Germs, Childbed Fever, and the Strange Story of Semmelweis

An email about my recent post on physician cognitive dissonance mentioned the case of the doctor that was hounded out of the profession by his colleagues for mentioning that failure to wash hands before delivery of babies was killing the mothers. The Scottish physician Alexander Gordon noticed that childbed fever was caused by an infectious agent passed by physicians in his 1795 publication, A Treatise on Epidemic Puerperal Fever of Aberdeen. It was later that obstetrician Ignac Semmelweis noticed doctors going directly from the autopsy room to the delivery room without washing hands in 1847. He blew the whistle and brought the wrath of the profession down upon his head.

Surgeon, scholar, best-selling author, Sherwin B. Nuland tells the strange story of Ignac Semmelweis with urgency and the insight gained from his own studies and clinical eperience. Semmelweis is remembered for the now-commonplace notion othat doctors must wash their hands before examining patients. In mid-nineteenth-centery Vienna, however, this was a subversive idea. With deaths from childbed fever exploding, Semmelweis discovered that doctors themselves were spreading the disease. While his simple reforms worked immediately–childbed fever in Vienna all but disappeared–they brought down upon Semmelweis the wrath of the establishment, and led to his tragic end.

This story is not over. There are at least 90,000 deaths every year in the U.S. from hospital induced infection and the number is increasing as microbes become more resistant to antibiotics. Recent studies show only about half of physicians and nurses wash hands between patients. Some hospitals encourage their patients to ask physicians and nurses if hands have been washed before they allow the clinicial to touch them.

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