Ignaz Semmelweis, We Salute You

Although Ignaz Philipp Semmelweis is not a medicine maker, he introduced something that is crucial for all of us in life sciences and beyond: the importance of hand washing. 

Born in Budapest in 1818, the fifth child of wealthy German merchants, Semmelweis had what would have then been considered an almost ideal start to a life. But it ended just 47 years later in tragic irony.

At 19, Semmelweis was studying law in Vienna but quickly switched his academic focus to medicine. At 26 he was awarded his doctor of medicine degree and began to focus on obstetrics. At this time (the 1840s), mortality rates for women after childbirth were as high as 30 percent – mainly due to puerperal infection. According to the conventional wisdom of the day, this “childbed fever” was caused by “overcrowding, poor ventilation, the onset of lactation, or miasma.”

At a time when many leading physicians had resigned themselves to the idea that this illness was unpreventable, Semmelweiss – against the instructions of his mentor at Vienna’s obstetrics clinic, Johann Klein – began to investigate the possible causes, finding that the obstetrics students responsible for undertaking the autopsies of women who had died of puerperal infection had neglected to wash their hands before examining others. Semmelweiss then introduced the radical idea of washing one’s hands in a chlorinated lime solution between inspections.

His peers acknowledged the significance of such an act, although Klein was reluctant to join in. It was considered churlish of a junior – and non-Austrian – physician to assume that a gentleman doctor’s hands were “dirty.” Nevertheless, as a result of hand-washing, Semmelweiss managed to bring mortality rates down from a little over 18 percent to just over one percent.

Revolution in the air
 

The late 1840s saw numerous uprisings across Europe’s political landscape. Semmelweiss, for his part in such demonstrations, found it difficult to advance professionally because of his own beliefs. After being removed from his post at the clinic, he returned to Hungary to take a role at the St. Rochus Hospital, Budapest. An outbreak of puerperal fever hit the hospital hard but – serendipitously – Semmelweis assumed charge and managed to reduce mortality down to just 0.85 percent. Meanwhile, mortality rates of the same illness in Vienna had returned to in excess of 10 percent.

His fellow Hungarians were more accepting of his ideas and methods than his Austrian counterparts, and Semmelweis was thus promoted to Professor at the University of Pest, where he settled, married, and raised a family.

Tragedy and irony
 

In a worrying echo of the media influence we see against vaccinations today, Semmelweis became the target of misinformation. But, in this case, prominent journals decried his methods, while fellow medical professionals plagiarized his work to take credit for reduced mortality. The vehement retaliation of Semmelweis all but ostracized him from professional medical circles.

Semmelweis started to spend more and more time drinking and associating with prostitutes. Such sudden changes in behavior may nowadays be attributed to mental health conditions, such as depression, or the potential presence of cognitive diseases. Unfortunately for Semmelweis, this was 1865 and his conditions were dismissed simply as “madness,” and so he somehow found himself, either by force or coercion, in an asylum for the mentally ill. There, he was beaten, isolated, placed in a straightjacket, and force fed castor oil – a powerful laxative.

He died two weeks later from an infection in a wound sustained during the beating and the unsanitary conditions of his cell. The basic method he had devised to save the lives of many women could not save Semmelweis himself. 

Legacy
 

Popular culture has been moved by the story of Semmelweis, inspiring children’s books, movies, plays, a West End musical, and his very own Google Doodle.

Academically, Semmlweis has been honored with numerous statues, including one in the courtyard of the University of Vienna, one in the Queen Mary University of London, and one in the New York State Department of Health in Albany. 

Speaking in January 2019 at the unveiling of a statue in Semmelweis’ native Hungary, WHO Director Tedros Adhanom Ghebreyesus described him as a “hero” whose work “was based on carefully built evidence, showing that simple hand washing by health workers saves lives.” 

Remembered now with the posthumous accolade the “Savior of Mothers,” Ignaz 

Semmelweis, we salute you.
 

If you enjoyed this episode, please take a look at the first in the series – James Phipps, We Salute You, which was inspired by the 200-year anniversary of the death of vaccine pioneer Edward Jenner.