Physician Pioneer Had Early Grasp on Importance of Handwashing

Cherokee_Water

Editor’s note: The following article from Walter (Wally) D. Wilkerson Jr., MD, was originally published in the newsletter of the Montgomery County Republican Party. The opinions expressed are those of the author, not of the Texas Medical Association.

Lindsey Fitzharris, a medical historian, penned an article in the March (19,) 2020 Wall Street Journal entitled “The Unsung Pioneer of Handwashing” that described a 19th century physician’s effort to convince the medical society of his day that germs were the cause of the death from what was called childbed or puerperal fever.

“It’s difficult to feel any sense of optimism during the Covid-19 pandemic,” Fitzharris wrote, “but one source of encouragement is that simple soap and water can be a powerful defense.”

Ignaz Semmelweis, a Hungarian physician, who was working in the maternity department of the Vienna General Hospital in the 1840s discovered what he thought was the cause for the high death rate among postpartum patients.

"The idea that the squalid conditions in the hospitals played a role in spreading infection didn’t cross many doctors’ minds,” Lindsey (Fitzharris) noted.

The Vienna Hospital in 1846 had two obstetrical clinics – one overseen by medical students and the other under the care of midwives. Semmelweis, then in his late 20s, noted that the clinic overseen by medical students had a mortality rate of 10% compared to a rate of 4% for the clinic overseen by midwives.

He did not accept the explanation that the marked difference in mortality rates was attributed to the fact that the medical students “handled patients more roughly.” He was also disturbed that the so-called “street births” had a comparative 0% mortality rate.

In 1847, Semmelweis had a breakthrough. One of his colleagues became ill after cutting his hand during an autopsy examination. The symptoms were similar to those in puerperal infection.

At the time, doctors did not wear gloves when delivering babies or performing cadaver examinations. Semmelweis required that doctors wash their hands in a solution of chlorinated lime (calcium hypochlorite) prior to treating patients.

“In April 1847, the mortality rate for new mothers on the students’ clinic was 18.3%. After handwashing was instituted in May, it fell to just over 2%,” the article says.

The results were compelling, but Semmelweis was unable to convince his colleagues. In 1861, he "lashed out” at his critics who he called “murderers.” He was thought to have become mentally ill and was confined in a mental hospital, where he sustained an injury that became infected. Ironically, he died from the infection in 1865.

It was not until the 1880s “that pioneers of germ theory such as Louis Pasteur, Joseph Lister, and Robert Koch proved to the world that disease really could be transmitted by microscopic particles, leading to a revolution in sanitary practices …. If any positive change comes from the pandemic, it may be that handwashing will at last become as universal as Semmelweis hoped,” Fitzharris noted.

Walter (Wally) Wilkerson Jr., MD, is a retired family physician in Conroe.

Last Updated On

May 18, 2020

Originally Published On

May 18, 2020

Related Content

Coronavirus