He eliminated climate as a cause because the climate was the same. Semmelweis immediately proposed a connection between cadaveric contamination and puerperal fever. This explained why the student midwives in the Second Clinic, who were not engaged in autopsies and had no contact with corpses, saw a much lower mortality rate. The germ theory of disease had not yet been accepted in Vienna.
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He soon became involved in the problem of puerperal infection, the scourge of maternity hospitals throughout Europe. Although most women delivered at home, those who had to seek hospitalization because of poverty, illegitimacy, or obstetrical complications faced mortality rates ranging as high as 25—30 percent.
Some thought that the infection was induced by overcrowding, poor ventilation, the onset of lactation, or miasma. Semmelweis proceeded to investigate its cause over the strong objections of his chief, who, like other continental physicians, had reconciled himself to the idea that the disease was unpreventable.
Semmelweis observed that, among women in the first division of the clinic, the death rate from childbed fever was two or three times as high as among those in the second division, although the two divisions were identical with the exception that students were taught in the first and midwives in the second. He put forward the thesis that perhaps the students carried something to the patients they examined during labour.
The death of a friend from a wound infection incurred during the examination of a woman who died of puerperal infection and the similarity of the findings in the two cases gave support to his reasoning. He concluded that students who came directly from the dissecting room to the maternity ward carried the infection from mothers who had died of the disease to healthy mothers.
He ordered the students to wash their hands in a solution of chlorinated lime before each examination. Under these procedures, the mortality rates in the first division dropped from His superior, on the other hand, was critical—not because he wanted to oppose him but because he failed to understand him.
Get exclusive access to content from our First Edition with your subscription. Subscribe today In the year a liberal political revolution swept Europe, and Semmelweis took part in the events in Vienna. After the revolution had been put down, Semmelweis found that his political activities had increased the obstacles to his professional work. In he was dropped from his post at the clinic. He then applied for a teaching post at the university in midwifery but was turned down.
He left Vienna and returned to Pest in He worked for the next six years at the St. Rochus Hospital in Pest. An epidemic of puerperal fever had broken out in the obstetrics department, and, at his request, Semmelweis was put in charge of the department. His measures promptly reduced the mortality rate, and in his years there it averaged only 0. In Prague and Vienna, meantime, the rate was still from 10 to 15 percent.
In he was appointed professor of obstetrics at the University of Pest. He married, had five children, and developed his private practice. His ideas were accepted in Hungary, and the government addressed a circular to all district authorities ordering the introduction of the prophylactic methods of Semmelweis.
Vienna remained hostile toward him, and the editor of the Wiener Medizinische Wochenschrift wrote that it was time to stop the nonsense about the chlorine hand wash. He sent it to all the prominent obstetricians and medical societies abroad, but the general reaction was adverse.
The weight of authority stood against his teachings. He addressed several open letters to professors of medicine in other countries, but to little effect. At a conference of German physicians and natural scientists, most of the speakers—including the pathologist Rudolf Virchow—rejected his doctrine.
The years of controversy gradually undermined his spirit. In he suffered a breakdown and was taken to a mental hospital, where he died. Ironically, his illness and death were caused by the infection of a wound on his right hand, apparently the result of an operation he had performed before being taken ill. He died of the same disease against which he had struggled all his professional life.
Ignaz Semmelweis, el pionero sanitario del lavado de manos