A Grim State of Affairs:
The year was 1846 and Vienna General Hospital had a complicated situation on their hands. The obstetrics ward was split in half, with one side being run by midwives, and the other by practicing physicians. A strange pattern began to develop; new mothers were dying left and right. Stranger still was the fact that the clinic run by the midwives had a death rate of about 2.7% while the physicians saw death rates as high as 11.4% in their patients. How could this be? Everyone was absolutely baffled by the occurrences because midwives had less training time and were thought to be without as much intelligence as men. Rumor spread that the physician’s ward was a clear death sentence, and as a result, women in labor would oftentimes attempt to hold their babies in, hoping that a space in the other wing of the hospital would become available.
(Blood and Guts: A History of Surgery)
What Was Killing Them:
On average, it was expected that about 1 in 5 new mothers would expire after birthing their offspring in the 19th century. What on earth was to blame for all of those untimely deaths? The culprit was non other than Puerperal fever (nicknamed childbed fever). Despite its nickname though, childbed fever could affect both men and women. This was a cruel infection that was often spread by bacteria getting past the inner surface of the uterus. After birth, the genital tract of the woman becomes swollen and stretched, and therefore, is more susceptible to infection. An infected woman would begin to develop a fever and would be troubled by strong abdominal cramps. Her uterus would remain swollen and blood and pus-riddled discharge would ooze from her vaginal opening. In most cases, blood poising would take effect and they would die from the shock. Death was slow and many women suffered for days on end. One of the most famous women to die from childbed fever was Mary Wollstonecraft, the British author and proto-feminist that wrote, A Vindication of the Rights of Women. She died in 1797, 11 days after giving birth to her daughter, Mary Shelly, the author of the dark classic, Frankenstein.
Semmelweiss’s Miraculous Observation:
In 1847, the 29 year old Ignaz Phillip Semmelweiss was appointed first assistant to the professor of the obstetrics ward in Vienna. He was horrified by the constant sight of suffering mothers and set out to find a solution to the hospital’s problem. He considered that perhaps women were dying from sheer fear of the doctors. Semmelweis even thought that their deaths could correlate with their modesty being diminished during examinations. With little accomplished, he became frustrated and took a minor vacation to clear his head. Upon his return, he received notice that his best friend, Jakob Kolletschka, accidentally got a cut on his hand during an autopsy and passed away a few days later. His symptoms, Semmelweiss noted, were incredibly similar to those that the women were facing when they contracted childbed fever. Suddenly, it all clicked! Physicians, unlike midwives, were permitted to conduct autopsies on the recently deceased in order to refine their skills and knowledge. Perhaps there was a correlation to the “dead matter”, as he put it, that doctors always had on their hands when dealing with their female patients. Semmelweiss, in his later publication, The Concept of Child-bed Fever, stated, “…I Maintain that Puerperal fever, without the exception of a single case, is a resorption fever produced by the resorption of decomposed animal matter.” Physicians would conduct autopsies and then, without washing their hands or their instruments, proceed to examine the females in labor. Unclean hands, bed-clothes, bedding and sponges, he thought, could all be harmful if they contained particles from dead bodies.
(Blood and Guts: A History of Surgery)
Ignaz Phillip Semmelweiss began insisting that everyone on his ward clean their hands, before seeing each patient, with chloride of lime. This chemical, as a form of comparison, is similar to the common household bleach that we use today. Death rates began to go down and the physician’s ward even had a lower death rate percentage than that of the midwives. Although his discovery seemed to speak for itself, his theory was heavily criticized. Doctors often complained that the chloride of lime would irritate their skin and people did not agree that clean hands were necessary. It was a status symbol for many physicians to flaunt the residue of a day’s work on their hands and aprons. Over the course of 15 years, Semmelweiss visited 3 different hospitals that were all suffering from deaths by Puerperal fever. His publication was ridiculed and, in many ways, he became an outcast in polite society. As time went on, his mental health began to decline and he spent his final days in a mental institution, where, ironically, he contracted and died from Puerperal fever. At the end of the day, everyone, and especially new mothers, owe Ignaz Phillip Semmelweiss a big thanks for his contribution to our understanding of infections and hospital cleanliness. His ability to solve the mystery at Vienna General Hospital has saved, and continues to save countless lives.
<If that didn’t make you thankful for modern medicine, then I don’t know what will!>
Until Next Time-
- Birth Story. “The Death of an Uncommon Woman.” Posted March 10, 2010. Accessed September 25, 2018. birthstory.net/tag/mary-wollstonecraft.
- Hollingham, Richard. Blood and Guts: A History of Surgery. New York: St. MArtin’s Press, 2008.
- Moore, Jonathan. Dreadful Diseases and Terrible Treatments: The Story of Medicine Through the Ages. Alabama: Sweet Water Press, 2017.
- “The Concept of Child-bed Fever.” In Source Book of Medical History. Notes by Logan Clendening, 607-610. New York: Dover Publications, 1942.