1 00:00:02,320 --> 00:00:06,920 Speaker 1: Happy Saturday, everybody. We have had several requests recently to 2 00:00:07,040 --> 00:00:10,880 Speaker 1: re release our previous podcast on ignance Semialviss and his 3 00:00:11,080 --> 00:00:15,239 Speaker 1: hand washing advocacy. In case you missed it, several vice 4 00:00:15,360 --> 00:00:18,880 Speaker 1: was the subject of a Google Doodle on March with 5 00:00:18,920 --> 00:00:22,480 Speaker 1: an accompanying animation on how to properly wash your hands. 6 00:00:22,920 --> 00:00:25,400 Speaker 1: This episode that we're playing today originally came out on 7 00:00:25,480 --> 00:00:30,840 Speaker 1: March twenty one. Yeah, we usually reserve Saturday classics for 8 00:00:30,880 --> 00:00:33,040 Speaker 1: things that are a little older, but since so many 9 00:00:33,080 --> 00:00:39,080 Speaker 1: people asked, here, we go enjoy. Welcome to Stuff you 10 00:00:39,120 --> 00:00:49,440 Speaker 1: missed in History class a production of I Heart Radio. Hello, 11 00:00:49,640 --> 00:00:53,000 Speaker 1: and welcome to the podcast. I'm Tracy V. Wilson, and 12 00:00:53,040 --> 00:00:56,720 Speaker 1: I'm Holly fry So Holly, I think a lot of 13 00:00:56,760 --> 00:00:59,360 Speaker 1: people take for granted the idea that you need to 14 00:00:59,400 --> 00:01:03,880 Speaker 1: wash your hay hands to prevent disease. Yes, but also 15 00:01:03,920 --> 00:01:08,119 Speaker 1: some people discounted well, and there's also a lot of 16 00:01:08,240 --> 00:01:11,120 Speaker 1: research that even though this is a pretty ubiquitous and 17 00:01:11,200 --> 00:01:14,520 Speaker 1: standard idea, a lot of people don't actually wash their 18 00:01:14,560 --> 00:01:17,120 Speaker 1: hands nearly as much as they should. But regardless of 19 00:01:17,160 --> 00:01:20,080 Speaker 1: all of that, it was not taken for granted in 20 00:01:20,200 --> 00:01:23,800 Speaker 1: nineteenth century Europe, including among doctors, that you needed to 21 00:01:23,840 --> 00:01:26,039 Speaker 1: wash your hands to prevent disease. And today we are 22 00:01:26,080 --> 00:01:29,080 Speaker 1: going to talk about Ignaz Semmel Vice. He was one 23 00:01:29,120 --> 00:01:31,920 Speaker 1: of the people who made this connection between hand washing 24 00:01:32,360 --> 00:01:35,560 Speaker 1: and disease prevention. The disease that he was preventing was 25 00:01:35,680 --> 00:01:39,720 Speaker 1: childbed fever, and even though it was not taken seriously 26 00:01:39,800 --> 00:01:43,320 Speaker 1: at the time, like people wrote him off entirely, today 27 00:01:43,319 --> 00:01:46,360 Speaker 1: he's known as everything from the father of infection control 28 00:01:46,560 --> 00:01:50,800 Speaker 1: and the savior of mothers and the conqueror of childbed fever, 29 00:01:52,040 --> 00:01:55,080 Speaker 1: which is a lot of, I mean, very lofty pronouncements. 30 00:01:55,120 --> 00:01:57,360 Speaker 1: And he did do amazing work, but it did not 31 00:01:57,520 --> 00:02:02,000 Speaker 1: last past his lifetime. Uh. This episode Also, to be clear, 32 00:02:02,040 --> 00:02:05,080 Speaker 1: it's about medicine in nineteenth century Europe and to a 33 00:02:05,160 --> 00:02:08,040 Speaker 1: lesser extent in North America. And we're definitely aware that 34 00:02:08,080 --> 00:02:10,560 Speaker 1: religions and cultures all over the world have their own 35 00:02:10,600 --> 00:02:14,640 Speaker 1: practices about everything from handwashing to delivering babies. It is 36 00:02:14,680 --> 00:02:16,720 Speaker 1: not about that at all. This is not a global 37 00:02:16,880 --> 00:02:19,560 Speaker 1: overview of hand hygiene and how it relates to medicine. 38 00:02:19,560 --> 00:02:23,320 Speaker 1: We're really looking at how the practice of obstetrics and 39 00:02:23,400 --> 00:02:27,280 Speaker 1: formal medical training collided in the eighteenth and nineteenth centuries, 40 00:02:27,440 --> 00:02:30,520 Speaker 1: and this is also a listener request we've gotten from 41 00:02:30,560 --> 00:02:35,520 Speaker 1: several people, including Margaret tom and Ashley. Child bed fever, 42 00:02:35,800 --> 00:02:39,320 Speaker 1: also known as pure pearl fever, is a postpartum infection 43 00:02:39,360 --> 00:02:42,400 Speaker 1: of the uterus or the vaginal canal, and it's often 44 00:02:42,440 --> 00:02:45,399 Speaker 1: caused by a streptococcal infection, but it can come from 45 00:02:45,400 --> 00:02:49,880 Speaker 1: other pathogens as well. Today, these infections are largely preventable 46 00:02:49,960 --> 00:02:53,679 Speaker 1: through hygiene and infection control procedures during labor and delivery, 47 00:02:54,240 --> 00:02:57,600 Speaker 1: and when they do happen, they're usually treatable with antibiotics. 48 00:02:57,720 --> 00:03:01,560 Speaker 1: So in places where competent care, clean water, and antibiotics 49 00:03:01,600 --> 00:03:06,120 Speaker 1: are readily available, pure pearl fever isn't very common. This 50 00:03:06,320 --> 00:03:09,040 Speaker 1: was not the case before the germ theory of disease 51 00:03:09,240 --> 00:03:13,080 Speaker 1: or the discovery of antibiotics. Until the late nineteenth century, 52 00:03:13,160 --> 00:03:17,280 Speaker 1: childbed fever was one of the most common complications of childbirth. 53 00:03:17,639 --> 00:03:23,680 Speaker 1: Within about three days of giving birth, patients developed abdominal pain, fevers, abscesses, 54 00:03:23,720 --> 00:03:26,440 Speaker 1: and other signs of infection, and this would often progress 55 00:03:26,480 --> 00:03:30,359 Speaker 1: to blood poisoning and death. Sometimes, incidents of child bed 56 00:03:30,400 --> 00:03:33,800 Speaker 1: fever were sporadic and between twenty and thirty percent of 57 00:03:33,800 --> 00:03:37,840 Speaker 1: those sporadic infections were fatal, but when an epidemic of 58 00:03:37,920 --> 00:03:40,840 Speaker 1: child bed fever swept through a community or a hospital, 59 00:03:40,880 --> 00:03:43,720 Speaker 1: it tended to be a lot deadlier, with seventy with 60 00:03:43,800 --> 00:03:47,880 Speaker 1: a seventy to eighty percent mortality rate, and a lot 61 00:03:48,040 --> 00:03:52,320 Speaker 1: of prominent women died of childbed fever throughout history, including 62 00:03:52,360 --> 00:03:56,360 Speaker 1: Mary Wolston Craft, Henry the Eighth Wife, Jane Seymour, and 63 00:03:56,520 --> 00:04:01,080 Speaker 1: possibly recent podcast subject Phyllis Wheatley. Obviously, a lot of 64 00:04:01,200 --> 00:04:03,960 Speaker 1: ordinary women did too that aren't in the history books. 65 00:04:04,520 --> 00:04:07,920 Speaker 1: It was something both expecting parents and their doctors and 66 00:04:08,000 --> 00:04:12,600 Speaker 1: midwives dreaded and feared. Childbed fever was described in medical 67 00:04:12,640 --> 00:04:15,320 Speaker 1: literature all the way back to Hippocrates in the fourth 68 00:04:15,320 --> 00:04:19,359 Speaker 1: century BC, and in the years before evidence based medicine. 69 00:04:19,400 --> 00:04:22,440 Speaker 1: People blamed it on a range of causes based on 70 00:04:22,480 --> 00:04:25,360 Speaker 1: whatever medical theories were in use at the time, so 71 00:04:25,720 --> 00:04:29,440 Speaker 1: everything from a balance an imbalance in the four Humors 72 00:04:29,839 --> 00:04:34,520 Speaker 1: to myasthmas or bad air. By the eighteenth century, doctors 73 00:04:34,560 --> 00:04:37,599 Speaker 1: were devoting a lot of writing to arguing about whether 74 00:04:37,640 --> 00:04:41,640 Speaker 1: it was an inflammatory or a putrefying disease. In the 75 00:04:41,720 --> 00:04:45,520 Speaker 1: eighteenth and nineteen centuries, a few things happened in tandem 76 00:04:45,560 --> 00:04:49,080 Speaker 1: that led to a big increase in childbed fever epidemics. 77 00:04:49,680 --> 00:04:52,480 Speaker 1: One was that more babies were being delivered in hospitals 78 00:04:52,560 --> 00:04:56,040 Speaker 1: rather than at home. In some cases, these hospitals were 79 00:04:56,080 --> 00:04:59,479 Speaker 1: part of social programs. The idea was to provide free 80 00:04:59,520 --> 00:05:03,440 Speaker 1: care before and after delivery to try to stop infanticide 81 00:05:03,680 --> 00:05:06,760 Speaker 1: among families that were living in poverty. Some of these 82 00:05:06,800 --> 00:05:10,800 Speaker 1: hospitals employed midwives, and others of them employed doctors, and 83 00:05:10,839 --> 00:05:14,839 Speaker 1: this was also a change. Before this point, doctors and surgeons, 84 00:05:14,839 --> 00:05:18,800 Speaker 1: who were almost exclusively male, had really only been involved 85 00:05:18,800 --> 00:05:22,680 Speaker 1: in delivering babies when there were really serious complications. It 86 00:05:22,800 --> 00:05:25,440 Speaker 1: was so unusual for a man to be involved in 87 00:05:25,520 --> 00:05:29,320 Speaker 1: delivery that in some places these doctors were called man midwives. 88 00:05:30,640 --> 00:05:33,000 Speaker 1: So the idea that a doctor would be involved in 89 00:05:33,000 --> 00:05:36,039 Speaker 1: the routine delivery of a baby was fairly new in 90 00:05:36,080 --> 00:05:40,280 Speaker 1: the seventeen hundreds. Also fairly new was the widespread use 91 00:05:40,320 --> 00:05:45,120 Speaker 1: of autopsies as part of medical education. Although autopsies existed 92 00:05:45,160 --> 00:05:47,320 Speaker 1: well before this point, it was only in the mid's 93 00:05:47,320 --> 00:05:50,640 Speaker 1: seventeen hundreds that the field of medicine really started using 94 00:05:50,680 --> 00:05:53,559 Speaker 1: them to try to improve on medical knowledge and teach 95 00:05:53,600 --> 00:05:57,880 Speaker 1: medical students, and in the late eighteenth and early nineteenth centuries, 96 00:05:58,080 --> 00:06:02,920 Speaker 1: doctors started using autopsies childbed fever victims, specifically to try 97 00:06:02,960 --> 00:06:06,120 Speaker 1: to learn more about the disease. All of this together 98 00:06:06,240 --> 00:06:09,480 Speaker 1: meant that at about the same time, more people were 99 00:06:09,480 --> 00:06:13,400 Speaker 1: giving birth in hospitals assisted by doctors, and more doctors 100 00:06:13,400 --> 00:06:17,080 Speaker 1: and medical students were handling and dissecting cadavers as part 101 00:06:17,080 --> 00:06:20,280 Speaker 1: of medical study, including the bodies of people who had 102 00:06:20,320 --> 00:06:24,559 Speaker 1: died of childbed fever. Because illnesses were blamed on things 103 00:06:24,600 --> 00:06:29,000 Speaker 1: like myasthmas and imbalanced humors rather than on pathogens, these 104 00:06:29,040 --> 00:06:33,240 Speaker 1: post mortem examinations were being conducted with bare hands, and 105 00:06:33,279 --> 00:06:37,240 Speaker 1: those bare hands were not usually washed before working with 106 00:06:37,360 --> 00:06:41,640 Speaker 1: living patients. Surgical gloves weren't even invented yet. That wouldn't 107 00:06:41,720 --> 00:06:44,560 Speaker 1: happen until the late eighteen hundreds, and when those gloves 108 00:06:44,600 --> 00:06:48,920 Speaker 1: were invented, they were really about protecting the hands from chemicals, 109 00:06:49,480 --> 00:06:52,640 Speaker 1: not protecting the patients from the spread of disease or 110 00:06:52,680 --> 00:06:57,560 Speaker 1: the doctors from contracting diseases from the patients. The result 111 00:06:57,600 --> 00:07:00,960 Speaker 1: of all of this was a dramatic increase acent epidemics 112 00:07:00,960 --> 00:07:05,480 Speaker 1: of child bed fever particularly in hospitals. One swept through 113 00:07:05,520 --> 00:07:09,920 Speaker 1: the Paris Hotel Dieu in seventeen in seventeen forty six, 114 00:07:10,560 --> 00:07:15,040 Speaker 1: another struck the British Lying In Hospital in seventeen sixty. 115 00:07:15,120 --> 00:07:18,200 Speaker 1: These were frequent and widespread enough that hospitals weren't usually 116 00:07:18,240 --> 00:07:21,720 Speaker 1: thought of as safe places to give birth. There were 117 00:07:22,000 --> 00:07:26,080 Speaker 1: definitely doctors who spotted the connection between autopsies and child 118 00:07:26,080 --> 00:07:29,120 Speaker 1: bed fever, or who suspected that the disease could be 119 00:07:29,160 --> 00:07:31,720 Speaker 1: spread from patient to patient by the doctors who were 120 00:07:31,720 --> 00:07:36,280 Speaker 1: treating them. These doctors published treatises and journal articles about 121 00:07:36,320 --> 00:07:38,840 Speaker 1: what they thought was causing child bed fever and how 122 00:07:38,880 --> 00:07:44,520 Speaker 1: to stop it. In seventeen Alexander Gordon of Aberdeen, Scotland 123 00:07:44,560 --> 00:07:47,760 Speaker 1: wrote his treatise on the Epidemic of Pure Pearl Fever, 124 00:07:48,400 --> 00:07:51,160 Speaker 1: and in it he theorized that doctors who had treated 125 00:07:51,160 --> 00:07:53,840 Speaker 1: a patient with child bed fever could pass it on 126 00:07:53,880 --> 00:07:58,640 Speaker 1: to other patients. He recommended burning the patient's bedclothes, along 127 00:07:58,680 --> 00:08:01,840 Speaker 1: with thorough hand washing and fumigating all of the clothing 128 00:08:01,880 --> 00:08:04,520 Speaker 1: of the doctors and nurses who were involved in the 129 00:08:04,560 --> 00:08:08,880 Speaker 1: infected patient's care. In eighteen twenty nine, when an epidemic 130 00:08:08,920 --> 00:08:12,640 Speaker 1: of childbed fever struck the Rotunda Hospital in Dublin, Ireland. 131 00:08:12,960 --> 00:08:15,800 Speaker 1: Hospital chief Robert Collins tried to stop it with a 132 00:08:15,880 --> 00:08:19,960 Speaker 1: forty eight hour chlorine fumigation. He also ordered that all 133 00:08:20,000 --> 00:08:23,239 Speaker 1: the floors and walls be scrubbed down with chlorinated lime 134 00:08:23,440 --> 00:08:26,400 Speaker 1: and all the linen's be heat treated. The number of 135 00:08:26,520 --> 00:08:30,160 Speaker 1: childbed fever cases at the hospital dropped almost to zero 136 00:08:30,280 --> 00:08:34,480 Speaker 1: after he did all this. In eighteen forty three, Oliver 137 00:08:34,600 --> 00:08:39,160 Speaker 1: Wendellholm Sr. Delivered a paper called the Contagiousness of Pure 138 00:08:39,200 --> 00:08:43,320 Speaker 1: Pearl Fever to the Boston Society of Medical Improvement. In it, 139 00:08:43,440 --> 00:08:46,559 Speaker 1: he said, quote, the disease known as pure pearl fever 140 00:08:46,760 --> 00:08:49,640 Speaker 1: is so far contagious as to be frequently carried from 141 00:08:49,720 --> 00:08:54,040 Speaker 1: patient to patient by physicians and nurses. He then went 142 00:08:54,080 --> 00:08:56,200 Speaker 1: on to describe a number of steps to try to 143 00:08:56,240 --> 00:08:59,480 Speaker 1: prevent the spread of the disease. These included that obstetricians 144 00:08:59,520 --> 00:09:03,760 Speaker 1: should ever conduct autopsies on patients who died of childbed fever, 145 00:09:04,320 --> 00:09:07,720 Speaker 1: and if for some reason an obstetrician had to, he 146 00:09:07,760 --> 00:09:11,040 Speaker 1: should very thoroughly clean himself, change all of his clothes, 147 00:09:11,120 --> 00:09:14,880 Speaker 1: and abstain from patient treatment for at least twenty four hours. 148 00:09:15,559 --> 00:09:18,360 Speaker 1: Holmes went on to recommend that if a doctor treated 149 00:09:18,360 --> 00:09:22,160 Speaker 1: a patient who then contracted childbed fever, he should consider 150 00:09:22,280 --> 00:09:24,959 Speaker 1: all of the patients that he went on to treat 151 00:09:25,040 --> 00:09:28,240 Speaker 1: to also be at risk until significant time had passed 152 00:09:28,280 --> 00:09:31,680 Speaker 1: without anybody else being infected, and if two of his 153 00:09:31,760 --> 00:09:35,160 Speaker 1: patients developed childbed fever in close proximity to one another, 154 00:09:35,200 --> 00:09:37,920 Speaker 1: he should remove himself from medical practice and bring in 155 00:09:37,960 --> 00:09:42,000 Speaker 1: a substitute for at least a month. Holmes's paper made 156 00:09:42,000 --> 00:09:45,120 Speaker 1: recommendations that would have been both useful and effective for 157 00:09:45,240 --> 00:09:48,480 Speaker 1: preventing the spread of childbed fever, but it didn't get 158 00:09:48,480 --> 00:09:50,920 Speaker 1: a lot of attention until it was reprinted as a 159 00:09:50,960 --> 00:09:55,360 Speaker 1: pamphlet and more widely distributed, and then the response among 160 00:09:55,400 --> 00:10:01,240 Speaker 1: the medical community was total dismissal and outright mockery. Charles D. Meigs, 161 00:10:01,320 --> 00:10:05,679 Speaker 1: an obstitution from Philadelphia, described holmes As theories and recommendations 162 00:10:05,720 --> 00:10:09,840 Speaker 1: as quote je June and Fizzinless Dreamings, and claimed that 163 00:10:09,920 --> 00:10:12,520 Speaker 1: any doctor who saw an increase in child bed fever 164 00:10:12,960 --> 00:10:16,680 Speaker 1: was just unlucky. When Agna's semil Weiss came to the 165 00:10:16,720 --> 00:10:20,120 Speaker 1: same conclusion that Oliver Wendell Holmes Senior, had, the response 166 00:10:20,160 --> 00:10:22,400 Speaker 1: from the rest of the medical community was very much 167 00:10:22,440 --> 00:10:24,920 Speaker 1: the same, and we'll talk about it after a sponsor 168 00:10:24,960 --> 00:10:38,200 Speaker 1: break becas semil Weiss was born on July one, eighteen eighteen, 169 00:10:38,320 --> 00:10:42,080 Speaker 1: and the Taban area of Buddha Hungary. Buddha would combine 170 00:10:42,120 --> 00:10:44,280 Speaker 1: with Pest in eighteen seventy three, so it was a 171 00:10:44,320 --> 00:10:47,640 Speaker 1: little bit later to become Buddha Pest. At the time, 172 00:10:47,760 --> 00:10:51,080 Speaker 1: Hungary was part of the Austrian Empire, and he was 173 00:10:51,160 --> 00:10:54,600 Speaker 1: the fifth of ten children born to Grosser Joseph Semilweiss 174 00:10:54,720 --> 00:10:58,880 Speaker 1: and Terisia Mueller. There's a bit of disagreement about the 175 00:10:58,920 --> 00:11:02,679 Speaker 1: family's heritage. Some accounts claim that they were Jewish and 176 00:11:02,720 --> 00:11:05,600 Speaker 1: that anti Semitism was a factor in later parts of 177 00:11:05,640 --> 00:11:11,680 Speaker 1: Semilvis's story, but Sherwin B. Newland, author of The Doctor's Plague, Germs, 178 00:11:11,760 --> 00:11:15,560 Speaker 1: child bed Fever, and The Strange Story of Ignaz Semilviis, 179 00:11:15,720 --> 00:11:18,840 Speaker 1: writes that parish registers document that the semil Weiss family 180 00:11:18,920 --> 00:11:22,800 Speaker 1: was Roman Catholic going back to the sixteen seventies. The 181 00:11:22,840 --> 00:11:26,000 Speaker 1: counter argument is that semil Weiss and his ancestors may 182 00:11:26,040 --> 00:11:29,480 Speaker 1: have been baptized for the sake of assimilation while the 183 00:11:29,520 --> 00:11:33,800 Speaker 1: family was still culturally Jewish, but this is largely conjecture 184 00:11:33,840 --> 00:11:36,560 Speaker 1: and it seems mostly just to be based on their surname. 185 00:11:37,559 --> 00:11:40,640 Speaker 1: In eighteen thirty seven, at the age of nineteen, semuil 186 00:11:40,679 --> 00:11:43,280 Speaker 1: Wess went to the University of Vienna to study law. 187 00:11:44,120 --> 00:11:46,439 Speaker 1: A year later he changed his course of study to 188 00:11:46,520 --> 00:11:49,400 Speaker 1: medicine and he graduated with his m d. In eighteen 189 00:11:49,440 --> 00:11:53,400 Speaker 1: forty four. He looked for a position practicing internal medicine, 190 00:11:53,400 --> 00:11:56,280 Speaker 1: but he couldn't find one, so he changed his focus 191 00:11:56,360 --> 00:11:59,760 Speaker 1: once again and looked for a position in obstetrics. On 192 00:12:00,120 --> 00:12:02,640 Speaker 1: life First, eighteen forty six, he was granted a two 193 00:12:02,720 --> 00:12:06,480 Speaker 1: year appointment as an assistant to Professor Johann Klein, who 194 00:12:06,520 --> 00:12:10,200 Speaker 1: was the director of the Vienna Algamini corunkin House or 195 00:12:10,240 --> 00:12:15,160 Speaker 1: the General Hospital. Vienna General Hospital was a teaching hospital, 196 00:12:15,640 --> 00:12:18,320 Speaker 1: so in this role Semmelweis was both a doctor and 197 00:12:18,400 --> 00:12:22,680 Speaker 1: a teacher. He supervised and educated medical students, and he 198 00:12:22,720 --> 00:12:26,840 Speaker 1: assisted with difficult deliveries. He was also the clerk of records, 199 00:12:26,880 --> 00:12:29,480 Speaker 1: which put him in a good position to spot patterns 200 00:12:29,520 --> 00:12:33,920 Speaker 1: among the patients and their outcomes. The maternity clinic at 201 00:12:33,960 --> 00:12:36,520 Speaker 1: the Vienna General Hospital was one of the ones that 202 00:12:36,559 --> 00:12:40,600 Speaker 1: had been established to provide free medical care to impoverished patients, 203 00:12:41,080 --> 00:12:44,520 Speaker 1: so patients essentially got free care and exchanged for helping 204 00:12:44,640 --> 00:12:48,920 Speaker 1: with the medical students educations. Originally, the hospital had one 205 00:12:49,000 --> 00:12:52,800 Speaker 1: maternity clinic, which was staffed by midwives, doctors, and their students, 206 00:12:53,040 --> 00:12:56,439 Speaker 1: and after a while that one clinic became so overcrowded 207 00:12:56,480 --> 00:12:58,920 Speaker 1: that the hospital opened a second one, which was still 208 00:12:58,960 --> 00:13:02,240 Speaker 1: staffed by a mix of doctors, midwives, and their students. 209 00:13:03,160 --> 00:13:06,840 Speaker 1: But around eighteen forty the two clinics were separated into 210 00:13:06,880 --> 00:13:10,680 Speaker 1: the first and second clinic. The first clinic was staffed 211 00:13:10,720 --> 00:13:13,920 Speaker 1: by doctors and medical students, and the second clinic was 212 00:13:13,960 --> 00:13:18,600 Speaker 1: staffed by midwives and midwiffery students. The two clinics alternated 213 00:13:18,640 --> 00:13:22,360 Speaker 1: admission days, so if the first clinic accepted patients on Monday, 214 00:13:22,760 --> 00:13:26,120 Speaker 1: the second clinic would accept patients on Tuesday, and so on. 215 00:13:26,720 --> 00:13:30,120 Speaker 1: When the maternity clinic first opened in seventeen eighty four, 216 00:13:30,280 --> 00:13:34,760 Speaker 1: the hospital director Lucas Boer, had not included post mortem 217 00:13:34,800 --> 00:13:37,600 Speaker 1: work as part of the obstetric student's course of study 218 00:13:37,679 --> 00:13:40,720 Speaker 1: because he thought it carried a risk of contagion, But 219 00:13:40,760 --> 00:13:43,840 Speaker 1: in eighteen twenty three Johann Klein took over as director 220 00:13:43,960 --> 00:13:47,080 Speaker 1: and started using autopsies as a teaching tool for the 221 00:13:47,120 --> 00:13:52,200 Speaker 1: obstetric students. By the time Semmelweis joined the hospital staff, 222 00:13:52,520 --> 00:13:55,280 Speaker 1: the rates of child bed fever at Vienna General Hospital 223 00:13:55,440 --> 00:13:59,680 Speaker 1: very dramatically between the two clinics. At the midwives clinic, 224 00:14:00,000 --> 00:14:03,240 Speaker 1: between one and two percent of patients died of child 225 00:14:03,240 --> 00:14:06,600 Speaker 1: bed fever, and at the doctor's clinic the rate varied 226 00:14:06,640 --> 00:14:10,520 Speaker 1: from five to with an average of about ten percent. 227 00:14:11,360 --> 00:14:14,640 Speaker 1: This difference between the two clinics was so huge and 228 00:14:14,720 --> 00:14:18,040 Speaker 1: so well known that laboring patients who were told that 229 00:14:18,080 --> 00:14:20,920 Speaker 1: they were being admitted to the doctor's clinic would beg 230 00:14:21,080 --> 00:14:24,680 Speaker 1: to be sent to the midwives clinic instead. Some even 231 00:14:24,760 --> 00:14:28,480 Speaker 1: gave birth in the street outside the clinic after hearing 232 00:14:28,480 --> 00:14:31,320 Speaker 1: that it was the doctor's day for admission, and then 233 00:14:31,360 --> 00:14:32,880 Speaker 1: they would say they had been on the way to 234 00:14:32,920 --> 00:14:35,320 Speaker 1: the hospital and the baby just came before they could 235 00:14:35,360 --> 00:14:38,320 Speaker 1: get there. That way, they would still have access to 236 00:14:38,360 --> 00:14:41,080 Speaker 1: the free care at the clinic, but without the risk 237 00:14:41,160 --> 00:14:44,480 Speaker 1: of death that was associated with it. That's gotta be 238 00:14:44,520 --> 00:14:47,240 Speaker 1: a terrifying choice when you're like, no, I'm I'm just 239 00:14:47,240 --> 00:14:49,120 Speaker 1: gonna do this in the street and then I'll let 240 00:14:49,160 --> 00:14:51,200 Speaker 1: them take care of me after that. Well, and I 241 00:14:51,200 --> 00:14:54,080 Speaker 1: imagine a thing I didn't find. Um, I didn't find 242 00:14:54,080 --> 00:14:56,600 Speaker 1: sources that said this, but considering that my own mother 243 00:14:56,680 --> 00:14:58,760 Speaker 1: did this when I was born, I imagine the people 244 00:14:58,800 --> 00:15:01,160 Speaker 1: that were like, I'm in labor, but I'm not far 245 00:15:01,240 --> 00:15:03,920 Speaker 1: into labor, and it's the doctor's day. I'm gonna wait 246 00:15:03,960 --> 00:15:07,160 Speaker 1: a few hours so i can go to the midwives clinic. 247 00:15:07,360 --> 00:15:09,960 Speaker 1: I imagine that was a thing too. My my parents 248 00:15:10,040 --> 00:15:12,160 Speaker 1: did that because if they waited till after midnight, they 249 00:15:12,200 --> 00:15:15,440 Speaker 1: wouldn't be billed for the extra day. Did not have 250 00:15:15,520 --> 00:15:19,680 Speaker 1: a ton of money. Simil Vis noticed that even these 251 00:15:19,720 --> 00:15:23,000 Speaker 1: births out in the street were safer than giving birth 252 00:15:23,040 --> 00:15:26,360 Speaker 1: in the doctor's clinic at the hospital. He wrote, quote 253 00:15:26,400 --> 00:15:30,080 Speaker 1: to me, it appeared logical that patients who experienced street 254 00:15:30,160 --> 00:15:33,400 Speaker 1: births would become ill at least as frequently as those 255 00:15:33,440 --> 00:15:36,960 Speaker 1: who delivered in the clinic. What protected those who delivered 256 00:15:36,960 --> 00:15:41,760 Speaker 1: outside the clinic from these destructive, unknown endemic influences. He 257 00:15:42,000 --> 00:15:46,160 Speaker 1: became completely fixated on this question. It was appalling and 258 00:15:46,280 --> 00:15:48,720 Speaker 1: deeply offensive to him that there was such a huge 259 00:15:48,760 --> 00:15:52,160 Speaker 1: difference between the doctors and the midwives clinics. So you 260 00:15:52,280 --> 00:15:55,040 Speaker 1: started trying to figure out what was different between the 261 00:15:55,080 --> 00:15:58,280 Speaker 1: two clinics, and then making adjustments to what the doctors 262 00:15:58,320 --> 00:16:02,480 Speaker 1: were doing. At the midwives clinic, patients lay on their 263 00:16:02,520 --> 00:16:05,480 Speaker 1: sides to deliver, but at the doctor's clinic they lay 264 00:16:05,520 --> 00:16:08,760 Speaker 1: on their backs. Similar Wizz changed the procedure at the 265 00:16:08,800 --> 00:16:12,680 Speaker 1: doctor's clinic to use sidelining, but that didn't make a difference. 266 00:16:13,760 --> 00:16:16,760 Speaker 1: They also noticed that anytime a patient was dying in 267 00:16:16,800 --> 00:16:19,640 Speaker 1: the doctor's clinic, the priest who was arriving to get 268 00:16:19,920 --> 00:16:22,600 Speaker 1: to give last rites basically had to walk through the 269 00:16:22,640 --> 00:16:25,320 Speaker 1: whole ward, and he rang a bell while he was 270 00:16:25,400 --> 00:16:28,760 Speaker 1: doing this. Some of us thought maybe this bell and 271 00:16:28,800 --> 00:16:31,920 Speaker 1: what it signified was so terrifying that it was making 272 00:16:31,960 --> 00:16:34,880 Speaker 1: people sick, so he got the priest to stop it 273 00:16:34,920 --> 00:16:38,640 Speaker 1: with the bell. That did not fix the problem. He 274 00:16:38,680 --> 00:16:41,360 Speaker 1: looked at how crowded the two clinics were, and it 275 00:16:41,440 --> 00:16:45,680 Speaker 1: turned out that the midwives clinic was understandably far more crowded. 276 00:16:46,160 --> 00:16:48,720 Speaker 1: He looked at the religious practices of the people working 277 00:16:48,720 --> 00:16:51,520 Speaker 1: in each clinic. He looked at the patient's diets, and 278 00:16:51,600 --> 00:16:56,040 Speaker 1: none of these things seemed to make a difference. Then 279 00:16:56,080 --> 00:16:59,840 Speaker 1: his friend and colleague, Jacob Colleca died of what appeared 280 00:16:59,840 --> 00:17:03,160 Speaker 1: to each childbed fever after accidentally being nicked with a 281 00:17:03,240 --> 00:17:06,640 Speaker 1: scalpel while performing an autopsy on someone who had died 282 00:17:06,680 --> 00:17:11,440 Speaker 1: of it, and Collectica's own autopsy results were very similar 283 00:17:11,480 --> 00:17:16,480 Speaker 1: to those of childbed fever victims. That's when Semilvieis realized 284 00:17:16,520 --> 00:17:20,600 Speaker 1: that midwiffery students weren't performing autopsies as part of their training, 285 00:17:21,119 --> 00:17:24,679 Speaker 1: only the medical students were. Another difference was that the 286 00:17:24,680 --> 00:17:28,640 Speaker 1: medical students were performing vaginal examinations on their patients as 287 00:17:28,680 --> 00:17:32,359 Speaker 1: a routine part of their care, while midwiffery students only 288 00:17:32,400 --> 00:17:35,120 Speaker 1: did so when there seemed to be a need for one. 289 00:17:35,480 --> 00:17:39,960 Speaker 1: Semilvis's conclusion was that some kind of cadaverous particles were 290 00:17:40,000 --> 00:17:43,480 Speaker 1: being transmitted from the autopsies to the patients in the 291 00:17:43,560 --> 00:17:47,919 Speaker 1: doctor's clinic. In mid May of eighteen forty seven, Semulvis 292 00:17:47,960 --> 00:17:52,000 Speaker 1: started instructing doctors and medical students to wash their hands 293 00:17:52,119 --> 00:17:56,440 Speaker 1: after conducting autopsies. They were to use chlorinated lime until 294 00:17:56,480 --> 00:17:59,280 Speaker 1: their hands had no trace of the putrid smell that 295 00:17:59,400 --> 00:18:03,399 Speaker 1: was left hind by a decaying body. He chose chlorinated 296 00:18:03,440 --> 00:18:05,560 Speaker 1: lime because it seemed to do the best job of 297 00:18:05,600 --> 00:18:10,160 Speaker 1: getting rid of the odor. But chlorinated lime is calcium hypochlorite, 298 00:18:10,200 --> 00:18:14,879 Speaker 1: which today is sold as powdered chlorine bleach. Chlorine bleach is, 299 00:18:15,160 --> 00:18:20,480 Speaker 1: of course a disinfectant. With Salis's handwashing protocol in place, 300 00:18:20,880 --> 00:18:23,680 Speaker 1: the rate of child bed fever mortality in the doctor's 301 00:18:23,720 --> 00:18:27,200 Speaker 1: clinics started to drop. It had been eighteen point three 302 00:18:27,200 --> 00:18:30,159 Speaker 1: percent in April, and by June it had dropped to 303 00:18:30,200 --> 00:18:34,320 Speaker 1: two point two. In August of eighty seven, for the 304 00:18:34,400 --> 00:18:38,680 Speaker 1: first time since the medical students started performing autopsies, no 305 00:18:38,720 --> 00:18:41,479 Speaker 1: one died of child bed fever in the doctor's clinic. 306 00:18:42,480 --> 00:18:46,280 Speaker 1: Some of us couldn't exactly explain why this had worked. 307 00:18:47,000 --> 00:18:49,960 Speaker 1: At one point, another outbreak of child bed fever spread 308 00:18:50,040 --> 00:18:52,600 Speaker 1: through the clinic, even though there had been no autopsy 309 00:18:52,720 --> 00:18:55,440 Speaker 1: to trigger it. So some of VISs began to suggest 310 00:18:55,600 --> 00:18:59,000 Speaker 1: that some patients might make their own so called cadaverous 311 00:18:59,080 --> 00:19:03,080 Speaker 1: particles their own bodies, rather than the autopsies being their 312 00:19:03,119 --> 00:19:08,040 Speaker 1: only source. Later on, he revised his hypothesis a third time, 313 00:19:08,160 --> 00:19:11,480 Speaker 1: saying that the cadaverous particles could come from any decaying 314 00:19:11,600 --> 00:19:15,600 Speaker 1: animal flesh, not just from a human body. The fact 315 00:19:15,600 --> 00:19:19,800 Speaker 1: that he couldn't adequately explain why his protocol worked became 316 00:19:19,840 --> 00:19:23,320 Speaker 1: one of the arguments against his findings. While some of 317 00:19:23,320 --> 00:19:26,760 Speaker 1: his medical students agreed with and supported his work, most 318 00:19:26,800 --> 00:19:29,959 Speaker 1: of the established doctors at the hospital dismissed him completely. 319 00:19:30,720 --> 00:19:34,080 Speaker 1: Director Johann Klein insisted that it was the clinic's new 320 00:19:34,160 --> 00:19:38,240 Speaker 1: ventilation system which was getting rid of dangerous miasmas and 321 00:19:38,320 --> 00:19:43,040 Speaker 1: that should get the credit. Other doctors also vehemently disagreed 322 00:19:43,119 --> 00:19:46,120 Speaker 1: with the idea that their own hands could have been 323 00:19:46,119 --> 00:19:50,680 Speaker 1: what was spreading such a devastating, painful, and emotionally wrenching disease. 324 00:19:51,400 --> 00:19:54,520 Speaker 1: It was unfathomable to them that a doctor could have 325 00:19:54,600 --> 00:19:58,400 Speaker 1: dirty hands in the first place. In their minds, doctors 326 00:19:58,400 --> 00:20:01,760 Speaker 1: were gentlemen, and a gentle men's hands were always clean, 327 00:20:02,480 --> 00:20:06,240 Speaker 1: and his word of several vices protocol spread beyond a hospital. 328 00:20:06,640 --> 00:20:09,280 Speaker 1: Doctors were also resistant to the idea of washing their 329 00:20:09,280 --> 00:20:12,639 Speaker 1: hands because they didn't necessarily have access to clean water 330 00:20:12,720 --> 00:20:15,840 Speaker 1: where they worked, and also because it was time consuming. 331 00:20:16,960 --> 00:20:19,280 Speaker 1: I like this weird chicken in the egg thing, where 332 00:20:19,320 --> 00:20:23,160 Speaker 1: like a gentleman's hands aren't clean because he takes such 333 00:20:23,200 --> 00:20:29,639 Speaker 1: fastidious care of himself, but just because he's a gentle yes. Uh. 334 00:20:29,760 --> 00:20:33,439 Speaker 1: Later on several vice would describe it this way quote. 335 00:20:33,800 --> 00:20:37,480 Speaker 1: Most medical lecture halls continued to resound with lectures on 336 00:20:37,520 --> 00:20:41,560 Speaker 1: epidemic child bed fever and with discourse against my theories. 337 00:20:42,240 --> 00:20:45,320 Speaker 1: The medical literature for the last twelve years continues to 338 00:20:45,400 --> 00:20:49,159 Speaker 1: swell with reports of pure Borough epidemics, and in eighteen 339 00:20:49,160 --> 00:20:52,720 Speaker 1: fifty four, in Vienna, the birthplace of my theory, four 340 00:20:52,800 --> 00:20:57,480 Speaker 1: hundred maternity patients died from child bed fever. In published 341 00:20:57,480 --> 00:21:01,480 Speaker 1: medical works, my teachings are either ignored or attacked. The 342 00:21:01,600 --> 00:21:05,560 Speaker 1: medical faculty at Wurtzburg awarded a prize to a monograph 343 00:21:05,680 --> 00:21:09,920 Speaker 1: written in eighteen fifty nine in which my teachings were rejected. 344 00:21:10,600 --> 00:21:12,520 Speaker 1: So he wrote that a little bit later, and to 345 00:21:12,720 --> 00:21:15,800 Speaker 1: return to this current part of the story, simil Weis 346 00:21:15,960 --> 00:21:18,560 Speaker 1: did not back down in the face of all this opposition. 347 00:21:19,280 --> 00:21:22,680 Speaker 1: In eighteen forty eight, he started requiring that medical students 348 00:21:22,760 --> 00:21:25,919 Speaker 1: clean all the instruments that were used during labor and 349 00:21:25,960 --> 00:21:29,800 Speaker 1: delivery with chlorinated lime as well. The clinic had already 350 00:21:29,840 --> 00:21:32,399 Speaker 1: had a month where there had been no deaths, and 351 00:21:32,440 --> 00:21:35,760 Speaker 1: at this point the ongoing mortality rate from child bed 352 00:21:35,800 --> 00:21:40,840 Speaker 1: fever at the hospital dropped almost to zero. As doctors 353 00:21:40,920 --> 00:21:46,520 Speaker 1: continued to dismiss his findings, Similviis became increasingly hostile and combative, 354 00:21:47,280 --> 00:21:51,359 Speaker 1: and simultaneously, uprisings were sweeping through the area as people 355 00:21:51,400 --> 00:21:56,760 Speaker 1: protested against the Habsburg dynasty in the Austrian Empire. Students 356 00:21:56,800 --> 00:22:00,440 Speaker 1: held a demonstration in Vienna on March thirteenth, eighteen four eight, 357 00:22:00,760 --> 00:22:04,000 Speaker 1: and the Hungarian Revolution of eighteen forty eight began two 358 00:22:04,040 --> 00:22:08,240 Speaker 1: days later. Although there's no evidence that Cemilviis was part 359 00:22:08,240 --> 00:22:11,920 Speaker 1: of these demonstrations, many of his student supporters were, which 360 00:22:11,960 --> 00:22:16,240 Speaker 1: probably inflamed tensions between him and the rest of the faculty. 361 00:22:16,680 --> 00:22:18,919 Speaker 1: As I said earlier, that position he had at the 362 00:22:18,920 --> 00:22:21,160 Speaker 1: maternity clinic and at the hospital had been a two 363 00:22:21,280 --> 00:22:25,000 Speaker 1: year appointment, and in eighteen forty nine the hospital elected 364 00:22:25,040 --> 00:22:28,160 Speaker 1: not to renew it. He was instead offered a position 365 00:22:28,160 --> 00:22:32,080 Speaker 1: that had no contact with cadavers. In eighteen fifty he 366 00:22:32,160 --> 00:22:35,720 Speaker 1: left Vienna to return home without announcing his departure or 367 00:22:35,840 --> 00:22:38,560 Speaker 1: saying goodbye to anyone. He knew we're going to talk 368 00:22:38,560 --> 00:22:41,560 Speaker 1: about semil Vice's life back in Hungary. After we first 369 00:22:41,560 --> 00:22:53,240 Speaker 1: pause for another sponsor break in eighteen fifty one, Ignaz 370 00:22:53,320 --> 00:22:57,040 Speaker 1: Semilviis was named head of obstetrics at St. Rocas Hospital. 371 00:22:57,280 --> 00:23:00,840 Speaker 1: Although this was really an honorary and un haide position, 372 00:23:01,400 --> 00:23:03,920 Speaker 1: he did hold it for the next few years, though, 373 00:23:04,000 --> 00:23:06,359 Speaker 1: during which time the rate of child bed fever at 374 00:23:06,359 --> 00:23:11,119 Speaker 1: the hospital dropped significantly. In the mid eighteen fifties, some 375 00:23:11,280 --> 00:23:14,240 Speaker 1: of Vis left St Roucas and became a professor at 376 00:23:14,320 --> 00:23:18,920 Speaker 1: Peste University. In eighteen fifty seven, he married Maria Widenhoffer, 377 00:23:19,040 --> 00:23:22,160 Speaker 1: and they went on to have five children together. During 378 00:23:22,240 --> 00:23:25,960 Speaker 1: these years, some of Vice continued to advocate for handwashing 379 00:23:26,000 --> 00:23:29,760 Speaker 1: after autopsies, and he also wrote a series of extremely 380 00:23:29,800 --> 00:23:33,120 Speaker 1: hostile open letters to the doctors who dismissed his ideas, 381 00:23:33,520 --> 00:23:36,399 Speaker 1: calling them murderers who were responsible for the deaths of 382 00:23:36,480 --> 00:23:40,639 Speaker 1: women through their negligence. This seems to me like a 383 00:23:40,760 --> 00:23:46,480 Speaker 1: very fair assessment, but but people began to increasingly think 384 00:23:46,520 --> 00:23:49,159 Speaker 1: he is just uh an angry man that no one 385 00:23:49,160 --> 00:23:52,480 Speaker 1: should listen to. He wrote things like, you, hair, professor, 386 00:23:52,600 --> 00:23:56,760 Speaker 1: have been a partner in this massacre, and should you 387 00:23:57,359 --> 00:24:01,359 Speaker 1: hair halfroth? Without having disproved my doctrine, continued to train 388 00:24:01,400 --> 00:24:04,600 Speaker 1: your pupils against it. I declare before God and the 389 00:24:04,600 --> 00:24:07,680 Speaker 1: world that you are a murderer, and the history of 390 00:24:07,760 --> 00:24:10,639 Speaker 1: childbed fever would not be unjust to you if it 391 00:24:10,680 --> 00:24:15,760 Speaker 1: memorialized you as a medical nero. In eighteen fifty eight, 392 00:24:15,920 --> 00:24:18,880 Speaker 1: after years of his supporters telling him he should publish 393 00:24:18,880 --> 00:24:22,600 Speaker 1: his work, he published The Ideology of child bed Fever. 394 00:24:23,560 --> 00:24:26,840 Speaker 1: Another work, The Difference in Opinion between Myself and the 395 00:24:26,880 --> 00:24:31,880 Speaker 1: English Physicians regarding child bed Fever, followed in eighteen sixty, 396 00:24:31,960 --> 00:24:34,440 Speaker 1: and in eighteen sixty one he published a book called 397 00:24:34,480 --> 00:24:38,320 Speaker 1: The Etiology, the Concept and the Prophylaxis of child bed Fever. 398 00:24:39,320 --> 00:24:42,120 Speaker 1: In places, this was a clear and well written treatise 399 00:24:42,160 --> 00:24:46,680 Speaker 1: on childbed fever, but large portions were actually diatribes against 400 00:24:46,680 --> 00:24:51,400 Speaker 1: his critics, some of them rambling, repetitive, and almost nonsensical. 401 00:24:52,160 --> 00:24:56,560 Speaker 1: Ignaz Semmelweiss had been described as abrasive, dogmatic, and even 402 00:24:56,680 --> 00:24:59,160 Speaker 1: route for most of his career, but by the time 403 00:24:59,200 --> 00:25:02,639 Speaker 1: this book came out, he was also starting to behave erratically. 404 00:25:03,280 --> 00:25:06,080 Speaker 1: This got worse in the early eighteen sixties, and on 405 00:25:06,200 --> 00:25:09,960 Speaker 1: July thirteenth, eighteen sixty five, he returned home from a 406 00:25:10,000 --> 00:25:13,359 Speaker 1: family outing and was behaving so bizarrely that his wife 407 00:25:13,400 --> 00:25:17,080 Speaker 1: became convinced that something was seriously wrong with him, and 408 00:25:17,119 --> 00:25:19,840 Speaker 1: then on July twenty one, he went to a meeting 409 00:25:19,880 --> 00:25:23,000 Speaker 1: at his job, where, among other things, he was supposed 410 00:25:23,040 --> 00:25:27,240 Speaker 1: to talk about candidates for a vacant lecturers post, and 411 00:25:27,280 --> 00:25:30,720 Speaker 1: according to his former assistant, instead he read a piece 412 00:25:30,720 --> 00:25:35,320 Speaker 1: of paper containing the midwives Oath of Practice. Clearly unaware 413 00:25:35,400 --> 00:25:40,040 Speaker 1: that he was doing anything amiss, Symbolsize planned to go 414 00:25:40,119 --> 00:25:42,679 Speaker 1: to a spa and take water treatments there, and he 415 00:25:42,760 --> 00:25:46,760 Speaker 1: departed with his wife and some attendants on July twenty nine, 416 00:25:47,160 --> 00:25:50,040 Speaker 1: but the next day, for reasons that aren't entirely clear, 417 00:25:50,480 --> 00:25:53,560 Speaker 1: he was instead committed to a public institution, where he 418 00:25:53,640 --> 00:25:56,920 Speaker 1: died on August thirteenth, eighteen sixty five, at the age 419 00:25:56,920 --> 00:26:00,640 Speaker 1: of forty seven. He was buried in Vienna to days later. 420 00:26:01,760 --> 00:26:05,280 Speaker 1: There are some conflicting reports about what happened at the institution. 421 00:26:06,080 --> 00:26:08,760 Speaker 1: In some accounts, he became so violent that he had 422 00:26:08,800 --> 00:26:12,040 Speaker 1: to be restrained, and during that encounter he was injured, 423 00:26:12,320 --> 00:26:15,560 Speaker 1: but in others, he was severely beaten by guards and 424 00:26:15,600 --> 00:26:19,000 Speaker 1: then left without any kind of medical treatment. Regardless of 425 00:26:19,040 --> 00:26:22,240 Speaker 1: exactly what happened, an injury to his finger that he 426 00:26:22,320 --> 00:26:25,119 Speaker 1: either had when he got to the hospital or sustained 427 00:26:25,119 --> 00:26:29,120 Speaker 1: in the incident became infected. An autopsy that was performed 428 00:26:29,160 --> 00:26:33,679 Speaker 1: at Vienna Algaminy crunkin House diagnosed quote paralysis of the 429 00:26:33,760 --> 00:26:37,680 Speaker 1: brain as his cause of death. Today, it seems likely 430 00:26:37,720 --> 00:26:40,879 Speaker 1: to have been sept to semia, but the autopsy also 431 00:26:40,960 --> 00:26:44,199 Speaker 1: revealed that he had severe injuries that do suggest that 432 00:26:44,240 --> 00:26:48,159 Speaker 1: he had been beaten. It's also not clear what caused 433 00:26:48,200 --> 00:26:51,080 Speaker 1: his behavior to become so erratic in the last years 434 00:26:51,119 --> 00:26:55,159 Speaker 1: of his life. Theories range from the continual stress of 435 00:26:55,200 --> 00:26:58,359 Speaker 1: being such a pariah in the medical community to early 436 00:26:58,400 --> 00:27:02,879 Speaker 1: onset Alzheimer's late stage syphilis, which was an occupational hazard 437 00:27:02,920 --> 00:27:05,800 Speaker 1: of being an obstetrician at a busy hospital at this 438 00:27:05,880 --> 00:27:09,879 Speaker 1: point in history. In the later years the cimil Vices life, 439 00:27:10,040 --> 00:27:13,520 Speaker 1: other doctors were also working on ideas that were related 440 00:27:13,560 --> 00:27:17,960 Speaker 1: to contagion and the germ theory of disease. In eighteen fifty, 441 00:27:18,040 --> 00:27:21,600 Speaker 1: two years after cemil Vice instituted handwashing at the Vanna 442 00:27:21,680 --> 00:27:26,119 Speaker 1: General Hospital, James Young Simpson of Scotland published a detailed 443 00:27:26,160 --> 00:27:30,280 Speaker 1: description of how materials more by could be introduced into 444 00:27:30,320 --> 00:27:33,600 Speaker 1: the body during labor and delivery, and how the postpartum 445 00:27:33,600 --> 00:27:37,480 Speaker 1: body was primed for infection and because of the dilation 446 00:27:37,640 --> 00:27:41,800 Speaker 1: and abrasion sustained during birth. He even made the comparison 447 00:27:41,880 --> 00:27:46,000 Speaker 1: between the attendants fingers and the ivory points that were 448 00:27:46,000 --> 00:27:50,480 Speaker 1: that had been used to administer smallpox vaccinations by transferring 449 00:27:50,520 --> 00:27:55,399 Speaker 1: material from a cowpox lesion to a person's skin. In 450 00:27:55,440 --> 00:27:59,760 Speaker 1: the eighteen fifties and sixties, Louis Pasteur was studying how 451 00:27:59,840 --> 00:28:04,159 Speaker 1: mycro organisms caused beer and wine to spoil. In eighteen 452 00:28:04,200 --> 00:28:08,000 Speaker 1: sixty seven, Joseph Lister began publishing work on preventing infection 453 00:28:08,119 --> 00:28:13,360 Speaker 1: during surgery, which included hygiene and handwashing with carbolic Ten 454 00:28:13,440 --> 00:28:16,480 Speaker 1: years prior to that, in eighteen fifty seven, Robert Coke 455 00:28:16,560 --> 00:28:21,480 Speaker 1: made the connection between the anthrax disease and the anthrax bacterium, 456 00:28:21,480 --> 00:28:24,960 Speaker 1: and later he helped articulate for criteria to prove that 457 00:28:25,000 --> 00:28:28,440 Speaker 1: a disease is caused by a specific micro organism, which 458 00:28:28,440 --> 00:28:32,639 Speaker 1: are called Coke's postulates today. These criteria are that the 459 00:28:32,680 --> 00:28:36,399 Speaker 1: micro organism is always associated with the disease, that it 460 00:28:36,440 --> 00:28:38,680 Speaker 1: can be taken from a diseased animal and grown in 461 00:28:38,680 --> 00:28:42,240 Speaker 1: a culture, that the cultured organism can cause the disease 462 00:28:42,280 --> 00:28:45,480 Speaker 1: in a healthy animal, and that the same micro organism 463 00:28:45,520 --> 00:28:49,400 Speaker 1: can be collected from the newly diseased animal. So, based 464 00:28:49,400 --> 00:28:52,680 Speaker 1: on the work of Louis Pasteur, Joseph Lister, Robert Coke, 465 00:28:52,760 --> 00:28:56,400 Speaker 1: and others, infection control finally became a routine part of 466 00:28:56,400 --> 00:29:00,760 Speaker 1: obstetrics in the eighties. But these researchers don't appear to 467 00:29:00,840 --> 00:29:03,600 Speaker 1: have been influenced by seul vices work at all. In 468 00:29:03,640 --> 00:29:06,040 Speaker 1: a lot of cases, they hadn't even heard of him 469 00:29:06,160 --> 00:29:10,120 Speaker 1: until long after they did their first groundbreaking work. He 470 00:29:10,320 --> 00:29:14,200 Speaker 1: faded into obscurity after his death until a Hungarian doctor 471 00:29:14,240 --> 00:29:18,640 Speaker 1: published a paper about him in eighteen eighty seven. Today 472 00:29:18,880 --> 00:29:21,840 Speaker 1: there are lots of hospitals and clinics named after Igno's 473 00:29:21,840 --> 00:29:25,880 Speaker 1: semil Vice, along with the semil Vice Medical Historical Museum 474 00:29:25,960 --> 00:29:30,120 Speaker 1: in Budapest, and at some point some unknown person coined 475 00:29:30,280 --> 00:29:33,640 Speaker 1: the simil Viz reflex to describe a rejection of new 476 00:29:33,680 --> 00:29:38,600 Speaker 1: information because it contradicts established norms. Even though pure pearl 477 00:29:38,680 --> 00:29:41,040 Speaker 1: fever is much less of an issue for a lot 478 00:29:41,080 --> 00:29:44,120 Speaker 1: of the world today than it was in nineteenth century Europe, 479 00:29:44,400 --> 00:29:48,040 Speaker 1: hospital acquired infections are still an issue even in the 480 00:29:48,080 --> 00:29:52,840 Speaker 1: most affluent parts of the world, known as nasocomial infections, 481 00:29:52,880 --> 00:29:57,280 Speaker 1: they're the most common complication in hospitalized people. They happened 482 00:29:57,280 --> 00:30:00,600 Speaker 1: in between five and ten percent of acute our patients, 483 00:30:00,720 --> 00:30:04,800 Speaker 1: and handwashing is a huge part of preventing them. YEA 484 00:30:05,200 --> 00:30:09,440 Speaker 1: for hand washing, Yes, please wash your hands. This This 485 00:30:09,480 --> 00:30:11,680 Speaker 1: story reminds me a little bit of Fritz Wiki, where 486 00:30:11,760 --> 00:30:15,719 Speaker 1: somebody is really clearly onto something and their contemporaries are 487 00:30:15,760 --> 00:30:18,320 Speaker 1: like Nope, nope, nope, and it makes them frustrated and 488 00:30:18,400 --> 00:30:23,080 Speaker 1: it's a little bit mad having to fight against that 489 00:30:23,120 --> 00:30:25,520 Speaker 1: all the time. Yes, some of the some of the 490 00:30:26,560 --> 00:30:28,240 Speaker 1: things that I read about him that have been written 491 00:30:28,280 --> 00:30:33,720 Speaker 1: more recently almost have a victim blamey aspect to them. 492 00:30:33,880 --> 00:30:35,840 Speaker 1: They they're sort of like, if he hadn't been such 493 00:30:35,880 --> 00:30:37,960 Speaker 1: a jerk about it, people might have listened to him. 494 00:30:38,000 --> 00:30:41,880 Speaker 1: And I'm like, women were literally dying, and he was like, 495 00:30:42,280 --> 00:30:45,320 Speaker 1: who cares how it works, washing your hands keeps the 496 00:30:45,400 --> 00:30:50,880 Speaker 1: women from dying. Why won't you just do it? And like, 497 00:30:51,360 --> 00:30:55,760 Speaker 1: I'm like that understandably made him really angry. Well, and 498 00:30:55,840 --> 00:31:00,720 Speaker 1: it is kind of hard to understand how people were 499 00:31:00,760 --> 00:31:04,440 Speaker 1: not getting the pattern recognition of everywhere he went and 500 00:31:04,520 --> 00:31:09,959 Speaker 1: instituted his practices, mortality went down, and so clearly something 501 00:31:10,040 --> 00:31:12,920 Speaker 1: was correct. Uh so it seems weird that they would 502 00:31:12,960 --> 00:31:15,160 Speaker 1: continue to be like, nope, nope, nope, no my hands, 503 00:31:15,160 --> 00:31:23,280 Speaker 1: I'm a gentleman. Thank you so much for joining us 504 00:31:23,320 --> 00:31:26,280 Speaker 1: today for this Saturday classic. 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