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Semmelweis, Ignaz Phillip

fever puerperal died mortality

[ zem elviys] (1818–65) Hungarian physician: pioneer in treatment of sepsis.

Semmelweis graduated in medicine in Vienna in 1844 and stayed there to specialize in obstetrics, working under J Klein in the General Hospital’s obstetric wards. There 10–30% of the women died from puerperal (childbirth) fever. Semmelweis studied the records and found that, in the clinic staffed by medical students, the mortality due to the fever was three times that in the clinic staffed by midwives. He also noted that the mortality had risen since Klein’s appointment as head of the unit. Then, when a colleague died in 1847 from a scalpel wound made in a post-mortem dissection, Semmelweis noted that his illness was closely similar to puerperal fever. He deduced that something was conveyed on the hands of the medical staff from the dissecting rooms to the patients. By insisting that they washed their hands in disinfectant, Semmelweis reduced the mortality to 1%. However, his success produced opposition rather than imitation; discouraged and persecuted he returned to his native Buda in 1850 and a few years later became insane. He died from a septic finger infection of the same kind as his colleague in Vienna in 1847. Only after success in antiseptic surgery, in the 1870s, did antiseptic procedures in midwifery become widespread.

Puerperal fever was due to a streptococcal infection, but this was not fully understood until the 1880s. Strangely, the advance in obstetrics could have been made much earlier; the procedures to avoid the fever had been proposed by A Gordon (1752–99) of Aberdeen in 1795 and by the literary anatomist Oliver Wendell Holmes (1809–94) of Harvard in 1843, but the former was largely ignored and the latter abused.

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