The Cause Concept And Prophylaxis Of Childbed Fever

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.

In the nineteenth century, tens of thousands of women died each year from childbed fever. The Carters describe birthing conditions and medical practices in Vienna during the time when young Semmelweis began to work in a maternity clinic there. He discovered that childbed fever arose because medical personnel did not wash adequately after dissecting corpses before doing vaginal examinations of women in labor. After he required students to disinfect themselves, the mortality rate immediately dropped. However, Semmelweis's views were not accepted by the senior physicians who believed the disease was due to a variety of causes. After strident attempts to persuade skeptics, Semmelweis was committed to a Viennese insane asylum where he died at age 42, possibly from beatings by asylum guards. Childbed fever, now called puerperal infection, continues to be a leading cause of maternal mortality, in spite of the best efforts of modern physicians.

A narrative of one of the key turning points in medical history.