Too Short for a Blog Post, Too Long for a Tweet 388

 

Here are a couple of excerpts from a book I recently read, "The Song of the Cell: An Exploration of Medicine and the New Human," by Siddhartha Mukherjee.

In a sense, then, one might define life as having cells, and cells as having life.

In 1847, Semmelweis’s colleague Dr. Jacob Kolletschka cut himself with a scalpel while performing an autopsy. He was soon febrile and septic; Semmelweis could hardly help but notice that Kolletschka’s symptoms mirrored those of the women with childbed fever. Here, then, was a potential answer: the first clinic was run by surgeons and medical students who shuttled casually between the pathology department and the maternity ward—from performing cadaver dissections and autopsies straight to delivering babies. In contrast, the second clinic was run by midwives, who had no contact with cadavers and never performed autopsies. Semmelweis wondered if the students and surgeons, who routinely examined women without gloves, were transferring some material substance—“cadaverous material,” he called it—from the decomposing cadavers into a pregnant woman’s body. 

He insisted that the students and the surgeons wash their hands with chlorine and water before entering the maternity wards. Semmelweis kept careful records of the deaths in the two clinics. The impact was astonishing, with the mortality rate in the first clinic declining by 90 percent. In April 1847, the mortality rate had been nearly 20 percent: one in five women died of childbed fever. By August, after rigorous hand washing had been instituted, the mortality among the new mothers had declined to 2 percent. 

As stunning as the results were, Semmelweis had no explanation that he could visualize. Was it blood? A fluid? A particle? Senior surgeons in Vienna didn’t believe in germ theory and had no interest in a junior assistant’s insistence that they wash their hands between the clinics. Semmelweis was harassed and ridiculed, passed over for a promotion, and eventually dismissed from the hospital. The idea that childbed fever was, in fact, a “doctor’s plague”—an iatrogenic, physician-induced disease—could hardly sit well with the professors of Vienna. He wrote increasingly frustrated and accusatory letters to obstetricians and surgeons all over Europe, all of whom dismissed Semmelweis as a crank. He eventually packed off to the backwaters of Budapest, only to suffer a mental breakdown. He was admitted to an asylum where the guards beat him, leaving him with broken bones and a gangrenous foot. Ignaz Semmelweis died in 1865, most likely of sepsis caused by the injuries; consumed, possibly, by germs—the very “material” substance that he had tried to identify as a cause of infections.