis.
For more on antiseptic technique, see Episode 74.
Especial agradecimento ao Dr. John H. Lienhard por autorizar a reprodução deste texto.