Moment of insight followed by derision
Moment of insight followed by derision
Their own hands were the vehicle for disease’
Ignaz Semmelweis (1818-1865) pioneered hand hygiene in medicine when trying to control the spread of puerperal (childbed) fever caused by Streptococcus pyogenes. But his brilliant, radical insight that the lack of hand hygiene was causing patient infections was not well received. As one author puts it, "His colleagues greeted his paper with jeers and scathing attacks on his character. They simply refused to believe that their own hands were the vehicle for disease. Instead, they attributed it to a spontaneous phenomenon arising from the combustible’ nature of the [patient]. Semmelweis’s academic rank was lowered, his hospital privileges restricted. Despondent, he was committed to an insane asylum, where he died of blood poisoning, a disease not unlike the puerperal fever he had almost conquered."1
Semmelweis first got the idea when he saw another physician — Dr. Kolletschka, a professor of forensic science — sustain a scalpel cut while working on a cadaver. Here is an account of the discovery:
"Kolletschka died after an agonized illness during which he showed many of the symptoms of the childbed fever. The similarity of symptoms suddenly suggested a connection of autopsies and childbed fever. Although there was as yet no concept of the role of germs in infection, Semmelweis realized Kolletschka had died because cadaveric matter’ or death tissue’ had entered and poisoned’ his blood.
"The similarity of Kolletschka’s death and childbed fever suggested by analogy that perhaps the [maternity patients] also died from poisoning by cadaveric matter.’ If true, this theory would imply that the women must somehow be having contact with such matter; i.e., what we today would call infection.’ This prediction was confirmed when Semmelweis realized that he and the medical students carried the matter to the women on their hands. They would come to the maternity ward directly from the dissections in the autopsy room to examine women in labor after only washing superficially. Who would have thought hand washing was relevant to childbed fever?
"Semmelweis tested his idea further, reasoning that, if true, the theory implied that by chemically destroying the cadaveric matter in thorough washing, the deaths should decrease. He ordered a new hand washing procedure as an experiment. All medical students were instructed to wash with chlorinated lime before any examination. The fever deaths promptly declined."2
References
1. Achterberg J. Woman As Healer. Shambhala Publications Inc.: Boston; 1990.
2. Mannoia VJ. What is Science? An Introduction to the Structure and Methodology of Science. University Press of America: Washington, DC; 1980.
Ignaz Semmelweis (1818-1865) pioneered hand hygiene in medicine when trying to control the spread of puerperal (childbed) fever caused by Streptococcus pyogenes.Subscribe Now for Access
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