Ignác Semmelweis — Storied No. 008

In 1847 the First Obstetrical Clinic of the Vienna General Hospital was one of the largest maternity wards in the world, and one of the deadliest. In April of that year, more than eighteen of every hundred women admitted did not leave alive. The women knew it. Some begged to be sent to the second clinic across the corridor, staffed by midwives, where the death rate was a third as high. Some gave birth in the street rather than go in at all. The doctors blamed bad air, overcrowding, the temperament of the mother — anything but themselves.

Ignác Semmelweis, a twenty-eight-year-old Hungarian assistant, counted instead. The difference between the two wards, he found, was not the air and not the women: it was the doctors, who walked to the delivery bed straight from the autopsy table. He made them wash their hands in chlorinated lime. Deaths in his ward fell by more than nine tenths within three months. For this he was pushed out of Vienna, argued with for fourteen years, and died in an asylum outside the city of an infected wound — one day after Joseph Lister, in Glasgow, first dressed a patient's wound with carbolic acid and began the antiseptic era that proved him right.

Buda to Vienna to a locked ward

The lifeline

1818

Born 1 July in the Tabán quarter of Buda, sixth of ten children of a grocer

1846

Made assistant at Vienna's First Obstetrical Clinic, where one mother in nine had been dying

1847

A friend's death from an autopsy cut gives him the cause; in May he orders hands washed in chlorinated lime

1855

Professor of obstetrics at the University of Pest — respected at home, dismissed abroad

1861

Publishes his 500-page book of tables and proof; the profession largely ignores it

1865

Dies 13 August in an asylum near Vienna, aged 47, of the sepsis he spent his life fighting

By the numbers

What handwashing did

18.3%

Of mothers in his ward died in April 1847 — the month before he acted

1.2%

The rate that July, after every hand was scrubbed in chlorinated lime

14

Years he waited, arguing, before publishing the book that defended the finding

47

His age at death — two weeks after he was committed, from an infected wound

The evidence he assembled

The work

1846

He counted. Over 1841–46 the doctors' clinic lost about 9.9% of mothers; the midwives' clinic next door lost 3.6%. The same city, the same women, admitted on alternating days — and nearly three times the death rate on one side of the corridor.

March 1847

The cause. His friend Jakob Kolletschka was cut by a student's scalpel during an autopsy and died. The post-mortem findings matched, organ for organ, those of the dead mothers. Semmelweis concluded that "cadaverous particles" were being carried on physicians' hands.

May 1847

The intervention. He required every student and doctor to scrub in a chlorinated lime solution before examining a patient — chosen because it destroyed the smell of the dissecting room, the only test he had.

1848

The result. Annual mortality in the First Clinic fell from 11.4% in 1846 to 1.27% in 1848. In two separate months that year, not one mother in the ward died.

1851–57

He repeated it. Taking unpaid charge of the obstetric ward at St. Rochus Hospital in Pest, he drove maternal mortality there below one per cent.

1861

The book. Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers — more than 500 pages of statistics and argument. It was reviewed badly, or not at all.

Broken, then vindicated

Recognition

In his lifetime

His superior, Professor Johann Klein, declined to renew his appointment in 1849
He left Vienna for Pest in 1850 without telling his friends he was going
Leading physicians — Rudolf Virchow among them — rejected his explanation
His late open letters called colleagues murderers, and cost him the last of his allies
Committed to the Döbling asylum on 30 July 1865; he was restrained, and died a fortnight later

Today

Lister's antiseptic surgery (from 1865) and Pasteur's germ theory vindicated him within a generation
Hungary's principal medical university has carried his name since 1969
UNESCO entered his discovery documents on the Memory of the World Register in 2013
Hand hygiene is now the single most-promoted measure in global infection control
The "Semmelweis reflex" names the impulse to reject evidence that contradicts belief

The place that made him

Tabán, Buda

He was born above his father's grocery, "The White Elephant", in the Tabán — a crowded riverside quarter of Buda, then a separate city facing Pest across the Danube. He was German-speaking, wrote awkward German all his life, and was never quite at home in Vienna's medical world. In the 1960s his remains were brought back from Austria and laid in the courtyard of that birth house, which is now the Semmelweis Medical History Museum.

6 of 10

His place among the children of Josef Semmelweis, grocer

1837

The year he went to Vienna to read law — and switched to medicine instead

1873

Buda, Óbuda and Pest merge into Budapest, eight years after his death

"When I look back upon the past, I can only dispel the sadness which falls upon me by gazing into that happy future when the infection will be banished." — The Etiology of Childbed Fever, 1861