Ignaz Philipp Semmelweis (July 1, 1818 –
August 13, 1865; also
Ignac Semmelweis, born
Semmelweis Ignác Fülöp), was a
Hungarian physician described as the
"savior of mothers", who discovered by 1847 that the
incidence of
puerperal fever could be drastically cut by
use of
hand
washing standards in
obstetrical
clinics. Puerperal fever (or
childbed fever) was common in
mid-19th-century hospitals and often
fatal, with mortality at 10%–35%.
Semmelweis postulated the theory of
washing with "chlorinated lime
solutions" in 1847 while working in Vienna General Hospital
's First Obstetrical Clinic, where doctors' wards
had three times the mortality of midwives'
wards. He published a book of his findings in childbed fever
in
Etiology,
Concept and Prophylaxis of Childbed Fever.
Despite various publications of results where hand-washing reduced
mortality below 1%, Semmelweis' practice only earned widespread
acceptance years after his death, when
Louis Pasteur confirmed the
germ theory. In 1865, a nervous
breakdown (or possibly
Alzheimer's) landed him in an
asylum, where Semmelweis died of
injuries, at age 47.
Family and early life

Terézia Müller and József Semmelweis,
the parents of Ignaz Semmelweis

Ignác Semmelweis as a child in
1830
Ignaz
Semmelweis was born on July 1, 1818 in Tabán
, a sector of
what is now Budapest
.
It was
then part of the Habsburg empire, now
Hungary
. He
was the fifth child out of ten of a prosperous
grocer family of József and Terézia Müller
Semmelweis. The family was
German-speaking and perhaps Jewish.
His
father, József Semmelweis (1778–1846), was born in Kismarton
, Kingdom of Hungary, Habsburg monarchy (today Eisenstadt
, Austria
).
József
achieved permission to set up shop in Buda in 1806 and, in the same
year, opened a wholesale business with spices and general consumer
goods named zum Weißen Elephanten (the White Elephant) in
Heindl-Haus in Tabán
(today a
museum). By 1810, he was a wealthy man when he married
Terézia Müller, daughter of the famous vehicle builder
Fülöp Müller.
Semmelweis
began studying law at the University of
Vienna
in the autumn of 1837, but by the following year,
for reasons that are no longer known, he had changed to
medicine. He was awarded his doctorate degree in medicine in
1844. After failing to obtain an appointment in a clinic for
internal medicine, Semmelweis decided to specialize in obstetrics.
Some of his teachers included
Carl von Rokitansky,
Josef Skoda and
Ferdinand von Hebra.
Discovery of cadaverous poisoning
Semmelweis
was appointed assistant to Professor Klein in the First Obstetrical Clinic
of the Vienna General Hospital
on July 1, 1846. A comparable position today
would be head resident. His duties were, amongst others, to examine
patients each morning in preparation for the professor's rounds,
supervise difficult deliveries and teach obstetrical students. He
was also responsible for the clerical records.
Maternity institutions were set up all over Europe to address
problems of
infanticide of
"illegitimate" children. They were set up as gratis institutions
and offered to care for the infants, which made them attractive to
underprivileged women, including prostitutes. In return for the
free services, the women would subject themselves to the training
of doctors and midwives. There were two maternity clinics at the
Viennese hospital. The
First Clinic had an average
maternal mortality rate due to puerperal fever of
about 10% (
actual
rates fluctuated wildly). The
Second Clinic's rate was
considerably lower, averaging less than 4%. This fact was known
outside the hospital. The two clinics admitted on alternate days
but women begged to be admitted to the Second Clinic due to the bad
reputation of the First Clinic. Semmelweis described desperate
women begging on their knees not to be admitted to the First
Clinic. Some women even preferred to give birth in the streets,
pretending to have given sudden birth
en route to the
hospital (a practice known as
street births), which meant
they would still qualify for the child care benefits without having
been admitted to the clinic. Semmelweis was puzzled that puerperal
fever was rare amongst women giving street births. "To me, it
appeared logical that patients who experienced street births would
become ill at least as frequently as those who delivered in the
clinic. [...] What protected those who delivered outside the clinic
from these destructive unknown endemic influences?"
Semmelweis was severely troubled and literally sickened that his
First Clinic had a much higher mortality rate due to puerperal
fever than the Second Clinic. It "made me so miserable that life
seemed worthless". The two clinics used almost the same techniques,
and Semmelweis started a meticulous work eliminating all possible
differences, even including religious practices. The only major
difference was the individuals who worked there. The First Clinic
was the teaching service for medical students, while the Second
Clinic had been selected in 1841 for the instruction of midwives
only.
Data for more
years]] are available.)
| |
First
clinic |
|
Second
clinic |
| Year |
Births |
Deaths |
Rate (%) |
|
Births |
Deaths |
Rate (%) |
| 1841 |
3,036 |
237 |
7.8 |
|
2,442 |
86 |
3.5 |
| 1842 |
3,287 |
518 |
15.8 |
|
2,659 |
202 |
7.6 |
| 1843 |
3,060 |
274 |
9.0 |
|
2,739 |
164 |
6.0 |
| 1844 |
3,157 |
260 |
8.2 |
|
2,956 |
68 |
2.3 |
| 1845 |
3,492 |
241 |
6.9 |
|
3,241 |
66 |
2.0 |
| 1846 |
4,010 |
459 |
11.4 |
|
3,754 |
105 |
2.8 |
He excluded "overcrowding" as a cause because the Second Clinic was
always more crowded as stated above but the mortality was lower. He
eliminated climate as a cause because the climate was not
different, and so on. The breakthrough for Ignaz Semmelweis
occurred in 1847 following the death of his good friend
Jakob Kolletschka who had been
accidentally poked with a student's scalpel while performing a
postmortem examination. Kolletschka's own
autopsy showed a
pathological situation similar to that of the
women who were dying from puerperal fever. Semmelweis immediately
proposed a connection between
cadaveric
contamination and puerperal fever.
He concluded that he and the medical students carried "cadaverous
particles" on their hands from the autopsy room to the patients
they examined in the First Obstetrical Clinic. This explained why
the student
midwives in the Second Clinic
who were not engaged in autopsies and had no contact with corpses
experienced a much lower mortality rate. There were still
opportunities for midwives to contaminate their hands,
however.
The
germ theory of disease
had not yet been developed at the time. Thus, Semmelweis concluded
that some unknown "cadaverous material" caused childbed fever. He
instituted a policy of using a solution of
chlorinated lime (modern
calcium hypochlorite, the compound used
in today's common household chlorine bleach solution) for washing
hands between autopsy work and the examination of patients. He did
this because he found that this chlorinated solution worked best to
remove the putrid smell of infected autopsy tissue, and thus
perhaps destroying the causal "poisonous" or contaminating
"cadaveric" agent hypothetically being transmitted by this
material.
The result was that the mortality rate dropped ten-fold, comparable
to the Second Clinic's. The mortality rate in April 1847 was 18.3%;
after handwashing was instituted in mid-May, the rates in June were
2.2% July 1.2 %, August 1.9% and, for the first time since the
introduction of anatomical orientation, the death rate was zero in
two months in the year following this discovery.
Efforts to reduce childbed fever
Semmelweis discovered that cases of
puerperal fever, a form of
septicaemia also known as
childbed
fever, could be cut drastically if doctors
washed their hands in a
chlorine solution before gynaecological examinations, but did not
explain why, as his discovery was prior to the 1864 germ theory of
Louis Pasteur.
While
employed as assistant to the professor of the maternity clinic at
the Vienna General Hospital
in Austria
in 1847,
Semmelweis introduced hand washing with chlorinated lime solutions for interns
who had performed autopsies. This immediately reduced the
incidence of fatal puerperal fever from about 10 percent (range
5–30 percent) to about 1–2 percent. At the time, diseases were
attributed to many different and unrelated causes. Each case was
considered unique, just like a human person is unique. Semmelweis'
hypothesis, that there was only one cause, that all that mattered
was cleanliness, was extreme at the time, and was largely ignored,
rejected or ridiculed. He was dismissed from the hospital (for
politics of the 1848 rebellion) and harassed by the medical
community in Vienna, which eventually forced him to move to
Pest.
Semmelweis was outraged by the indifference of the medical
profession and began writing open and increasingly angry letters to
prominent European obstetricians, at times denouncing them as
irresponsible murderers. His contemporaries, including his wife,
believed he was losing his mind, and in 1865 he was committed to an
asylum. In an ironic twist of
fate, he died there of
septicaemia only
14 days later, possibly after being severely beaten by guards.
Semmelweis' practice only earned widespread acceptance years after
his death, when
Louis Pasteur
developed the
germ theory of
disease which offered a theoretical explanation for Semmelweis'
findings. He is considered a pioneer of antiseptic
procedures.
Conflict with established medical opinions
Semmelweis' observations conflicted with the established scientific
and medical opinions of the time. The theory of
diseases was highly influenced by ideas of an
imbalance of the basic "
four humours"
in the body, a theory known as
dyscrasia,
for which the main treatment was
bloodlettings. Medical texts at the time
emphasized that each case of disease was unique, the result of a
personal imbalance, and the main difficulty of the medical
profession was to establish precisely each patient's unique
situation, case by case.
The findings from autopsies of deceased women also showed a
confusing multitude of various physical signs, which emphasised the
belief that puerperal fever was not one, but many different, yet
unidentified, diseases. Semmmelweis' main finding—that all
instances of puerperal fever could be traced back to only one
single cause: lack of cleanliness—was simply unacceptable. His
findings also ran against the conventional wisdom that diseases
spread in the form of "bad air", also known as
miasmas or vaguely as "unfavourable
atmospheric-cosmic-terrestrial influences". Semmelweis'
groundbreaking idea—that harmful infectious particles could sit in
minuscule amounts on fingers—was contrary to all established
medical understanding.
As a result, his ideas were rejected by the medical community.
Other more subtle factors may also have played a role. Some
doctors, for instance, were offended at the suggestion that they
should wash their hands; they felt that their social status as
gentlemen was inconsistent with the idea that their hands could be
unclean.
Specifically, Semmelweis' claims were thought to lack scientific
basis, since he could offer no acceptable explanation for his
findings. Such a scientific explanation was made possible only some
decades later when the
germ theory of
disease was developed by
Louis
Pasteur,
Joseph
Lister, and others.
During 1848 Ignaz Semmelweis widened the scope of his washing
protocol to include all instruments coming in contact with patients
in labor, and used mortality-rate
time
series to document his success in virtually eliminating
puerperal fever from the hospital ward.
Hesitant publication of results and first signs of trouble
Toward the end of 1847, accounts of Semmelweis's work began to
spread around Europe. Semmelweis and his students wrote letters to
the directors of several prominent maternity clinics describing
their recent observations.
Ferdinand von Hebra, the editor
of a leading Austrian medical journal, announced Semmelweis's
discovery in the December 1847 and April 1848 issues of the medical
journal. Hebra claimed that Semmelweis's work had a practical
significance comparable to that of
Edward
Jenner's introduction of cowpox inoculations to prevent
smallpox.
In late 1848, one of Semmelweis' former students wrote a lecture
explaining Semmelweis' work. The lecture was presented before the
Royal Medical and Surgical Society in London and a review published
in
The Lancet, a prominent
medical journal. A few months later, another of Semmelweis's former
students published a similar essay in a French periodical.
As accounts of the dramatic reduction in mortality rates in Vienna
were being circulated throughout Europe, Semmelweis had reason to
expect that the chlorine washings would be widely adopted, saving
tens of thousands of lives. Early responses to his work also gave
clear signs of coming trouble, however. Some physicians had clearly
misinterpreted his claims.
James
Young Simpson, for instance, saw no difference between
Semmelweis' groundbreaking findings and the British idea suggested
by
Oliver Wendell Holmes
in 1843 that childbed fever was contagious (i.e. that infected
persons could pass the infection to others). Indeed, initial
responses to Semmelweis' findings were that
he had said nothing
new.
In fact, Semmelweis was warning against all decaying organic
matter—not just against a specific contagion that originated from
victims of childbed fever themselves. This misunderstanding, and
others like it, occurred partly because Semmelweis's work was known
only through secondhand reports written by his colleagues and
students. At this crucial stage, Semmelweis himself published
nothing. These and similar misinterpretations would continue to
cloud discussions of his work throughout the century.
Some accounts emphasise that Semmelweis refused to communicate his
method officially to the learned circles of Vienna, nor was he
eager to explain it on paper.
Political turmoil and dismissal from the Vienna hospital
In 1848
a series of tumultous
revolutions swept across Europe. The resulting political
turmoil would affect Semmelweis' career. In Vienna on March 13,
1848, students demonstrated in favor of increased civil rights,
including trial by jury and freedom of expression. The
demonstration was led by medical students and young faculty members
and were joined by workers from the suburbs.
Two days later in
Hungary, demonstrations and uprisings led to the Hungarian Revolution of 1848
and a full scale war against the ruling Habsburgs of the Austrian
Empire
. In Vienna, the March demonstration was
followed by months of general unrest.
There is no evidence that Semmelweis was personally involved in the
events of 1848. It is known that some of his brothers were punished
for active participation in the Hungarian independence movement,
and it seems likely that the Hungarian born Semmelweis was
sympathetic to the cause. Semmelweis's superior, professor
Johann Klein, is described as a conservative
Austrian, likely at unease with the independence movements and at
alarmed with the other
revolutions of 1848 in
the Habsburg areas. It seems likely that Klein mistrusted
Semmelweis.
When Semmelweis' term was about to expire
Carl Braun also applied for the
position of
assistant in the First Clinic, possibly at
Klein's own invitation. Semmelweis and Braun were the only two
applicants for the post. Semmelweis's predecessor,
Breit, had been granted a
two-year extension Semmelweis's application for an extension was
supported by
Josef Škoda and
Carl von Rokitansky and
by most of the medical faculty. But Klein chose Braun for the
position. Semmelweis was obliged to leave the obstetrical clinic
when his term expired on 20 March 1849.
The day his term expired, Semmelweis petitioned the Viennese
authorities to be made
docent of
obstetrics. A docent was a private lecturer who taught students and
who had access to some university facilities. At first, because of
Klein's opposition, Semmelweis's petition was denied. He reapplied,
but had to wait until October 10, 1850 (almost years) before
finally being appointed docent of
theoretical obstetrics .
The terms refused him access to cadavers and limited him to
teaching students by using leather fabricated
mannequins only. A few days after being notified
of his appointment, Semmelweis left Vienna abruptly and returned to
Pest. It appears that he left without so much as saying good-bye to
his former friends and colleagues, a move which may have offended
them. According to his own account, he left Vienna because he was
"unable to endure further frustrations in dealing with the Viennese
medical establishment".
Life in Pest-Buda

Wedding portraits of Ignaz Semmelweis
and Mária Weidenhoffer (1857)
During
1848–1849 some troops from the Habsburg-ruled Austrian
Empire
thwarted the Hungarian
independence movement, executed or imprisoned its leaders and
in the process destroyed parts of Pest
. It
seems likely that Semmelweis, upon arriving from the Habsburg
Vienna in 1850, was not warmly welcomed in Pest.
On May 20, 1851 Semmelweis took the relatively insignificant
position of unpaid, honorary head physician of the obstetric ward
of Pest's small St. Rochus Hospital. He held that position for six
years, until June 1857. Childbed fever was rampant at the clinic;
at a visit in 1850, just after returning to Pest, Semmelweis found
one fresh corpse, another patient in severe agony, and four others
seriously ill with the disease. After taking over in 1851,
Semmelweis virtually eliminated the disease. During 1851–1855 only
8 patients died from childbed fever out of 933 births
(0.85%).
Despite the impressive results, Semmelweis's ideas were not
accepted by the other obstetricians in Budapest. The professor of
obstetrics at the University of Pest,
Ede Flórián Birly, never adopted
Semmelweis' methods. He continued to believe that puerperal fever
was due to uncleanliness of the bowel. Therefore, extensive purges
was the preferred treatment.
After professor Birly died in 1854, Semmelweis applied for the
position. So did
Carl
Braun—Semmelweis' nemesis and successor as
Johann Klein's assistant in Vienna—and Braun
received more votes from his Hungarian colleagues than Semmelweis
did. Semmelweis was eventually appointed in 1855, but only because
the Viennese authorities overruled the wishes of the Hungarians
because Braun did not speak Hungarian. As professor of obstetrics,
Semmelweis instituted chlorine washings at the University of Pest
maternity clinic. Once again he attained impressive results.
Semmelweis turned down an offer in 1857 to
become professor of obstetrics at the University of Zurich
. The same year, Semmelweis married Mária
Weidenhoffer (1837–1910), nineteen years his younger and the
daughter of a successful merchant in Pest
. They had five children: a son who died
shortly after birth, a daughter who died at the age of 4 months,
another son who committed suicide at age 23 (possibly due to
gambling debts), another daughter who would remain unmarried, and a
third daughter who would have children of her own.
Response by the medical community

Semmelweis' main work:
Die
Ätiologie, der Begriff und die Prophylaxis des
Kindbettfiebers, 1861 (front page)
One of the first to respond to Semmelweis' 1848 communications was
James Young Simpson who wrote a
stinging letter. Simpson surmised that the English obstetrical
literature must be totally unknown in Vienna, otherwise Semmelweis
would have known that the English have long regarded childbed fever
as contagious and would have employed chlorine washings to protect
against it.
Semmelweis's views were much more favorably received in England
than on the continent, but he was more often cited than understood.
The English consistently regarded Semmelweis as having supported
their theory of contagion. A typical example was W. Tyler Smith who
claimed that Semmelweis "made out very conclusively" that "
miasms derived from the dissecting room will excite
puerperal disease."
In 1856, Semmelweis' assistant József Fleischer reported the
successful results of handwashings at St. Rochus and Pest maternity
institutions in the Viennese Medical Weekly (
Wiener Medizinische
Wochenschrift). The editor remarked sarcastically that it
was time people stopped being misled about the theory of chlorine
washings.
In 1858 Semmelweis finally published his own account of his work in
an essay entitled, "The Etiology of Childbed Fever". Two years
later he published a second essay, "The Difference in Opinion
between Myself and the English Physicians regarding Childbed
Fever". In 1861, Semmelweis finally published his main work
Die
Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers
(German for
The Etiology, Concept and Prophylaxis of Childbed
Fever).
In his 1861 book, Semmelweis lamented the slow adoption of his
ideas: "Most medical lecture halls continue to resound with
lectures on epidemic childbed fever and with discourses against my
theories. […] The
medical
literature for the last twelve years continues to swell with
reports of puerperal epidemics, and in 1854 in Vienna, the
birthplace of my theory, 400 maternity patients died from childbed
fever. In published medical works my teachings are either ignored
or attacked. The medical faculty at Würzburg awarded a prize to a
monograph written in 1859 in which my teachings were
rejected".
In Berlin, the professor of obstetrics,
Joseph Hermann Schmidt, approved of
obstetrical students having ready access to morgues in which they
could spend time while waiting for the labor process.
In a textbook,
Carl Braun,
Semmelweis's successor as assistant in the first clinic, identified
30 causes of childbed fever; only the 28th of these was cadaverous
infection. Other causes included conception and pregnancy, uremia,
pressure exerted on adjacent organs by the shrinking uterus,
emotional traumata, mistakes in diet, chilling, and atmospheric
epidemic influences. The impact of Braun's views are clearly
visible in the
rising mortality rates in the 1850s.
Ede Flórián Birly,
Semmelweis' predecessor as Professor of Obstetrics at the
University of Pest, never accepted Semmelweis' teachings; he
continued to believe that puerperal fever was due to uncleanliness
of the bowel.
August Breisky, an obstetrician in
Prague, rejected Semmelweis's book as "naive" and he referred to it
as "the Koran of puerperal theology". Breisky objected that
Semmelweis had not proved that puerperal fever and
pyemia are identical, and he insisted that other
factors beyond decaying organic matter certainly had to be included
in the
etiology of the disease.
Carl Edvard Marius Levy,
head of the Copenhagen maternity hospital and an outspoken critic
of Semmelweis' ideas, had reservations concerning the unspecific
nature of cadaverous particles and that the supposed quantities
were unreasonably small. "If Dr. Semmelweis had limited his opinion
regarding infections from corpses to
puerperal corpses, I
would have been less disposed to denial than I am. […] And, with
due respect for the cleanliness of the Viennese students, it seems
improbable that enough infective matter or vapor could be secluded
around the fingernails to kill a patient." In fact,
Robert Koch later used precisely this fact to
prove that various infecting materials contained living organisms
which could reproduce in the human body, i.e. that since the poison
could be neither chemical nor physical in operation, it must be
biological.
At a conference of German physicians and
natural scientists, most of the speakers
rejected his doctrine, including the celebrated
Rudolf Virchow, who was a scientist of the
highest authority of his time. Virchow’s great authority in medical
circles potently contributed to the lack of recognition of the
Semmelweis doctrine for a long time.
It has been contended that Semmelweis could have had an even
greater impact if he had managed to communicate his findings more
effectively and avoid antagonising the medical establishment, even
given the opposition from entrenched viewpoints.
Breakdown, death and oblivion

Semmelweis' 1862
Open Letter to
all Professors of Obstetrics
Beginning from 1861 Semmelweis suffered from various nervous
complaints. He suffered from severe depression and became
excessively absent minded. Paintings from 1857 to 1864 show a
progression of aging. He turned every conversation to the topic of
childbed fever.
After a number of unfavorable foreign reviews of his 1861 book,
Semmelweis lashed out against his critics in series of Open
Letters. They were addressed to various prominent European
obstetricians, including
Späth,
Scanzoni,
Siebold, and to "all
obstetricians". They were full of bitterness, desperation, fury,
and were "highly polemical and superlatively offensive" at times
denouncing his critics as irresponsible murderers or ignoramuses.
He also called upon Siebold to arrange a meeting of German
obstetricians somewhere in Germany to provide a forum for
discussions on puerperal fever where he would stay "until all have
been converted to his theory." The attacks undermined his
professional credibility.
In mid-1865, his public behaviour became irritating and
embarrassing to his associates. He also began to drink
immoderately; he spent progressively more time away from his
family, sometimes in the company of a prostitute; and his wife
noticed changes in his sexual behavior. On July 13, 1865 the
Semmelweis family visited friends, and during the visit
Semmelweis's behavior seemed particularly inappropriate.
It is impossible to appraise the nature of Semmelweis' disorder. It
may have been
Alzheimer's
disease, a form of
senile
dementia, which is associated with rapid aging. It may have
been third stage of
syphilis, a then-common
disease of obstetricians who examined thousands of women at gratis
institutions. Or it may have been emotional exhaustion from
overwork and stress.
In 1865
János Balassa wrote a
document referring Semmelweis to a mental institution. On July 30
Ferdinand von Hebra lured him,
under the pretense of visiting one of Hebra's "new Institutes", to
a Viennese insane asylum located in Lazarettgasse
(
Landes-Irren-anstalt in die Lazarettgasse). Semmelweis
surmised what was happening and tried to leave. He was severely
beaten by several guards, secured in a
straitjacket and confined to a darkened cell.
Apart from the straitjacket, treatments at the
mental institution included dousing with
cold water and administering
castor oil,
a
laxative. He died after two weeks, on
August 13, 1865, aged 47, from a
gangrenous
wound, possibly inflicted by the beating. The autopsy revealed
extensive internal injuries, the cause of death
pyemia—
blood
poisoning.
Semmelweis was buried in Vienna on August 15, 1865. Only a few
persons attended the services. A brief announcements of his death
was made in a few medical periodicals in Vienna and Budapest.
Although the rules of the Hungarian Association of Physicians and
Natural Scientists specified that a commemorative address be
delivered in honor of a member who had died in the preceding year,
there was no address for Semmelweis; his death was never even
mentioned.
János Diescher was appointed Semmelweis' successor at the Pest
University maternity clinic. Immediately mortality rates jumped
sixfold to six percent. But the physicians of Budapest said
nothing; there were no inquiries and no protests. Almost no
one—either in Vienna or in Budapest—seems to have been willing to
acknowledge Semmelweis's life and work.
His remains were transferred to Budapest in 1891. On October 11,
1964 they were transferred once more to the house in which he was
born.
The house is now a historical museum and library,
honoring Ignaz Semmelweis.
Legacy
Semmelweis' advice on chlorine washings was probably more
influential than he realized himself. Many doctors, particularly in
Germany, appeared quite willing to experiment with the practical
handwashing measures that he proposed, but virtually everyone
rejected his basic and ground-breaking theoretical innovation—that
the disease had only one cause, lack of cleanliness.
Professor Gustav Adolf Michaelis from a
maternity institution in Kiel
replied
positively to Semmelweis' suggestions—eventually he committed
suicide, however, because he felt responsible for the death of his
own cousin, whom he had examined after she gave birth.
Only belatedly did his observational evidence gain wide acceptance;
more than twenty years later,
Louis
Pasteur's work offered a
theoretical explanation for
Semmelweis' observations—the
germ
theory of disease. As such, the Semmelweis story is often used
in university courses with
epistemology
content, e.g. philosophy of science courses—demonstrating the
virtues of
empiricism or
positivism and providing a historical account of
which types of knowledge count as scientific (and thus accepted)
knowledge, and which do not. It is an irony that Semmelweis'
critics considered themselves positivists. They could not accept
his ideas of minuscule and largely invisible amounts of decaying
organic matter as a cause of every case of childbed fever. To them,
Semmelweis seemed to be reverting to the speculative theories of
earlier decades that were so repugnant to his positivist
contemporaries.
The so-called
Semmelweis reflex or
effect is a metaphor for a certain type of human behaviour
characterized by reflex-like rejection of new knowledge because it
contradicts entrenched norms, beliefs or paradigms—named after
Semmelweis whose perfectly reasonable hand-washing suggestions were
ridiculed and rejected by his contemporaries. There is some
uncertainty about the origin and generally accepted use of the
expression.
Other legacies of Semmelweis include:
- Semmelweis is now recognized as a pioneer of antiseptic policy
- Semmelweis
University, a university for medicine and health-related
disciplines (located in Budapest,
Hungary
), is named after Semmelweis; and
- The Semmelweis Orvostörténeti Múzeum (Semmelweis
Medical History Museum) is located in the former home of
Semmelweis
- The Semmelweis Klinik, a hospital for women located in Vienna,
Austria
- In 2008 Semmelweis was selected as the motif for an Austrian
commemorative
coin.
Film
Literature
- is the classic reference, in Latin print, not the orginal
Gothic print.
- Louis-Ferdinand
Céline completed his Ph. D. thesis on Semmelweis in 1924. It
was published as a fictionalised biography under the title La
Vie et l'œuvre de Philippe Ignace Semmelweis in 1936 (English:
The Life and Work of Semmelweis, tr. by Robert Allerton
Parker, Boston : Little, Brown and Company, 1937/The Life and
Work of Semmelweiss: A Fictional Biography, tr. by John
Harman, Atlas Press, 2008).
- Morton Thompson's 1949 novel
The Cry and the
Covenant is based on the life of Semmelweiss.
See also
Notes
- (references to Carter's foreword and notes indicated "*")
- Semmelweis Orvostörténeti Múzeum website
References
- (references to Carter's foreword and notes indicated "*")
- Semmelweis Orvostörténeti Múzeum website
}}
External links
- Sloan Science and Film / Short Films /
Semmelweis by Jim Berry 17 minutes
- Extracts from Semmelweis' 1861 book, The Etiology, Concept, and
Prophylaxis of Childbed Fever were published in the January 2008
edition of Social Medicine
- BMJ: Ignaz Semmelweis
- Catholic Encyclopedia entry
- Who Named it? Ignaz Philipp Semmelweis
- Tan S Y and Brown J Ignaz Philipp Semmelweis
- Caroline M De Costa, The contagiousness of childbed
fever : a short history of puerperal sepsis and its treatment, eMJA
The Medical Journal of Australia, MJA 2002 177 (11/12):
668–671
- review, The Fool of Pest, The New York Review of
Books, 51:3 (February 26, 2004)
- The
Semmelweis Society, an organization dedicated to protecting
physicians from "sham peer review"
- Semmelweis's first post-stamp, Hungary,
1932
- Pulse-Project Audio Lecture: Benedek Varga on “The Myth
and Cult of Ignaz Semmelweis: Constructing History of Science
during the 20th Century”