Ignaz Philipp Semmelweis

The Hungarian physician Ignaz Philipp Semmelweis (1818-1865) was a pioneer of antisepsis in obstetrics and demonstrated that many cases of puerperal fever could be prevented.

Ignaz Philipp Semmelweis, the son of a prosperous shopkeeper, was born on July 1, 1818, at Buda, a city united with Pest in 1873 to form Budapest. After 2 years at the University of Pest, 19-year-old Ignaz matriculated at the University of Vienna as a law student. Unhappy, he returned to the University of Pest and studied medicine (1838-1840). After completing further studies at the University of Vienna, he received a medical degree in April 1844. Following 4 months of special instruction in midwifery, Semmelweis became a provisionary assistant at the First Obstetric Clinic in the large Vienna Lying-In Hospital. Two years later he became a regular assistant to the director of this clinic.

Semmelweis was especially distressed by the horrors of puerperal fever. Within a few hours after delivery, numerous mothers would be afflicted with high fever, rapid pulse, distended abdomen, and excruciating pain. One out of 10 would die as a result of this infection. One observation haunted Semmelweis. The hospital was divided into two clinics: the first for the instruction of medical students, the second for the training of midwives. The mortality due to puerperal fever was significantly greater in the first clinic. Traditional ideas ascribed puerperal fever to epidemic influences; if this were true, both clinics should be equally affected. Overcrowding was suggested; yet the second clinic was ordinarily more crowded than the first. Semmelweis incessantly searched for a better understanding of his puzzling observations.

In 1847 Semmelweis's colleague J. Kolletschka unexpectedly died of an overwhelming infection following a wound he sustained while performing an autopsy. Semmelweis realized that the course of the disease in his friend was remarkably similar to the sequence of events in puerperal fever. Here was an explanation of the difference in mortality between the two clinics: the medical students and teachers dissected corpses, whereas the midwives did no autopsies. The teachers and pupils could thus carry infectious particles from the cadavers to the natural wounds of a woman in childbirth. Accordingly, teachers and students who had been dissecting were requested to wash their hands with a solution of chlorinated lime before examining the laboring patients. As a result, during 1848 the mortality of the first clinic was less than that of the second clinic.

Surprisingly, opposition to Semmelweis's observations was intense, for the paradox of being healer and murderer was intolerable for most. When confronted with Semmelweis's explanations, conscientious obstetricians pleaded "not guilty." Semmelweis could not understand these reactions. A few outstanding doctors supported him; nevertheless, the tide of controversy grew to such an extent that Semmelweis was "retired" from his position as assistant at the first clinic. In 1850 he left Vienna and returned to Budapest.

At the St. Rochus Hospital in Budapest, Semmelweis was allowed to introduce disinfection in the obstetrical division. In 1855 he became professor of theoretical and practical midwifery at the University of Pest. In 1857 he married. But the deaths of two children during the next few years added personal grief to professional suffering, a suffering that intensified as opposition to his ideas spread throughout Europe.

With much reluctance Semmelweis organized his observations and published his great work on puerperal fever, The Etiology, Concept, and Prophylaxis of Childbed Fever (1861). Even this did not silence his opponents, and Semmelweis, unable to accept this resistance, was committed to an insane asylum in 1865, where he died of blood poisoning. Not until 1883 did the Boston Lying-In Hospital introduce methods of antisepsis, methods similar to those used several decades earlier by Semmelweis.

Further Reading

• The most readable biography of Semmelweis is Frank G. Slaughter, Immortal Magyar: Semmelweis, Conqueror of Childbed Fever (1950). For greater detail, especially about the opposition to Semmelweis's views, see Sir William J. Sinclair, Semmelweis: His Life and His Doctrine (1909).
• Childbed fever: a scientific biography of Ignaz Semmelweis, Westport, Conn.: Greenwood Press, 1994.
• Slaughter, Frank G. (Frank Gill), Immortal Magyar: Semmelweis, conqueror of childbed fever, New York, Schuman, 1950.