The Strange Story of Ignác Semmelweis

Ignác Semmelweis (1818-65) was a Hungarian doctor, who worked in hospitals in Budapest and Vienna.

As a medical scientist he was great, as a person he was (especially in his later years) difficult, as a communicator he was his own worst enemy.

When he arrived at Vienna’s General Hospital in 1844, he found that hundreds of mothers (and sometimes also their new-born babies) were dying from childbed fever (also known as puerperal fever). The same thing was happening in hospitals across Europe and in the US. Nobody knew why; and nobody could do anything to stop it.

In 1847 Semmelweis discovered how and why the women (and some of their babies) died: the doctors transmitted an infection from one patient to the next. He also invented a simple cure: the doctors must wash (today we will say disinfect) their hands before examining a patient.

Today this notion is commonplace, but in the nineteenth century the medical world was not ready to accept it, even though his cure worked like a miracle: the mortality rate in his ward dropped to less than 1 per cent (when his cure was followed to the letter). Some doctors accepted it, but many did not, and some of his opponents had power and influence in the medical world and in hospital administrations.

For Semmelweis the struggle against the deadly disease became a personal crusade, and as his personality changed for the worse, he had great difficulty convincing others that he was right (which he was). Eventually, he lost first his mind and then his life. He got an infection in his hand. In other words: he was killed by the very disease, which he had fought so hard to prevent.

In The Doctors' Plague the dramatic life and career of Semmelweis are described in great detail. The author, Sherwin B. Nuland, is clinical professor of surgery at the Yale University School of Medicine. He is also the author of several books about the history of medicine.

Nuland got some good reviews. On the back cover of the paperback version (2004) there are excerpts from reviews of the hardcover version (2003). Here are three examples:

NEW YORK TIMES says:

“A medical detective story about the ambitious yet troubled physician who figured out how to prevent a deadly infection spread by doctors.”

HOUSTON CHRONICLE says:

“Nuland’s dissection of one of history’s great losses is unforgettable.”

SAN FRANCISCO CHRONICLE says the author

“does a superb job of clearly describing the social and medical atmosphere of that time.”

I agree with the positive reviews. This book is well-researched and well-written. Nuland gives us the triumph as well as the tragedy of Semmelweis. While showing profound respect for the Hungarian doctor as a medical scientist, he is not afraid to point out how and where Semmelweis failed to follow up on his great discovery:

(1) He did not conduct any experiments to prove his case in a laboratory. In fact, there was one experiment, which was inconclusive, and that was the end of it.

(2) He did not use a microscope. At the time the quality of microscopes were being improved – and a few years later his arguments would be confirmed by other scientists, who were ready to use this technology.

(3) He did not present his great discovery in professional medical journals in order to let other doctors know about it. When he finally did sit down to write a book, it did not do him or his case any good. His book, which was published in 1861, was not exactly reader-friendly (to put it mildly). In a way it made the situation worse, because his aggressive style of writing created more resistance to his ideas.

In his afterword, Nuland describes the legacy of Semmelweis:

When he died, “his work was neglected and all but forgotten… To receive his due of honor, he had to be rediscovered.”

When he was rediscovered, the change was remarkable: the man, whose work had been rejected by many in high places, “became associated with the notion of genius, first in Hungary and later throughout the world.”

In 1891 “his remains were brought home from their ignored grave in Vienna” and placed in a cemetery in Budapest.

In 1963 his remains were exhumed again and this time “placed in the courtyard wall of the house where he was born,” while the house itself was converted to a museum named after him and dedicated to the history of medicine. Finally, and in more than one way, Semmelweis had come home.

The museum in Budapest is still there. I think it is great there is a museum to honour this man. Unfortunately, it is very old-fashioned: For more information about this place see my blog: The Semmelweis Museum.

Let me add a few honours, which are not mentioned in the book:

** A stamp with his name and portrait was issued in Hungary in 1932, in Germany in 1956, and in Austria in 1965

** A 50 Euro gold-coin with his name and portrait was issued in Austria in 2008

In addition, his tumultuous career has been portrayed in a television drama two times. The first movie was made in Germany in 1989. It was directed by Michael Verhoeven, while the role of Semmelweis was played by Heiner Lauterbach. The second movie was made in Holland in 1994. It was directed by Floor Maas, while the role of Semmelweis was played by Stefan de Walle.

Illustrations are not exactly the strong side of this book. There are merely six small pictures in black-and-white. But the story is there, a true and important story. Therefore I will say: do not worry about the illustrations. Just focus on the text.

This is a great book about a great discovery.

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Sherwin B. Nuland,
The Doctors' Plague: Germs, Child Bed Fever,
and the strange Story of Ignác Semmelweis,
W. W. Norton, 2003, 2004, 192 pages

 

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Below:
This painting of Ignás Semmelweis hangs in the museum in Budapest.
The painting is dark and hangs in a dark room.
Therefore it is difficult to take a good picture of this portrait.

 

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