It is always easy to identify the bad guys, and in movies ,they are often either end up shot dead or brutally punished. However, what if they are mute, invisible, and deadly? Unexpectedly, unlike typical fairy tales, we will be in a silent blood shed combat. True enough, many lives were lost and still counting till this day, however with that one simple initiative taken had saved millions probably billions from death, a commonly popular phrase known as “washing your hands”.
Now, what is so great about hand washing you may think. Isn’t it a norm everyone does daily which keeps us safe from various diseases? Well, believe or not, there was a time where doctors doesn’t sanitize themselves back and forth undergoing surgeries and giving medical check ups to other patients. Thus, allow me to share with you readers on the melancholic yet honourabe birth of hand washing.
There once was a man known as “the saviour of mothers” named Ignaz Semmelweis (Ignác Fülöp Semmelweis) . This hero was born as the fifth child out of ten of the prosperous grocer family of József Semmelweis and Teréz Müller in July the first, year 1818. Ignaz Semmelweis was a Hungarian physician from Buda, Hungary now called as Budapest, Hungary in present time.After obtaining a Doctor’s degree from Vienna (1844) from University of Pest & Vienna, he worked as an assistant to Professor Johan Klein at Vienna General Hospital’s First Obstetric Clinic in 1847. It was the place where history was made which benefited many to date. The clinic was primarily to hospitalise women due to illegitimacy, poverty or obstetrical complications.
In the mid-19th century, puerperal fever (childbed fever) which occurs in the uterine tract of women after giving birth or after undergoing abortion was common and often fatal where it was miserably ended with raging fevers, putrid pus emanating from the birth canal, painful abscesses in the abdomen and chest, and an irreversible descent into an absolute hell of sepsis and death — all within 24 hours of the baby’s birth. Most doctors during that period assumed that overcrowding, poor ventilation, miasma or onset of the location was the cause of the fever and never gave a second thought about it, except Ignaz Semmelweis. Even under forceful objections from his chief who reconciled to the idea that the disease was inevitable, he still risked his professional career to proof the real reason of the puerperal fever.
Based on his observation, women who passed from childbed fever in the 1st division was around three times higher compared to the 2nd division as it was more prevalent in the 1st division. Both divisions were extremely identical until further investigation, he found out that the only odd factor was the people running in both divisions. Medical students were placed in the first whereas midwives were operating in the second. In addition to that, he also wondered why women who underwent street birth, gave birth on the way to the hospital and were not admitted rarely showed any signs of fever compared to those who did.
One day, his good friend Jakob Kolletschka who was a Professor of forensic medicine, died from a wound infection where a student’s scalpel accidentally pocked him. It incurred during the postmortem examination of a women who died of puerperal infection. He then concluded that there was a connection between cadaveric contamination and the morgue puerperal fever. The medical students had carried “ cadaverous particle” which now known as the bacteria called Group A hemolytic streptococcus from the dissecting room to the maternity ward where healthy mothers were admitted. Immediately, he mandated all medical students to wash their hands in a chlorinated lime solution (calcium hypochorite) before and after each examinations. It managed to remove putrid smell of infected autopsy tissue, which probably deactivated contaminated “ cadaveric” agent. Soon after, the mortality rate immensely decreased from 18.29% to 1.27% in the 1st division whereas there were zero deaths of childbed fever in his division during March and August of 1848.
Many younger medical men in Vienna recognised the significance of Ignaz Semmelweis magical discovery. However, his superior was offended and was greatly critical due to his failure of understanding the theory behind Ignaz Semmelweis’ handwashing practice.This is because handwashing was an extreme and alien-like habit at that time which was largely ignored, rejected and ridiculed by citizens.
In year 1849, he was fired from his professional work as he took part in events in Vienna as liberal political revolution swept Europe. Sadly, Ignaz Semmelweis was also turned down from a teaching post in University in midwifery. With all barriers around him led by his poorly made decision, he managed to give a successful lecture on “The Origin of Puerperal Fever” at the Medical Society of Vienna. Soon after that in 1850, he left Vienna and returned to Pest.
In proof of his discovery, he applied his theory again by combating the epidemic of puerperal fever which had broken out in the obstetric department of St. Rochus Hospital in Pest where he worked for 6 years. As a result, the mortality rate declined to an average of 0.85% whereas the mortality rate was still around 10 to 15 percent in Prague and Vienna.
The last of Ignaz Semmelweis’s sanity lasted until when he was appointed as Professor of obstetric at University of Pest in 1855 where he finally got married to the love of his life and bear five children. Starting from 1857, his life became a misery.
In that same year, Vienna remained hostile towards Ignaz Semmelweis. To add salt to wound, the editor of Wiener Medizinische Wochenschrift wrote that it was time to stop the nonsense about clorine handwash. In 1861, Ignaz Semmelweis tried to publish his work Die Ätiologie, der Begriff und die Prophylaxis des Kindbettfiebers (The Etiology, Concept, and Prophylaxis of Childbed Fever) which was sent to all prominent obstetricians and medical societies abroad. However, many disapproved his principle work during a conference of German physicians and natural scientist.
Even the pathologist Rudolf Virchow who was a scientist of the highest authorities at his time rejected his doctrine. It was not all their fault for the denial as many doctors in the early to mid 1800s argued that diseases resulted from imbalances among four humors, which they postulated to exist in all human bodies, and that each disease was unique because each person was unique. They said that a healthy person had a perfect balance of the four humors of black bile, yellow bile, phlegm, and blood. Semmelweis’s findings that all puerperal cases resulted from unhygienic practices contrasted with the theory of humors.
Therefore, these events slowly made Ignaz Semmelweis mad and insane to the point where he was outraged by the indifference of the medical professors and began writing open and increasingly angry letters, denouncing them as “irresponsible murderers”. Just like any mundane, the years of controversy gradually dragged Ignaz Semmelweis’s spirit to rock bottom.
The years of continuous mockery, ridiculed and shamed by the people mentally killed Ignaz Semmelweis to the point he had nervous breakdown where his contemporaries including his wife thought that he was losing his mind. Then, unlike how most superheroes had a happy ending, Ignaz Semmelweis was commited to an asylum (Landesirrenanstelt Pobling) by the authority. Fourteen days later on 30th July 1865, he died at the age of 47 from a gangrenous wound on his right hand. To date, the cause of his death was still unclear as some said he died from the heavily beatings of the guards, whereas some also said he died due to blood poisoning and Alzheimer.
Ignaz Semmelweis’s work was only subsequently accepted after his death. It was due to the recognition by Joseph Lister, the father of modern antisepsis acting as the French Microbiologist’s researcher and Louis Pasteur who confirmed the germ theory of disease. Joseph Lister did say;
“I think with the greatest admiration of him and his achievement and it fills me with joy that at last he is given the respect due to him.”
Although Semmelweis began the charge for hand hygiene in the 19th century, it has not always fallen on receptive ears. However, Ignaz Semmelweis scarification did not go to waste, and in honour of his pitiful life discovery which is strictly implemented in the COVID-19 pandemic outbreak, we should listen to him and wash our hands. Let us not allow the painful history rewrites itself in our era.
Viccentia Pachamuthu adalah siswa Kolej Matrikulasi Negeri Sembilan dalam jurusan Sains. Beliau adalah penulis yang terpilih dalam Liga Penulisan Artikel Pengajian Tinggi.