He asked doctors to wash their hands. It saved the mothers, and it cost him everything.
In 1840s Vienna, one of Europe's largest maternity hospitals had two wards, and the women of the city knew the difference. In the clinic run by midwives, about one mother in 37 died of childbed fever. In the clinic run by doctors and medical students, it was about one in nine. Women begged not to be admitted on the doctors' days; some gave birth in the street on the way rather than arrive in time.
A 28-year-old Hungarian assistant named Ignaz Semmelweis set out to find out why. His answer was that the doctors came straight from dissecting corpses to examining women in labour, carrying death on their hands. In May 1847 he put a basin of chlorinated lime at the door. Within months the death rate fell to the level of the midwives' ward. His colleagues' reply was to let his contract lapse.
From Buda to Döbling
The lifeline
1818
Born 1 July in Tabán, Buda, the son of a prosperous grocer
1846
Becomes assistant in Vienna's First Obstetrical Clinic, where mothers die at four times the rate next door
1847
Orders handwashing in chlorinated lime; deaths collapse within weeks
1849
His post is not renewed; he soon leaves Vienna for Pest
1861
Publishes his life's argument on childbed fever. It is largely dismissed
1865
Dies at 47 in a Vienna asylum of an infected wound, two weeks after being committed
By the numbers
The arithmetic of a basin
11.4%
Mothers who died in the doctors' clinic in 1846: 459 of 4,010 births
2.7%
The rate the same year in the midwives' clinic next door: 105 of 3,754
1.27%
The doctors' clinic in 1848, the first full year of handwashing
0.85%
Maternal deaths on his unpaid ward at St Rochus Hospital, Pest, 1851–57
First Clinic, Vienna · maternal deaths by month, 1847
April
18.3%
May
12.2%
June
2.2%
July
1.2%
August
1.9%
Chlorine handwashing began in mid-May 1847. Figures from Semmelweis's own tables (1861).
What he found, and what he did
The work
1846
The two clinics, compared. Same hospital, same intake on alternating days. He ruled out crowding, climate, diet and "miasma" one by one: the only real difference was who did the examining.
1847
A colleague's death. His friend Jakob Kolletschka, a professor of forensic medicine, was nicked by a student's scalpel during an autopsy and died of an illness Semmelweis recognised as the same one killing the mothers.
1847
The basin of chlorinated lime. He chose chlorine because it removed the smell of the dissecting room from his hands, and reasoned that it would remove whatever caused the smell as well. From mid-May, every examiner washed in it.
1851–57
St Rochus Hospital, Pest. As unpaid honorary head of its maternity ward, he brought childbed-fever deaths below 1%.
1855
Professor of obstetrics at the University of Pest, where he applied the same rules to its clinic.
1861
Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers, his book on the cause and prevention of childbed fever, followed by furious open letters calling his opponents murderers.
Ignored, then vindicated
Recognition
In his lifetime
His Vienna assistantship was not renewed in 1849
He was offered a lecturer's post limited to teaching on mannequins, and left Vienna within days
Leading obstetricians and the pathologist Rudolf Virchow rejected his theory
He had no germ theory to explain why it worked, and published his full case only 14 years later
Today
Pasteur's and Lister's work in the 1860s supplied the explanation he lacked
Budapest's medical university has carried his name since 1969
Hungary marks its Day of Health Care on his birthday, 1 July
UNESCO added his documents to its Memory of the World register in 2013
The "Semmelweis reflex" now names the habit of rejecting evidence that upsets established belief
The place that made him
Tabán, Buda
He grew up in a German-speaking family in the old riverside quarter below Buda Castle, above his father's grocery. The house he was born in, on what is now Apród utca, is today the Semmelweis Museum of Medical History, and since 1964 his remains have rested in its garden.
5th
of ten children born to József Semmelweis, grocer
1873
The year Buda, Pest and Óbuda were united as Budapest
1930s
Most of the old Tabán was cleared; his birth house survived
"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 from the lying-in hospitals."
— Ignaz Semmelweis, The Etiology of Childbed Fever (1861), trans. K. Codell Carter
