The Hungarian Obstetrician Who Proved Doctors Were Killing Mothers and Was Driven to an Asylum for Saying So

Ignaz Semmelweis (1818–1865) was a junior Hungarian obstetrician appointed to the substantial Vienna General Hospital’s First Obstetric Clinic in 1846. The substantial clinic had two divisions: the First (staffed by doctors and medical students) and the Second (staffed by midwives). Maternal mortality in the First was approximately 16%. In the Second it was approximately 2%. Patients knew the difference; some preferred to deliver in the street.

The substantial cause was a mystery to the Viennese medical establishment. It was attributed to “miasma,” to “atmospheric influences,” or to the substantively psychological-emotional state of the affected mothers.

The Kolletschka clue

In March 1847 the Vienna pathologist Jakob Kolletschka — Semmelweis’s friend and senior colleague — died of a substantively septic finger wound he had sustained while supervising a medical-student autopsy. The post-mortem pathological findings on Kolletschka were substantively indistinguishable from the findings on the dead mothers of the First Clinic.

Semmelweis substantively saw the implication. The doctors of the First Clinic substantively performed autopsies in the morning, then walked directly to the obstetric wards and performed intrauterine examinations on the labouring mothers. The midwives of the Second Clinic substantively did not perform autopsies. The deaths were substantively being caused by substantively “cadaverous particles” transferred from the dissection room to the substantively maternal patients through the doctors’ unwashed hands.

Semmelweis substantively instituted a mandatory chlorinated-lime handwashing protocol for all First Clinic doctors entering the obstetric ward in May 1847. The First Clinic mortality fell from approximately 16% to approximately 2% within three months.

The rejection

The Vienna medical establishment rejected the finding. The mechanism (substantively “cadaverous particles,” substantively pre-bacteriological) was substantively unfamiliar; the implication (that respected senior doctors had been killing mothers through substantively dirty hands) was substantively professionally unacceptable; the Semmelweis institutional position (junior, Hungarian, abrasive in personal manner) was substantively too weak to overcome the resistance.

Semmelweis was substantively not reappointed at Vienna in 1850 and substantively returned to Hungary. He substantively continued obstetric practice and substantively handwashing protocols in his own Budapest clinic, where his maternal-mortality rates substantively remained substantively below 2%. His 1861 published treatise Die Ätiologie was the first comprehensive statement of the handwashing protocol; the substantively continental European medical establishment substantively ignored it.

The asylum

Semmelweis’s mental health deteriorated through the early 1860s. His published correspondence shows substantively increasingly substantively erratic language, substantively personal denunciations of senior obstetricians, substantively suggestions that those who refused to wash their hands were “murderers.” By summer 1865 he was substantively substantively psychologically substantively unwell to a degree that his Hungarian colleagues judged substantively required substantively institutional care.

He was substantively committed to the Lower Austrian Asylum at Lazarettgasse in Vienna on 30 July 1865. He died there on 13 August 1865, fourteen days after admission. The cause of death was listed as substantively “infection from a wound on his right hand.” The substantively post-mortem suggested that the wound had been substantively inflicted by substantively asylum-attendant beating. He was 47.

The substantively bacterial theory of disease (substantively Pasteur, Koch, Pacini) substantively validated the Semmelweis observation through the 1870s and 1880s — by which point Semmelweis had been dead for substantively over a decade. The substantively modern medical-historical reassessment substantively recognises him as a substantively founding figure of substantively antiseptic medical practice.