Ignaz Semmelweis: Medical pioneer persecuted for telling the truth

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In 19th century Europe, it was very dangerous for a woman to give birth, with mortality rates in European hospitals ranging as high as 25–30 percent.1

Ignaz
Ignaz Semmelweis

It was safer to give birth at home with a private doctor or midwife, or even to deliver the baby in the street! Why were hospitals of the time so dangerous for women? One of the main culprits was puerperal (or childbed) fever.2 Ignaz Philipp Semmelweis (1818–1865), was the medical doctor attributed with discovering the cause of puerperal fever and how to prevent it.

The problem tackled

Born Semmelweis Ignác Fülöp3 in what is now the Hungarian capital Budapest, he was educated at the universities of Pest and Vienna,4 and received a medical degree from the latter in 1844. In July 1846, he was appointed assistant to Johann Klein, professor of obstetrics at the Vienna General Hospital. Semmelweis immediately proceeded to investigate the cause of childbed fever—“over the strong objections of his chief, who, like other continental physicians had reconciled himself to the idea that the disease was unpreventable.”1

The First Division was staffed by male doctors and medical students, and the death rate from childbed fever there was several times higher than in the Second Division, where only female midwives were involved. “Why the difference?” wondered Semmelweis.

He ruled out possible causes such as overcrowding—the number of deliveries annually was about the same in each division, usually between 3,000 and 3,500.5 Also the climate was the same for both, likewise any supposed ‘bad air’.6 Different birthing positions, diet, and ventilation also all had no effect.

But there was one very important difference. Doctors in the First Division performed autopsies each morning on mothers who had died the previous day, and they then came directly from the dissecting room to the delivery room to attend to births. Midwives, who attended Second Division births, were excluded from the dissecting room. Semmelweis also noted that childbed fever was rare in women who gave birth away from the hospital, e.g. at home with the help of a midwife or private doctor, or even with self-delivery on the street.5 “How could these dissimilar events be significant?” he pondered. And, “Why did the babies of mothers who had died also frequently die of a similar fever, and have similar autopsy abnormalities?”

The problem solved

One day in March 1847, a colleague Semmelweis admired, Professor Jacob Kolletschka, was pricked in his finger with the scalpel a student was using in the autopsy of a woman who had died of puerperal fever. The wound became infected and he died. His own autopsy showed his “organs and tissues were filled with pus and abnormalities exactly like those common in women who had succumbed to puerperal fever, and sometimes in their infants.”7

Concerning this, Semmelweis wrote: “I brooded over the case with intense emotion, until suddenly … it became clear to me that childbed fever, the fatal sickness of the newborn and the disease of Professor Kolletschka were one and the same because they all consist pathologically of the same anatomic changes. If, therefore, in the case of Professor Kolletschka general sepsis [contamination of the blood] arose from the inoculation of cadaver particles, then puerperal fever must originate from the same source … the transmitting source of those cadaver particles was to be found in the hands of the students and attending physicians.”8

From May 1847, Semmelweis ordered all doctors and students in the First Division to wash their hands and brush their fingernails in a chlorine solution before they attended the mothers in the maternity ward. He didn’t know that the wash was actually killing germs; chlorine wash was simply the best way he knew of to remove the strong offensive odour of autopsy tissue from the doctor’s hands.

Ignaz-Semmelweis

The result was astounding: “During the last seven months of the year, only 56 women died, of the 1,841 delivered in the First Division.9 In 1848 … the First Division had a puerperal death rate of 1.2 percent, and the Second Division of 1.3 percent, virtually equal.”10

The solution rejected!

Congratulations all round? Well, not quite. Although the younger doctors supported him,1 Semmelweis’s conclusions contradicted the prevailing establishment belief that the disease was unpreventable. Furthermore, his solution implicated the doctors involved. If he was correct, then the doctors who assisted mothers giving birth without first decontaminating their hands were inadvertently responsible for those same mothers’ deaths.

Semmelweis’s theory that cleanliness was the key was therefore rejected and ridiculed by his older contemporaries. His position at the hospital expired in March 1849, and Prof. Klein refused to renew it. Frustrated, Semmelweis abruptly returned to Pest in 1850, and for the next six years was director of obstetrics at St Rochus Hospital there. His chlorine-water measures reduced the maternity mortality rate here to 0.85%.1 However, Vienna (where the deathrate was still 10 to 15%)1 remained hostile to him, and the editor of the Viennese Medical Weekly (Wiener Medizinische Wochenschrift) wrote that “it was time to stop the nonsense about chlorine hand wash.”1

Finally, in 1861, Semmelweis published his principal treatise on the cause and prevention of childbed fever.11 Unfortunately it was over 500 pages, mostly in convoluted prose, and was repetitive in parts, bombastic, accusatory, and thoroughly hard to read. Peer reviews were hostile. Embittered, he wrote scathing ‘open letters’ to his former professors, as well as to those in other countries, but to little effect.

A major objection was that Semmelweis could not produce a demonstrable cause for his conclusion. The Austrian medical establishment rejected his proposal of unobserved “minuscule and largely invisible amounts of decaying organic matter”. But this didn’t disprove that there really was a statistically proven phenomenon of transmissible fatal disease. The chlorine hand-wash did reduce maternal mortality, even though no one knew why at the time. It was unreasonable for them to reject the existence of the phenomenon just because a cause had not yet been discovered.

As time went by, Semmelweis became angrier, more dejected, and more stressed. In 1865, he was detained in a mental hospital against his will. When he tried to leave, he was severely beaten by the guards, bound in a straitjacket, and imprisoned in a darkened cell. Two weeks later, at the age of 47, he died from a septic wound, probably caused by the beating.12

Semmelweis vindicated

Shortly thereafter, Louis Pasteur confirmed the existence of microorganisms. This offered a theoretical explanation of Semmelweis’s observations; his ‘cadaverous particles’ were in fact bacteria. Sir Joseph Lister, Bt., ‘the father of modern surgery’, learning of Pasteur’s work, began applying antiseptic procedures to the practice of surgery, resulting in a dramatic fall in post-operative deaths from infection. Lister’s ideas, too, were greeted with skepticism and it took nearly 30 years for ‘Listerism’, or antiseptic surgery, to become accepted medical practice.13 Lister himself acknowledged: “Without Semmelweis my achievements would be nothing. To this great son of Hungary Surgery owes most.”14

After so many years of rejection and opposition, Semmelweis is today recognized for his enormous discovery. The Semmelweis University in Budapest is named after him, as are the Semmelweis Medical History Museum located in his former home, the Semmelweis Hospital in Miskolc, Hungary, and the Semmelweis Clinic for Women in Vienna. His image appears on the 1968 Hungarian 50 Forint gold coin (for the 150th anniversary of his birth) and on the stamps of several countries.

IS-coin
Hungary 1968 150th Anniversary—Semmelweis 50 Forint gold coin

The Semmelweis reflex

The Semmelweis reflex is the informal name coined for the tendency of people to deny new evidence or knowledge that contradicts established beliefs or their worldview. As Semmelweis experienced, long-held ideas can remain entrenched despite potent evidence to the contrary, and people can and do persecute those who challenge the consensus, even when the consensus is wrong.

There is a dramatic example of this phenomenon present in our modern culture. Today, the scientific establishment preaches an atheistic evolutionary worldview that is totally opposed to the biblical worldview that God created the earth and all life therein, and that He did it comparatively recently. Many who uphold the Bible’s worldview have experienced ridicule, and some have been retrenched from their jobs.15 Why? Not because of the validity of any alleged evidence for evolution, but because Bible-believing creationists challenge the ruling paradigm.

Today the evidence of design in the universe and in nature is powerful confirmation of the biblical worldview that God is and that He created the world.16 Nevertheless this is rejected by the scientific establishment, as geneticist Prof. Richard Lewontin has (in)famously said: “We take the side of science in spite of the patent absurdity of some of its constructs … in spite of the tolerance of the scientific community for unsubstantiated just-so stories, because we have a prior commitment, a commitment to materialism. … Moreover, that materialism is absolute, for we cannot allow a Divine Foot in the door.17(Emphasis added.)

Over the years, Creation magazine has published many hundreds of articles showing the truth of biblical creation, and the bankruptcy of atheistic evolution. The evidence is clear and unequivocal. We have everything to gain by putting our faith and trust in our Creator and Saviour.

Response from a reader:

I enjoyed reading about Ignaz Semmelweis in the last issue of Creation 38(2). Even though I have read his biography, there was more to learn.

In Numbers 19:11, 12 God gave instructions as to what to do after touching a dead body—a week being considered unclean, and a cleansing procedure. The instructions for washing after touching someone with a discharge (Leviticus 15) would also be appropriate. All this given about 1500 BC—well ahead of the medical practice current in Europe more than 3000 years later

While the Bible is not primarily a book on science, it is a 'correct' book, science included !

Theodore K. M.D.

Canada

References and notes

  1. Imre Zoltán, Ignaz Philipp Semmelweis, Encyclopaedia Britannica online, 16 July 2014. Return to text.
  2. Puerperal fever, also known as childbed fever or postpartum infection, is any bacterial infection of the female reproductive organs following childbirth or miscarriage, which begins shortly after delivery. Return to text.
  3. Hungarian names have the surname first, like Chinese and Japanese names. Return to text.
  4. Capital of Austria. Return to text.
  5. Nuland, S., The Doctors’ Plague, Norton & Co., New York, p. 97, 2003. Return to text.
  6. Or ‘miasma’, then thought to be a poisonous vapour that emanated from rotting vegetable matter, or even just from the earth. Return to text.
  7. Nuland, S., ref. 5, p. 98. Return to text.
  8. Nuland, S., ref. 5, pp. 99–100, being a translation from Semmelweis’s 1861 treatise (Ref. 11). Return to text.
  9. In October 1847, a woman with an ulcerating breast cancer was admitted to the First Division, and 11 of the 12 other patients there at that time died of puerperal fever. Another group of patients died in November after a woman with a knee infection was admitted. Nurses were the cause of transmitting infectious material. This, in fact, supported his new theory—whether the invisible particles came from a cadaver or some other source, “the cause of the disease was absorption of decomposed organic matter” (Nuland, S., ref. 5, p. 102). Return to text.
  10. Nuland, S., ref. 5, p. 101. Return to text.
  11. Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers; (The Etiology [cause], the Concept, and the Prophylaxis [prevention] of Childbed Fever). Return to text.
  12. Dr Sherwin Nuland gives details, ref. 5, p. 168. Return to text.
  13. In London in 1842, Prof. Thomas Watson had recommended chlorine washing “to prevent the medical practitioner becoming a vehicle of contagion and death between one patient and another.” The creationist physician James Simpson, famous for discovering anaesthesia, supported Semmelweis’s methods. Also, in America in 1843, Dr Oliver Wendell Holmes (father of the eugenicist Supreme Court Justice Oliver Wendell Holmes Jr.) recommended hand-washing and avoidance of autopsies in his essay, The Contagiousness of Puerperal Fever, for which he was ridiculed by his medical contemporaries. (See De Costa, C.M., “The contagiousness of childbed fever”: a short history of puerperal sepsis and its treatment, MJA 177: 668–71, 2/16 December 2002.) Return to text.
  14. Encyclopaedia Britannica 1961, Vol. 20, p. 318. Return to text.
  15. For details, see the DVD Expelled: No Intelligence Allowed; reviewed at creation.com/expelled. See also Bergman J, Slaughter of the Dissidents: The Shocking Truth About Killing the Careers of Darwin Doubters, Leafcutter Press, Southworth WA, USA, 2008; reviewed at creation.com/slaughter. Return to text.
  16. See Grigg, R., A brief history of design, Creation 22(2):50–53, 2000; creation.com/design-history. Return to text.
  17. Lewontin. R., Billions and Billions of Demons, New York Review of Books, p. 31, 9 January 1997; creation.com/lewontin. Note: Lewontin confuses science with naturalism. Return to text.

Readers’ comments

Anthony B.
Although unknown to humans at the time of Creation, micro-organisms must have existed and were probably created on the 5th and 6th days. Many microbes are beneficial and I think we can assume they all were, prior to the Fall when disease and death started following Adam and Eve’s sin.

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