Pictures from the Past of the Healing Arts / Orvostörténeti Közlemények – Supplementum 18-19. (Budapest, 2000)

Semmelweis's Birthplace - the Home of the Museum

Some authors are of the opinion that the role of Kolletschka's death in Semmelweis discovery is too romantic. Since Semmelweis himself refers to this at several times when reporting on his discovery, it should be accepted nevertheless, because it seems more reasonable to believe the truth of his own words than the 'critical' observations of his late biographers. Nobody questions the significance of the Vienna School in Semmclweis's discovery, the fact that it had provided him with the indispensable scientific background, searching and examining spirit. But it does not contradict after all, to the fact that the last impression, the last association, the genius glimmer of knowledge was due to the death of his friend. Eventually, Semmelweis concluded that the infectious material which caused cadaver fever caused also puerperal fever and that the causes were in both cases one and the same: i.e. lthe cadaver particles were introduced into the blood-vascular system.'' And they were taken over by the examining physicians and medical students themselves who did post-mortem examinations and were constantly dealing with cadavers. The cadaverous matter could not be removed from the doctors' hands merely by washing them with soap and water — as the peculiar smell which was retained also revealed it. Students in midwifery were not engaged in autopsies and this explained the sharp difference of mortality rates between the two clinics. A disinfectant was needed which could remove the 'cadaverous poison'. After experimenting with different chemicals, he chose chlorinated lime. In May 1847 Semmelweis prescribed ablutions with chlorinated lime water. He made it compulsory for all physicians, medical students and the nursing staff. This new measure produced amazing results: the maternal mortality rate was greatly reduced, in May it stood at 12.24% by June it had fallen to 2.38%, by July to 1.20%, and by August to 1.89 per cent. In October 1847 a patient was admitted in the First Clinic suffering from purulent uterine cancer. Eleven out of the twelve women who shared her sick-ward died. Semmelweis realized that not only cadaverous particles could produce puerperal fever but 'any pudric organic material' of the living organism. Consequently, he made chlorinated lime hand-wash compulsory also between each examinations. Next month another patient, suffering from carious knee-joint, infected her room-mates. It became clear that the infectious agent could be transferred to the patients not only by the putrid particle attached to the fingers of the doctors but it could also be delivered by 'atmospheric conditions' — as they called it — i.e. by foul air loaded with exhalations from putrefying animal matter, where the putrid material could easily find its way through the air to the genitalia of other patients lying in the room. The exact execution of chlorinated lime hand-wash resulted in a great reduction in the mortality rate, in the 1st Clinic it was 1.27%, in the 2nd Clinic 1.33%. In March and August 1848 nobody died in the clinics. Each theory that had been intended to explain the causes of puerperal fever were done away with and the Semmelweis-doctrine was born. He clearly defined the aetiology of the disease and the ways and means for its prevention which is nothing else than asepsis, the prophylaxis of infection. This simple truth, however, proved for many not to be easily ac20