Ignaz Philipp Semmelweis[Note 1] (German: [ɪˈɡnaːts ˈzɛml̩vaɪs]; Hungarian: Semmelweis Ignác Fülöp; 1 July 1818 – 13 August 1865) was a Hungarian physician of ethnic-German ancestry,[2][3][4] now known as an early pioneer of antiseptic procedures. Described as the "saviour of mothers",[2] Semmelweis discovered that the incidence of puerperal fever (also known as "childbed fever") could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal. Semmelweis proposed the practice of washing hands with chlorinated lime solutions in 1847 while working in Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards.[5] He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.
Despite various publications of results where hand washing reduced mortality to below 1%, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community. Semmelweis could offer no acceptable scientific explanation for his findings, and some doctors were offended at the suggestion that they should wash their hands. Semmelweis's practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist's research, practiced and operated, using hygienic methods, with great success. In 1865, Semmelweis was committed to an asylum, where he died at age 47 of pyaemia, after being beaten by the guards, only 14 days after he was committed.
Beginning in 1861, Semmelweis suffered from various nervous complaints. He suffered from severe depression and became absentminded. Paintings from 1857 to 1864 show a progression of aging.[Note 13] He turned every conversation to the topic of childbed fever.
After a number of unfavorable foreign reviews of his 1861 book, Semmelweis lashed out against his critics in a series of Open Letters.[Note 14] They were addressed to various prominent European obstetricians, including Späth, Scanzoni, Siebold, and to "all obstetricians". They were full of bitterness, desperation, and fury and were "highly polemical and superlatively offensive",[8]:57 at times denouncing his critics as irresponsible murderers[11]:73 or ignoramuses.[8]:41 He also called upon Siebold to arrange a meeting of German obstetricians somewhere in Germany to provide a forum for discussions on puerperal fever, where he would stay "until all have been converted to his theory."[19]
In mid-1865, his public behaviour became irritating and embarrassing to his associates. He also began to drink immoderately; he spent progressively more time away from his family, sometimes in the company of a prostitute; and his wife noticed changes in his sexual behavior. On July 13, 1865, the Semmelweis family visited friends, and during the visit Semmelweis's behavior seemed particularly inappropriate.[11]:74
The exact nature of Semmelweis's affliction has been a subject of some debate. According to K Codell Carter, in his biography of Semmelweis, the exact nature of his affliction cannot be determined:
In 1865, János Balassa wrote a document referring Semmelweis to a mental institution. On July 30, Ferdinand Ritter von Hebra lured him, under the pretense of visiting one of Hebra's "new Institutes", to a Viennese insane asylum located in Lazarettgasse (Landes-Irren-Anstalt in der Lazarettgasse).[9]:293 Semmelweis surmised what was happening and tried to leave. He was severely beaten by several guards, secured in a straitjacket, and confined to a darkened cell. Apart from the straitjacket, treatments at the mental institution included dousing with cold water and administering castor oil, a laxative. He died after two weeks, on August 13, 1865, aged 47, from a gangrenous wound, possibly caused by the beating. The autopsy gave the cause of death as pyemia—blood poisoning.[11]:76–78
Semmelweis was buried in Vienna on August 15, 1865. Only a few people attended the service.[11]:78 Brief announcements of his death appeared in a few medical periodicals in Vienna and Budapest. Although the rules of the Hungarian Association of Physicians and Natural Scientists specified that a commemorative address be delivered in honor of a member who had died in the preceding year, there was no address for Semmelweis; his death was never even mentioned.[11]:79
János Diescher was appointed Semmelweis's successor at the Pest University maternity clinic. Immediately, mortality rates jumped sixfold to 6%, but the physicians of Budapest said nothing; there were no inquiries and no protests. Almost no one — either in Vienna or in Budapest — seems to have been willing to acknowledge Semmelweis's life and work.[11]:79
His remains were transferred to Budapest in 1891. On 11 October 1964, they were transferred once more to the house in which he was born. The house[24] is now a historical museum and library, honoring Ignaz Semmelweis.[8]:58
Legacy[редактиране на кода]
Semmelweis' advice on chlorine washings was probably more influential than he realized. Many doctors, particularly in Germany, appeared quite willing to experiment with the practical hand washing measures that he proposed, but virtually everyone rejected his basic and ground-breaking theoretical innovation — that the disease had only one cause, lack of cleanliness.[8]:48 Professor Gustav Adolf Michaelis from a maternity institution in Kiel replied positively to Semmelweis' suggestions — eventually he committed suicide, however, because he felt responsible for the death of his own cousin, whom he had examined after she gave birth.[8]:176–178
Only belatedly did his observational evidence gain wide acceptance; more than twenty years later, Louis Pasteur's work offered a theoretical explanation for Semmelweis' observations — the germ theory of disease. As such, the Semmelweis story is often used in university courses with epistemology content, e.g. philosophy of science courses—demonstrating the virtues of empiricism or positivism and providing a historical account of which types of knowledge count as scientific (and thus accepted) knowledge, and which do not. It has been seen as an irony that Semmelweis' critics considered themselves positivists, but even positivism suffers problems in the face of theories which seem magical or superstitious, such as the idea that "corpse particles" might turn a person into a corpse, with no causal mechanism being stipulated, after a simple contact. To his contemporaries, Semmelweis seemed to be reverting to the speculative theories of earlier decades that were so repugnant to his positivist contemporaries.[8]:45
The so-called Semmelweis reflex — a metaphor for a certain type of human behaviour characterized by reflex-like rejection of new knowledge because it contradicts entrenched norms, beliefs, or paradigms — is named after Semmelweis, whose ideas were ridiculed and rejected by his contemporaries.
Other legacies of Semmelweis include:
- Semmelweis is now recognized as a pioneer of antiseptic policy
- Semmelweis University, a university for medicine and health-related disciplines (located in Budapest, Hungary), is named after Semmelweis
- The Semmelweis Orvostörténeti Múzeum (Semmelweis Medical History Museum) is located in the former home of Semmelweis[24]
- The Semmelweis Klinik, a hospital for women located in Vienna, Austria
- The Semmelweis Hospital in Miskolc, Hungary
- In 2008, Semmelweis was selected as the motif for an Austrian commemorative coin.[25]
Films[редактиране на кода]
- That Mothers Might Live (1938), U.S.A., MGM, director: Fred Zinnemann, Oscar for the best short film
- Semmelweis (1940), Hungary, Mester Film, director: André de Toth
- Semmelweis — Retter der Mütter (1950), East Germany, DEFA, director: Georg C. Klaren
- Ignaz Semmelweis – Arzt der Frauen (1987), West Germany/Austria, ZDF/ORF, director: Michael Verhoeven
- Semmelweis (1994), the Netherlands, Humanistische Omroep Stichting, director: Floor Maas
- Docteur Semmelweis (1995), France/Poland, director: Roger Andrieux
- Semmelweis (2001 short film), U.S.A./Austria, Belvedere Film, director: Jim Berry
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