Ignaz Semmelweis: The Doctor Who Was Ridiculed for Telling Surgeons to Wash Their Hands
Updated: Oct 27
In the 1840s, having a baby in one of Europe's great teaching hospitals could be a death sentence. Thousands of healthy young women gave birth, came down with a raging fever a few days later and died in agony. Doctors called it childbed fever, and they had plenty of theories about it. Bad air. Overcrowding. The mother's own fear. Nobody really knew.
Then a young Hungarian doctor in Vienna worked out what was causing it. It was the doctors themselves. They were carrying death into the wards on their own unwashed hands, straight from the corpses they'd been cutting up downstairs.
His name was Ignaz Semmelweis. He found a way to stop it that cost almost nothing and took a few seconds. And for his trouble, he was mocked, pushed out of his job and, eventually, locked up in an asylum, where he died at 47.
Quick Answers
Who was Ignaz Semmelweis? A Hungarian doctor who worked in the maternity wards of Vienna General Hospital in the 1840s and discovered that doctors' unwashed hands were spreading the deadly childbed fever.
What did he discover? That medical students were carrying infection from the corpses they dissected to women giving birth. When he made them wash their hands in a chlorinated lime solution in 1847, deaths on his ward plummeted.
Why was he ridiculed? His idea clashed with the accepted theories of disease, implied that doctors themselves were killing their patients, and he was bad at explaining it. He also made powerful enemies and attacked critics as murderers.
How did he die? He was tricked into entering an asylum near Vienna in 1865, where he was beaten by guards. He died two weeks later, on 13 August 1865, aged 47, of an infection.
Why is he called the saviour of mothers? Because his simple handwashing rule could have prevented thousands of deaths in childbirth. He was proved right only after germ theory was accepted, years after he died.
A Grocer's Son from Buda
Ignaz Philipp Semmelweis was born on 1 July 1818 in Tabán, a district of Buda, which is now part of Budapest. His father, József, was a prosperous grocer, and Ignaz was the fifth of ten children.
He was sent to Vienna in 1837 to study law, but switched to medicine almost straight away. He qualified as a doctor in 1844 and, unable to get the post he wanted in internal medicine, ended up in obstetrics. In July 1846 he started work as an assistant in the First Obstetrical Clinic at the Vienna General Hospital, the biggest maternity hospital in the world.
A Tale of Two Clinics
The hospital had two maternity clinics, and women were admitted to them on alternate days. The First Clinic was used to train medical students. The Second Clinic was used to train midwives.
Everyone knew there was a difference between them. In the six years before Semmelweis arrived, around one in ten women who gave birth in the First Clinic died, most of them from childbed fever, or puerperal fever as doctors called it. In the Second Clinic, it was nearer one in thirty.
The women of Vienna knew it too. Some begged on their knees not to be admitted to the First Clinic. Others deliberately gave birth on the way to the hospital, so-called street births, because women who arrived having already delivered their babies were still entitled to free care. Semmelweis noticed something odd about them. Even after giving birth in the street, in the cold and the dirt, these women were far less likely to get childbed fever than the women delivered inside his clinic.
Ruling Things Out
Semmelweis was obsessed with the problem, and he went about it methodically. He looked at overcrowding, but the Second Clinic was actually more crowded. He looked at the weather, but both clinics had the same weather. He even changed the positions women gave birth in, and stopped a priest ringing a bell as he walked through the ward to give the last rites, in case fear was killing them. Nothing made any difference.
Medical opinion at the time blamed miasma, a kind of poisonous bad air, or some mysterious atmospheric influence. But Semmelweis couldn't see how bad air could kill women in one clinic and spare the women in the clinic next door.
The Death of Jakob Kolletschka
The breakthrough came from a tragedy. In March 1847 Semmelweis's friend and colleague Jakob Kolletschka, a professor of forensic medicine, was accidentally nicked by a student's scalpel while doing an autopsy. The wound became infected, and within days Kolletschka was dead.
Semmelweis read the report of his friend's post-mortem and was stunned. The damage to Kolletschka's body was almost identical to what he'd seen in dozens of women who'd died of childbed fever. Whatever had killed his friend, it was the same thing that was killing the mothers.
And then it all fell into place. The doctors and medical students in the First Clinic started each morning in the dissecting room, cutting up corpses, and then went straight up to the wards to examine women in labour. The midwives in the Second Clinic never touched a corpse. Semmelweis concluded that the students were carrying what he called cadaverous particles on their hands, from the dead into the bodies of the living. Germs hadn't been discovered yet, but he'd found their trail.
Washing Hands
In May 1847 Semmelweis ordered everyone examining women in the First Clinic to wash their hands first in a solution of chlorinated lime. He chose it because it was the best thing he could find for getting rid of the smell of the dissecting room, which seemed to cling to hands even after washing them with soap.
The results were astonishing. In April 1847, before the new rule, around 18 per cent of the women in the First Clinic died. Within a few months the death rate was down to around 2 per cent, and in some months nobody died at all. He soon extended the rule to instruments too.
Semmelweis wasn't quite the first person to suspect doctors were spreading childbed fever. Alexander Gordon, a doctor in Aberdeen, had made a similar point in 1795, and in 1843 the American doctor Oliver Wendell Holmes had argued that the disease was contagious and carried by doctors. But Semmelweis had the numbers, and he'd shown that a simple routine could stop it.
Why Nobody Listened
You'd think that would have made him a hero. Instead, it made him enemies.
Part of the problem was the idea itself. Semmelweis was effectively telling the most respected doctors in Europe that they had been killing their own patients. Many of them were gentlemen, and they didn't like being told their hands were dirty. His theory also didn't fit with how medicine understood disease at the time, and he had no way of explaining what his invisible particles actually were.
Part of the problem was Semmelweis himself. He didn't publish his findings properly for years. Supportive colleagues, including the dermatologist Ferdinand von Hebra and the pathologist Carl von Rokitansky, wrote about his work on his behalf, but he barely wrote anything himself. He was stubborn and quick-tempered, and he didn't handle criticism well.
And part of it was politics. His boss, Professor Johann Klein, was deeply conservative and didn't appreciate the implication that his clinic had been killing women. 1848 was a year of revolution across Europe, and Semmelweis, a Hungarian, was seen as being on the wrong side of it. When his assistant's post came up for renewal in March 1849, Klein refused to extend it.
Semmelweis hung on in Vienna for a while. In 1850 he finally gave a lecture on his work, and was offered a junior teaching post. But he was only allowed to teach using a dummy, not real patients. Insulted, he packed up and left for Pest almost immediately, without even saying goodbye to his friends.
Back in Hungary
In 1851 Semmelweis took over the maternity ward at St Rochus Hospital in Pest. It was an unpaid post, but he brought in his handwashing rules, and childbed fever there almost disappeared. In 1855 he was appointed professor of obstetrics at the University of Pest, and he married and started a family.
In 1861, 14 years after his discovery, he finally
published his findings in a book, The Etiology, Concept and Prophylaxis of Childbed Fever. It was long, repetitive and hard to read, and the reviews were mostly hostile. Some of the most influential doctors in Europe, including the great German pathologist Rudolf Virchow, rejected his ideas.
Semmelweis didn't take it well. He began writing furious open letters to his critics, accusing them of being murderers. He told one leading obstetrician that if he went on teaching students without his handwashing rules, he'd be committing murder. It's hard to argue he was wrong, but it didn't win anybody over.
The Asylum
By the mid-1860s, Semmelweis's behaviour had become increasingly erratic. He drank, he picked fights, and he seemed obsessed with childbed fever to the exclusion of everything else. At a university meeting in July 1865 he stood up and, instead of speaking, read out the midwives' oath. Historians still argue about what was wrong with him. Some think it was early dementia, others a serious mental illness, others the after-effects of syphilis.
His family and colleagues decided to have him committed. Hebra, his old supporter, lured him to Vienna on the pretext of showing him a new institute, and instead took him to an asylum in Döbling, on the edge of the city. When Semmelweis realised where he was and tried to leave, he was beaten by the guards, put in a straitjacket and locked in a dark cell.
He died two weeks later, on 13 August 1865. He was 47. The official cause of death was blood poisoning from an infected wound, which meant he'd almost certainly died of the same kind of infection he'd spent his life trying to prevent. When his body was examined again in the 1960s, the injuries suggested the beating had been far more violent than anyone had admitted.
Hardly anyone came to his funeral in Vienna. The medical journals barely noticed he'd gone.
Proved Right, Too Late
Within a few years of his death, the world caught up. In the 1860s Louis Pasteur showed that microscopic organisms caused fermentation and decay, and in 1867 the British surgeon Joseph Lister began using carbolic acid to kill germs in wounds and operating theatres. Germ theory explained exactly what Semmelweis had seen in Vienna, and gave doctors a reason to do what he'd told them to do. Even then, handwashing took decades to become routine.
Today Semmelweis is a national hero in Hungary, where he's known as the saviour of mothers. The leading medical university in Budapest is named after him, and the house where he was born is now a museum of medical history, with his remains buried in its garden. His name has even become a term in psychology. The Semmelweis reflex describes the tendency to reject new evidence because it goes against what you already believe.
In a way, that's the cruellest legacy of all. Semmelweis worked out how to save thousands of lives, and the people who could have used it simply refused to believe him. The next time someone reminds you to wash your hands, you've got a stubborn Hungarian doctor to thank.
Suggested Reading
Want to dig deeper into the story of Ignaz Semmelweis? These are worth a look.
The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis by Sherwin B. Nuland. A short, vivid account of Semmelweis's discovery and why the medical world ignored it.
Childbed Fever: A Scientific Biography of Ignaz Semmelweis by K. Codell Carter and Barbara R. Carter. A detailed look at Semmelweis's work and the science behind it.
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Sources
Nuland, Sherwin B. The Doctors' Plague. W. W. Norton, 2003.
Carter, K. Codell and Carter, Barbara R. Childbed Fever: A Scientific Biography of Ignaz Semmelweis. Greenwood Press, 1994.
Loudon, Irvine. Ignaz Phillip Semmelweis' studies of death in childbirth. Journal of the Royal Society of Medicine, 2013.
