Remembering Ignaz Semmelweis, the first doctor to say ‘wash your hands’

From the 1870s, eventually, physicians began adopting the practice of handwashing with soap and water.

With the COVID-19 pandemic spreading across countries, one of the most important things recommended to protect oneself from the virus is washing hands.

Scrubbing hands with soap and water, one of the most effective methods to stop the spread of several illnesses, is universally recommended today; even considered common sense.

In the mid-19th century, however, when the spread of germs was considerably less understood, this advice was treated with scorn. The Hungarian physician Ignaz Semmelweis, who stressed this practice, faced years of ridicule from his peers, and died a tragic death.

Semmelweis and handwashing

In the 1840s, when Semmelweis was working at the Vienna General Hospital, most women gave birth at home. Only those from poorer backgrounds, or those with obstetrical complications, etc., would deliver at a hospital. The reason why the hospital was not preferred was the high rate of mortality due to childbed fever there, as high as 25-30 per cent.

While many believed that reasons such as poor ventilation and overcrowding were to blame, Semmelweis began his own investigation.

There were two separate maternity wards at the Vienna hospital– the first division staffed by male doctors and the second by female midwives. Semmelweis observed that women under care in the first division were dying from childbed fever at two or three times the rate of patients in the second division.

The doctor probed several hypotheses– women’s body positions during childbirth, embarrassment upon being examined by a male doctor, a fear of the priest who visited the ward– and ruled them all out.

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He then observed what he concluded to be the reason: in the first division, the male doctors and students would examine patients and deliver babies after performing autopsies in the morning. The midwives in the second division only worked there and had no other contact.

The death of a pathologist in the hospital convinced Semmelweis. Before his death, he had pricked his finger while performing an autopsy on a woman who had died from childbed fever. The pathologist showed symptoms of childbed disease, thus implying that other people in the hospital too could get sick from the illness.

Semmelweis concluded that the doctors who would come to the maternity ward directly from the dissecting room carried “cadaverous particles” from mothers who had died from childbed disease to healthy mothers, leading to infections and ultimately deaths.

In 1847, Semmelweis ordered the male doctors to wash their hands and instruments in a solution of chlorinated lime before examining healthy mothers in the maternity ward.

The results were phenomenal– mortality rates in the first division dropped from 18.27 to 1.27 per cent, and in March and August of 1848, not a single woman died.

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Hungarian physician Ignaz Semmelweis, who stressed this practice, faced years of ridicule from his peers, and died a tragic death (Source: Wikimedia Commons)

Rejection and death

Semmelweis began speaking about the virtues of hand washing, his novel technique flying in the face of accepted medical wisdom of the time. His peers rejected his logic, and many thought that Semmelweis’s theory blamed them for the deaths of their patients. The Vienna hospital abandoned handwashing, despite the reduction in the mortality rate.

The anguished doctor wrote open letters to the medical fraternity, and published his principal work in 1861 after returning to Hungary, but to no avail. After suffering a nervous breakdown in 1865, Semmelweis was admitted to a mental hospital, where he died.

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Handwashing is finally accepted

It was only two years after Semmelwies’s death that Joseph Lister, the pioneering surgeon, also began to encourage the idea of getting hands and instruments sanitised to stop the spread of infectious diseases.

From the 1870s, eventually, physicians began adopting the practice.

Semmelwies’s work also went on to provide the foundation for Louis Pasteur’s germ theory– the currently accepted scientific theory for many diseases.

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