He paved the way for sterile doctrine

Ignaz Philipp Semmelweis was born in 1818, in Ofen, a small town on the banks of the Danube in a small family. In 1846, he was appointed to work at a hospital in the city of Vienna. Here, Semmelweis is always worried because the mortality rate of puerperal fever is too high and has kept a close eye on this phenomenon.

Spreading bacterial infections

In 325, Emperor Constantine thought that Christianity was the most humane religion of its time and convinced the Episcopal Council of Nicaea to build a facility to care for the sick for each city. It is possible that these are the first hospitals in the world but according to current standards are too backward. In these hospitals, patients are randomly placed in a patient's room, whether or not they have an infection. The contagious diseases infiltrate the disease chamber and infect many patients with other diseases. For surgical patients, it is less likely to avoid complications of surgical infection. Hand and tool disinfection is almost not set.

Until the 1800s, pollution in the hospital did not improve much. Water system, waste treatment system is very primitive and backward. Surgeons often clean tools on their own clothes. Rarely, bedding for patients is changed. Infection is rampant. In particular, in obstetrics and gynecology, during the reproductive period is a threat to the mother. At that time, there were only a few visionaries, aware of the correlation between contamination and disease.

In the late eighteenth and early nineteenth centuries, in many hospitals in Europe, the mortality rate of women was often very high, sometimes up to one third of births. They stepped into the delivery room with anxiety and anxiety and thought of death waiting for obsession. At that time, many infectious diseases were identified but it was not until Semmelweis proved that postpartum fever was due to infection.

Go find the truth

Alexandre Gordon was the first to identify risk factors for postpartum fever. Through his own survey of the postpartum fever epidemic in Aberdeen, Scotland, in 1793, he published a monograph discussing the puerperal fever epidemic in Aberdeen, in which he confirmed a physician was a contagious person. infection for pregnant women.

Next, Oliver Wendell Holmes, in a historical essay The transmission of postpartum fever published in 1843 also presents a similar concept. He affirmed that the disease would spread from one person to another and the physician happened to play a decisive role. Holmes's essay did not make a sound for the physicians at the time.

However, Ignaz Philipp Semmelweis, Hungarian obstetrician, confirmed that postpartum fever was caused by infection. He demonstrated that the maternal mortality rate would be significantly reduced if the hands were immersed in calcium chloride solution before delivery. Through close observation, he noted the difference between the two mortality rates of two obstetrics departments in the hospital. The first department is used to guide students. These students from the autopsy room do not wash their hands and go straight to the delivery room to practice. The death rate here is very high from 12-30%. Meanwhile, the second department only used to guide midwives, they did not participate in autopsy, the rate of women died or postpartum fever and only 3% died. He surmised that the cause of puerperal fever was caused by hands containing pathogens due to not washing the hands of doctors and medical students.

In 1847, a friend of Semmelweis, Dr. Kollestschka died of septicemia because a clumsy student injected a finger into his finger while slaughtering a woman who died of postpartum fever. From this fatal case report, an idea suddenly flashed in his mind. Unexpectedly strange: the sign of Dr. Kollestschka is like a sign of maternal death due to puerperal fever. Semmelweis is aware that postpartum fever is a septicemia and from the autopsy room, physicians and students have transmitted the disease to the mother. Thus, all is clear: contaminated hands cause postpartum fever.

Life ups and downs

In May 1847, Semmelweis put forward a positive measure: 'Anyone who looks at pregnant women, before going to the delivery room, must wash their hands with soap and soak their hands in chloride solution'. The death rate from infection decreases rapidly. In April, when this measure was not applied, the death rate was 18%. In July, after applying, the mortality rate was only 1%.

Semmelweis asked the doctors to wash their hands before
visit for pregnant women.(Photo: Corbis)

However, at that time, many people thought that it was too much to recommend hand washing between Semmelweis' patient contacts and no doctors would accept it. Even they do not admit, their unwashed hands are the cause of death for women. Some others argue that his research results are lacking scientific evidence. In 1849, he was fired from Vience Hospital and went to work in the Department of Obstetrics and Gynecology, Pest's St. Hospital. Rochus Hospital in Hungary. In 1850, he was forced to return to his homeland in pain and disappointment. 4 years later, he worked at St. Hospital. Rochus, Pest city, Hungary. Here, for 6 years, Semmelweis sought to prove the truth of his doctrine.

His idea was only accepted in a limited way. Although in other departments, the incidence of infection is still high, the postpartum fever gradually disappears in Semmelweis patients. His method of disinfection was a great success, preventing blood infection after postpartum fever. He not only disinfected the servants of the waiters but also disinfected both tools, syringes, gauze, even blankets and clothing. And the death rate is only 8. In 1856, he was promoted to professor at Pest Academy.

Until 1860, Vience Hospital still considered him a traitor, even though he himself worked at that hospital, who eradicated high fever mortality rates in newborns from 35/101 cases. died.

In 1861, Semmelweis published a monograph on Principles, concepts and prevention of postpartum fever. There, the etiology data and how to prevent puerperal fever are presented very clearly. Although this is a classic in medicine, it did not make a significant echo for the obstetricians in the world at that time.

Today, in Hungary, the Semminweis Museum, Semminweis Hospital is established. In Austria, Semminweis Obstetrics Hospital was established and he was credited with paving the way for the theory of sterility and the theory of hospital infections.