Etiology, Concept and Prophylaxis of Childbed Fever (Volume 2)

by Ignaz Semmelweis, K. Codell Carter (Translator)

    In 1859 a Hungarian obstetrician named Ignaz Semmelweis, reflecting on his years as resident in the Vienna maternity clinic, wrote a graphic account of his attempt to diagnose and eliminate the then epidemic scourge of childbed fever.  The resulting Etiology triggered an immediate and international squall of protest from Semmelweis’s colleagues; today it is recognized as a pioneering classic of medical history.  Now, for the first time in many years, Codell Carter makes that classic available to the English-speaking reader in this vivid translation of the 1861 original, augmented by footnotes and an explanatory introduction.  For students and scholars of medical history and philosophy, obstetrics and women’s studies, the accessibility of this moving and revolutionary work, important both as an historical document and as a groundbreaking precursor of modern medical theory, is long overdue.
    Semmelweis’s exposure to the childbed fever was concurrent with his appointment to the Vienna maternity hospital in 1846.  Like many similar hospitals and clinics in the major cities of nineteenth-century Europe and America, where death rates from the illness sometimes climbed as high as 40 percent of admitted patients, the Viennese wards were ravaged by the fever.  Intensely troubled by the tragic and baffling loss of so many young mothers, Semmelweis sought answers.  The Etiology was testimony to his success.  Based on overwhelming personal evidence, it constituted a classic description of a disease, its causes, and its prevention.  It also allowed a necessary response to the obstetrician’s already vocal, rabid, and perhaps predictable critics.  For Semmelweis’s central thesis was a startling one - the fever, he correctly surmised, was caused not by epidemic or endemic influences but by unsterilized and thus often contaminated hands of the attending physicians themselves.
    Carter’s translation of this radical work, judiciously abridged and extensively footnoted, captures all the drama and impassioned conviction of the original.  Complementing this translation is a lucid introduction that places Semmelweis’s Etiology in historical perspective and clarifies its contemporary value.  That value, Carter argues, is considerable.  Important as a model of clinical analysis and as a chronicle of early nineteenth-century obstetrical practices, the Etiology is also a revolutionary polemic in its innovative doctrine of antisepsis and in its unique etiological explanation of disease.  As such its recognition and reclamation allows a crucial understanding, one that clarifies the roots and theory of modern medicine and ultimately redeems and important, resolute, pathfinder.

Genres: Science

288 pages, Paperback

First published September 15, 1983

About the author

Ignaz Philipp Semmelweis was a Hungarian physician of German extraction now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever (also known as "childbed fever") could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%. Semmelweis proposed the practice of washing hands with chlorinated lime solutions in 1847 while working in Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards. He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.

Despite various publications of results where hand washing reduced mortality to below 1%, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community. Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis's practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist's research, practiced and operated, using hygienic methods, with great success. In 1865, Semmelweis was committed to an asylum, where he died at age 47 of pyaemia, after being beaten by the guards, only 14 days after he was committed.

- Wikipedia

Reviews

[Julie O'toole · Rating 5 out of 5]

What is a pity: beyond how he suffered at the hands of the medical practitioners of his day, is how unknown he is to women. Women everywhere owe him their lives.

[Katherine Parker]

The writing in this can be redundant, and Semmelweis is not quite as much of the tragic hero as I had thought he was at first, but this is gripping reading if you are a nerd and interested in early epidemiology and childbirth. I find the statistical tables very interesting, and he makes a moving confession about his own hand (literally) in the deaths of numerous women. I imagine that this weighed on his conscience quite heavily when he realized that it was 'the examining finger' which was responsible for the spread of childbed fever. I am not far in but will definitely keep reading.

The only issue I take with this translation is that I have found a number of instance where the numeral 7 has been mistaken for the numeral 1, leading to mistranslation and the appearance of faulty dating - I would think the copy editor would have caught this and rectified it.

[Elizabeth · Rating 4 out of 5]

Semmelweis is one of the heroes in the development of proper sanitation in medical settings. His work on childbed fever is his explanation of his observations (including meticulous record-keeping) on the value of thorough hand-washing (using strong antiseptics and not just soap and water) in the prevention of childbed fever in a lying in hospital in Budapest. Readers can learn from this work the conditions obtaining in the hospital, the organization of the medical profession in nineteenth-century Austria-Hungary, and the debates among proponents of various schools of infection in the nineteenth century. Some of the latter, in particular, require a greater knowledge of medical history than most readers (self included) might have of the medical debates of the times, but an intelligent reader should be able to sort out the main camps adequately from the book. Semmelweis is, of course, writing a highly partisan account (and some of his critiques of other theorists seem to be splitting hairs a bit) and one that was in advance of identifying the childbed fever pathogen under the microscope.

[Iqra Tasmiae]

Pg 153, part 7, chapter 6, "Of Woman Born".