Ignaz Semmelweis, savior of mothers

2012/04/01 Etxebeste Aduriz, Egoitz - Elhuyar Zientzia Iturria: Elhuyar aldizkaria

• Historia
• Medikuntza
• Biografiak

Before going to the first Clinic, many were expected to give birth on the street. The Obstetrics Service of the General Hospital of Vienna had two clinics. Depending on the day of the week, women who came to childbirth were treated alternately in one or the other. When the first Clinic was adequate, more than one of them began to steal from her knees to take her to the second. In fact, the First Clinic had a very bad reputation: it was open to the fact that many of the women who arrived there did not leave alive.

XIX. It was the middle of the twentieth century and puerperal fever was affecting intensely in hospital delivery rooms. It was a common disease for the doctors of the time and could not act against it.

But the Hungarian doctor Ignaz Semmelweis was concerned about the deaths caused by this disease. He was hired in 1846 as head of the First Semmelweis Clinic. And he began to investigate evil. His concern only increased when he compared data from two clinics over the past six years: The mortality rate in the Primary Clinic was 10% and in the Secondary Clinic of 3%. The idea that it was open on the street was not baladí.

And surprised, Semmelweis realized that the mortality was also much lower among those who left on the street. "For me, it would have been logical that the mortality rate of those who were leaving on the street was at least equal to that of the clinic," he wrote.

Deeply regretting the differences that could exist between the two clinics, he began to analyze if the climate was the same, using the same techniques, the same religious practices... The only difference between the two clinics was the people who worked in them: In the first Clinic were the medical students and the professors who were in charge of the deliveries, and in the second, the midwives.

But Semmelweiss saw no reason to explain the difference between mortality rates. Until in 1847 the unexpected death of his friend Dr. Kolletschka occurred. During the autopsy of a corpse, there was a wound with the step of a student and the infection that spread through it caused the death of septicemia (general infection of the blood).

Semmelweis analyzes the results of his friend's autopsy and, suddenly, he sees it clear: "Very depressed [by the death of my friend], I studied the case with obsession and emotion, until a thought passed me by the head; immediately I saw clearly that the puerperal fever and the death of Dr. Kolletschka were a death and the same, with the same pathological evolution. Therefore, in the case of Dr. Kolletschka.. the infection... if it comes from the inoculation of the particles of the corpses, the puerperal fever should come from the same source."

In fact, in the First Clinic, it was customary for students to practice with the bodies of the women who died the previous day in the morning, and in the afternoon, for women who were in the delivery rooms to be screened with the "smell of corpse in their hands". In the Secondary Clinic, midwives did not dissect the bodies. Thus, Semmelweis came to the conclusion that "the fingers and hands of students and doctors stained in dissections carried that deadly poison from the bodies to the sexual organs of women."

The measure to be taken was simple: wash your hands. Semmelweis knew that soap was not enough to remove this funeral smell and opted for calcium hypochlorite. At the entrance of the parting rooms he put sinks, as well as signs indicating: "Any student or doctor who accesses the delivery room for exams should wash their hands with a solution of calcium hypochlorite... From one examination to another, the hands are washed with soap and water."

The success was remarkable. Before the adoption of the measures, in April 1847, mortality reached 18% and, in mid-May, the mortality rate reached 2.2% in June, 1.2% in July and 1.9% in August.

However, most doctors did not accept the discovery of Semmelweis. It was offensive that doctors had to wash their hands. Even thinking that the hands of people of the level of doctors could be as dirty as to cause death... Semmelweis only received ridicule and laughter.

When the time came to renew the contract in 1849, it was not renewed. The following year she presented her conclusions at a conference in which she was also rejected. Indignant went to Budapest, without saying goodbye to his friends. There, at St. Rochus Hospital, he was given an unpaid post. And there he also showed that with the measures he proposed, the almost disappearance of puerperal fever was achieved. But the medical community was not willing to accept it and continued to give up.

He began writing open letters: "I call a murderer to all those who are against the measures I have proposed to avoid puerperal fever! (...) I think they can only be considered murderers. And whoever has the heart in his place will think it like me! It is not necessary to close the partum rooms to end the sinister that we regret, we have to throw away the tocologists that are the real epidemic".

Semmelweis worsened. It touched the depression, diverted all the conversations to the puerperal fever, began to have mental problems, was increasingly aggressive... He was finally interned in a psychiatric. They took him deceived and when he realized what they were doing he tried to escape, the guards hit hard. He died in two weeks, on August 13, 1865, at the age of 47. Autopsy revealed the cause of death: septicemia.

Fourteen years later, on March 11, 1879, at a conference of the Paris Academy of Medicine, a doctor talked about the possible causes of the epidemic in the delivery rooms. "None of them causes epidemic," a man about 60 years old cut off from his chair. "Nurses and doctors are the ones who pass the microbes of healthy infected women! ". The speaker responded that these microbes would never be found. Then, the man got up, went to the slate and drew a series of circles in chain. "What aspect do you have here! ". Streptococcus was a drawing of bacteria. It was Louis Pasteur.