Lindsey Fitzharris, a medical historian, penned a article in the March 2020 Wall Street Journal entitled “The Unsung Pioneer of Hand-Washing” that described a 19th Century physician’s effort to convince the medical society of his day that germs were the cause of the death from what was called childbed or puerperal fever. “It’s difficult to feel any sense of optimism during the Covid-19 pandemic”, Fitzharris wrote, “but one source of encouragement is that simple soap and water can be a powerful defense.” Ignaz Semmelweis, a Hungarian physician, who was working in the maternity department of the Vienna General Hospital in the 1840s discovered what he thought was the cause for the high death rate among postpartum patients.
“The idea that the squalid conditions in the hospitals played a role in spreading infection didn’t cross many doctors’ minds”, Lindsey noted. The Vienna Hospital in 1846 had two obstetrical clinics – one overseen by medical students and the other under the care of midwives. Semmelweis, then in his late 20s, noted that the clinic overseen by medical students had a mortality rate of 10% compared to a rate of 4% for the clinic overseen by midwives. He did not accept the explanation that the marked difference in mortality rates was attributed to the fact that the medical students “handled patients more roughly”. He was also disturbed that the so-called “street births” had a comparative zero percent mortality rate.
In 1847, Semmelweis had a breakthrough. One of his colleagues became ill after cutting his hand during an autopsy examination. The symptoms were similar to those in puerperal infection. At the time, doctors did not wear gloves when delivering babies or performing cadaver examination. Semmelweis required that doctors wash their hands in a solution of chlorinated lime (calcium hpochlorite) prior to treating patients. “In April 1847, the mortality rate for new mothers on the students’ clinic was 18.3%. After hand-washing was instituted in
May, it fell to just over 2%.” The results were compelling, but Semmelweis was unable to convince his colleagues. In 1861, he ‘lashed out” at his critics who he called “murderers”. He was thought to have become mentally ill and was confined in a mental hospital where he sustained an injury that became infected. Ironically, he died from the infection in 1865. It was not until the 1880s “that pioneers of germ theory such as Louis Pasteur, Joseph Lister and Robert Koch proved to the world that disease really could be transmitted by microscopic particles, leading to a revolution in sanitary practices……If any positive change comes from the pandemic, it may be that hand-washing will at last become as universal as Semmelweis hoped”, Fitzharris noted.
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