1 00:00:01,160 --> 00:00:04,120 Speaker 1: Welcome to steph you missed in history class from how 2 00:00:04,160 --> 00:00:14,440 Speaker 1: Stuff Works dot Com. Hello, and welcome to the podcast. 3 00:00:14,560 --> 00:00:18,560 Speaker 1: I'm Tracy V. Wilson and I'm Holly fry So. Holly, 4 00:00:18,720 --> 00:00:21,079 Speaker 1: I think a lot of people take for granted the 5 00:00:21,160 --> 00:00:26,479 Speaker 1: idea that you need to wash your hands to prevent disease. Yes, 6 00:00:26,680 --> 00:00:30,440 Speaker 1: but also some people discount it well. And there's also 7 00:00:30,560 --> 00:00:32,960 Speaker 1: a lot of research that even though this is a 8 00:00:33,000 --> 00:00:36,640 Speaker 1: pretty ubiquitous and standard idea, a lot of people don't 9 00:00:36,680 --> 00:00:39,440 Speaker 1: actually wash their hands nearly as much as they should. 10 00:00:39,479 --> 00:00:42,519 Speaker 1: But regardless of all of that, it was not taken 11 00:00:42,560 --> 00:00:46,519 Speaker 1: for granted in nineteenth century Europe, including among doctors, that 12 00:00:46,600 --> 00:00:48,760 Speaker 1: you needed to wash your hands to prevent disease. And 13 00:00:48,760 --> 00:00:51,400 Speaker 1: today we are going to talk about Ignaz Semmel Vice, 14 00:00:51,840 --> 00:00:53,959 Speaker 1: who was one of the people who made this connection 15 00:00:54,080 --> 00:00:58,120 Speaker 1: between hand washing and disease prevention. The disease that he 16 00:00:58,200 --> 00:01:01,120 Speaker 1: was preventing was childbed fever, and even though it was 17 00:01:01,200 --> 00:01:04,640 Speaker 1: not taken seriously at the time, like people wrote him 18 00:01:04,680 --> 00:01:08,400 Speaker 1: off entirely, today he's known as everything from the father 19 00:01:08,480 --> 00:01:12,400 Speaker 1: of infection control and the savior of mothers and the 20 00:01:12,440 --> 00:01:16,280 Speaker 1: conqueror of child bed fever, which is a lot of 21 00:01:16,680 --> 00:01:19,760 Speaker 1: I mean, very lofty pronouncements, and he did do amazing work, 22 00:01:19,840 --> 00:01:24,520 Speaker 1: but it did not last past his lifetime. Uh. This episode. Also, 23 00:01:24,680 --> 00:01:27,680 Speaker 1: to be clear, it's about medicine in nineteenth century Europe 24 00:01:27,920 --> 00:01:30,280 Speaker 1: and to a lesser extent in North America. And we're 25 00:01:30,319 --> 00:01:33,240 Speaker 1: definitely aware that religions and cultures all over the world 26 00:01:33,319 --> 00:01:37,280 Speaker 1: have their own practices about everything from handwashing to delivering babies. 27 00:01:37,560 --> 00:01:39,440 Speaker 1: It is not about that at all. This is not 28 00:01:39,480 --> 00:01:42,279 Speaker 1: a global overview of hand hygiene and how it relates 29 00:01:42,280 --> 00:01:45,600 Speaker 1: to medicine. We're really looking at how the practice of 30 00:01:45,600 --> 00:01:49,520 Speaker 1: obstetrics and formal medical training collided in the eighteenth and 31 00:01:49,600 --> 00:01:53,280 Speaker 1: nineteenth centuries. And this is also a listener request we've 32 00:01:53,280 --> 00:01:58,160 Speaker 1: gotten from several people, including Margaret Tom and Ashley Child. 33 00:01:58,200 --> 00:02:01,160 Speaker 1: Bed fever, also known as pew a pearl fever, is 34 00:02:01,200 --> 00:02:04,400 Speaker 1: a postpartum infection of the uterus or the vaginal canal, 35 00:02:05,040 --> 00:02:08,040 Speaker 1: and it's often caused by a streptococcal infection, but it 36 00:02:08,080 --> 00:02:11,920 Speaker 1: can come from other pathogens as well. Today, these infections 37 00:02:11,919 --> 00:02:16,000 Speaker 1: are largely preventable through hygiene and infection control procedures during 38 00:02:16,040 --> 00:02:19,320 Speaker 1: labor and delivery, and when they do happen, they're usually 39 00:02:19,360 --> 00:02:23,840 Speaker 1: treatable with antibiotics, so in places where competent care, clean water, 40 00:02:23,960 --> 00:02:28,520 Speaker 1: and antibiotics are readily available, pure pearl fever isn't very common. 41 00:02:29,120 --> 00:02:31,760 Speaker 1: This was not the case before the germ theory of 42 00:02:31,840 --> 00:02:36,320 Speaker 1: disease or the discovery of antibiotics. Until the late nineteenth century, 43 00:02:36,400 --> 00:02:40,480 Speaker 1: childbed fever was one of the most common complications of childbirth. 44 00:02:40,840 --> 00:02:46,919 Speaker 1: Within about three days of giving birth, patients developed abdominal pain, fevers, abscesses, 45 00:02:46,960 --> 00:02:49,680 Speaker 1: and other signs of infection, and this would often progress 46 00:02:49,720 --> 00:02:53,600 Speaker 1: to blood poisoning and death. Sometimes incidents of child bed 47 00:02:53,639 --> 00:02:57,280 Speaker 1: fever were sporadic, and between twenty and thirty of those 48 00:02:57,280 --> 00:03:01,359 Speaker 1: sporadic infections were fatal. But when an epidemic of child 49 00:03:01,440 --> 00:03:04,200 Speaker 1: bed fever swept through a community or a hospital, it 50 00:03:04,280 --> 00:03:06,960 Speaker 1: tended to be a lot deadlier, with seventy two with 51 00:03:07,040 --> 00:03:11,200 Speaker 1: a seventy to eighty percent mortality rate, and a lot 52 00:03:11,240 --> 00:03:14,959 Speaker 1: of prominent women died of child bed fever throughout history, 53 00:03:15,080 --> 00:03:18,760 Speaker 1: including Mary Wolston Craft, Henry the Eighth Wife, Jane Seymour, 54 00:03:19,400 --> 00:03:24,160 Speaker 1: and possibly recent podcast subject Phyllis Wheatley. Obviously, a lot 55 00:03:24,200 --> 00:03:26,360 Speaker 1: of ordinary women did to you that aren't in the 56 00:03:26,440 --> 00:03:30,480 Speaker 1: history books. It was something both expecting parents and their 57 00:03:30,560 --> 00:03:34,679 Speaker 1: doctors and midwives dreaded and feared. Child bed fever was 58 00:03:34,760 --> 00:03:37,960 Speaker 1: described in medical literature all the way back to Hippocrates 59 00:03:38,040 --> 00:03:41,240 Speaker 1: in the fourth century BC, and in the years before 60 00:03:41,320 --> 00:03:44,360 Speaker 1: evidence based medicine. People blamed it on a range of 61 00:03:44,440 --> 00:03:47,800 Speaker 1: causes based on whatever medical theories were in use at 62 00:03:47,800 --> 00:03:51,480 Speaker 1: the time, so everything from a balance an imbalance in 63 00:03:51,520 --> 00:03:56,240 Speaker 1: the four Humors to myasthmas or bad air. By the 64 00:03:56,320 --> 00:03:59,760 Speaker 1: eighteenth century, doctors were devoting a lot of writing to 65 00:04:00,040 --> 00:04:03,680 Speaker 1: arguing about whether it was an inflammatory or a putrefying disease. 66 00:04:04,640 --> 00:04:08,120 Speaker 1: In the eighteenth and nineteen centuries, a few things happened 67 00:04:08,120 --> 00:04:10,840 Speaker 1: in tandem that led to a big increase in child 68 00:04:10,920 --> 00:04:14,520 Speaker 1: bed fever epidemics. One was that more babies were being 69 00:04:14,520 --> 00:04:18,320 Speaker 1: delivered in hospitals rather than at home. In some cases, 70 00:04:18,360 --> 00:04:21,800 Speaker 1: these hospitals were part of social programs. The idea was 71 00:04:21,839 --> 00:04:25,360 Speaker 1: to provide free care before and after delivery to try 72 00:04:25,360 --> 00:04:29,040 Speaker 1: to stop infanticide among families that were living in poverty. 73 00:04:29,520 --> 00:04:32,720 Speaker 1: Some of these hospitals employed midwives and others of them 74 00:04:32,800 --> 00:04:36,240 Speaker 1: employed doctors, and this was also a change. Before this 75 00:04:36,400 --> 00:04:40,520 Speaker 1: point doctors and surgeons, who were almost exclusively male had 76 00:04:40,600 --> 00:04:43,600 Speaker 1: really only been involved in delivering babies when there were 77 00:04:43,640 --> 00:04:47,719 Speaker 1: really serious complications. It was so unusual for a man 78 00:04:47,880 --> 00:04:50,640 Speaker 1: to be involved in delivery that in some places these 79 00:04:50,680 --> 00:04:54,880 Speaker 1: doctors were called man midwives, So the idea that a 80 00:04:54,920 --> 00:04:57,400 Speaker 1: doctor would be involved in the routine delivery of a 81 00:04:57,440 --> 00:05:02,040 Speaker 1: baby was fairly new in the seventeen hundreds. Also fairly 82 00:05:02,080 --> 00:05:05,000 Speaker 1: knew was the widespread use of autopsies as part of 83 00:05:05,040 --> 00:05:09,599 Speaker 1: medical education. Although autopsies existed well before this point, it 84 00:05:09,680 --> 00:05:12,119 Speaker 1: was only in the mid seventeen hundreds that the field 85 00:05:12,120 --> 00:05:14,960 Speaker 1: of medicine really started using them to try to improve 86 00:05:15,000 --> 00:05:18,920 Speaker 1: on medical knowledge and teach medical students. In the late 87 00:05:18,960 --> 00:05:23,240 Speaker 1: eighteenth and early nineteenth centuries, doctors started using autopsies of 88 00:05:23,320 --> 00:05:27,000 Speaker 1: childbed fever victims, specifically to try to learn more about 89 00:05:27,040 --> 00:05:30,680 Speaker 1: the disease. All of this together meant that at about 90 00:05:30,760 --> 00:05:34,039 Speaker 1: the same time, more people were giving birth in hospitals 91 00:05:34,080 --> 00:05:37,719 Speaker 1: assisted by doctors, and more doctors and medical students were 92 00:05:37,760 --> 00:05:42,200 Speaker 1: handling and dissecting cadavers as part of medical study, including 93 00:05:42,240 --> 00:05:44,600 Speaker 1: the bodies of people who had died of childbed fever. 94 00:05:45,400 --> 00:05:49,720 Speaker 1: Because illnesses were blamed on things like myasthmas and imbalanced 95 00:05:49,800 --> 00:05:54,120 Speaker 1: humors rather than on pathogens. These post mortem examinations were 96 00:05:54,120 --> 00:05:58,200 Speaker 1: being conducted with bare hands, and those bare hands were 97 00:05:58,200 --> 00:06:03,160 Speaker 1: not usually washed before working with living patients. Surgical gloves 98 00:06:03,200 --> 00:06:05,920 Speaker 1: weren't even invented yet. That wouldn't happen until the late 99 00:06:05,960 --> 00:06:09,440 Speaker 1: eighteen hundreds, and when those gloves were invented, they were 100 00:06:09,480 --> 00:06:14,000 Speaker 1: really about protecting the hands from chemicals, not protecting the 101 00:06:14,120 --> 00:06:17,000 Speaker 1: patients from the spread of disease or the doctors from 102 00:06:17,040 --> 00:06:21,280 Speaker 1: contracting diseases from the patients. The result of all of 103 00:06:21,279 --> 00:06:25,239 Speaker 1: this was a dramatic increase in epidemics of child bed fever, 104 00:06:25,720 --> 00:06:29,920 Speaker 1: particularly in hospitals. One swept through the Paris Hotel Dieu 105 00:06:30,080 --> 00:06:35,239 Speaker 1: in seventeen in seventeen forty six, another struck the British 106 00:06:35,360 --> 00:06:39,279 Speaker 1: lying In hospital in seventeen sixty. These were frequent and 107 00:06:39,320 --> 00:06:42,560 Speaker 1: widespread enough that hospitals weren't usually thought of as safe 108 00:06:42,560 --> 00:06:47,200 Speaker 1: places to give birth. There were definitely doctors who spotted 109 00:06:47,240 --> 00:06:50,760 Speaker 1: the connection between autopsies and child bed fever, or who 110 00:06:50,800 --> 00:06:53,400 Speaker 1: suspected that the disease could be spread from patient to 111 00:06:53,480 --> 00:06:56,960 Speaker 1: patient by the doctors who were treating them. These doctors 112 00:06:57,040 --> 00:07:00,359 Speaker 1: published treatises and journal articles about what they thought was 113 00:07:00,400 --> 00:07:04,080 Speaker 1: causing childbed fever and how to stop it. In sv 114 00:07:05,400 --> 00:07:08,960 Speaker 1: Alexander Gordon of Aberdeen, Scotland wrote his treatise on the 115 00:07:09,000 --> 00:07:13,000 Speaker 1: Epidemic of Pure Pearl Fever, and in it he theorized 116 00:07:13,080 --> 00:07:15,840 Speaker 1: that doctors who had treated a patient with childbed fever 117 00:07:16,160 --> 00:07:20,000 Speaker 1: could pass it on to other patients. He recommended burning 118 00:07:20,000 --> 00:07:24,440 Speaker 1: the patient's bedclothes, along with thorough handwashing and fumigating all 119 00:07:24,480 --> 00:07:26,960 Speaker 1: of the clothing of the doctors and nurses who were 120 00:07:27,000 --> 00:07:31,240 Speaker 1: involved in the infected patient's care. In eighteen twenty nine, 121 00:07:31,240 --> 00:07:34,040 Speaker 1: when an epidemic of childbed fever struck the rotun To 122 00:07:34,160 --> 00:07:38,320 Speaker 1: Hospital in Dublin, Ireland, hospital chief Robert Collins tried to 123 00:07:38,320 --> 00:07:42,160 Speaker 1: stop it with a forty eight hour chlorine fumigation. He 124 00:07:42,280 --> 00:07:45,120 Speaker 1: also ordered that all the floors and walls be scrubbed 125 00:07:45,120 --> 00:07:48,600 Speaker 1: down with chlorinated lime and all the linen's be heat treated. 126 00:07:49,000 --> 00:07:52,360 Speaker 1: The number of childbed fever cases at the hospital dropped 127 00:07:52,360 --> 00:07:56,400 Speaker 1: almost to zero after he did all this. In eighteen 128 00:07:56,480 --> 00:08:00,200 Speaker 1: forty three, Oliver Wendell Holmes Sr. Delivered a paper are 129 00:08:00,200 --> 00:08:03,880 Speaker 1: called the Contagiousness of Pure pearl fever to the Boston 130 00:08:04,000 --> 00:08:07,800 Speaker 1: Society of Medical Improvement. In it, he said, quote, the 131 00:08:07,920 --> 00:08:11,360 Speaker 1: disease known as pure pearl fever is so far contagious 132 00:08:11,360 --> 00:08:14,520 Speaker 1: as to be frequently carried from patient to patient by 133 00:08:14,600 --> 00:08:18,080 Speaker 1: physicians and nurses. He then went on to describe a 134 00:08:18,160 --> 00:08:20,240 Speaker 1: number of steps to try to prevent the spread of 135 00:08:20,240 --> 00:08:24,520 Speaker 1: the disease. These included that obstetricians should never conduct autopsies 136 00:08:24,520 --> 00:08:28,040 Speaker 1: on patients who died of childbed fever, and if for 137 00:08:28,120 --> 00:08:32,120 Speaker 1: some reason an obstetrician had to, he should very thoroughly 138 00:08:32,160 --> 00:08:35,360 Speaker 1: clean himself, change all of his clothes, and abstain from 139 00:08:35,400 --> 00:08:39,440 Speaker 1: patient treatment for at least twenty four hours. Holmes went 140 00:08:39,440 --> 00:08:42,079 Speaker 1: on to recommend that if a doctor treated a patient 141 00:08:42,200 --> 00:08:46,040 Speaker 1: who then contracted childbed fever, he should consider all of 142 00:08:46,080 --> 00:08:48,800 Speaker 1: the patients that he went on to treat to also 143 00:08:48,880 --> 00:08:52,199 Speaker 1: be at risk until significant time had passed without anybody 144 00:08:52,200 --> 00:08:55,920 Speaker 1: else being infected, and if two of his patients developed 145 00:08:56,040 --> 00:08:58,800 Speaker 1: childbed fever in close proximity to one another, he should 146 00:08:58,840 --> 00:09:02,000 Speaker 1: remove himself from metical practice and bring in a substitute 147 00:09:02,040 --> 00:09:06,120 Speaker 1: for at least a month. Holmes's paper made recommendations that 148 00:09:06,160 --> 00:09:09,079 Speaker 1: would have been both useful and effective for preventing the 149 00:09:09,160 --> 00:09:11,800 Speaker 1: spread of child bed fever, but it didn't get a 150 00:09:11,800 --> 00:09:14,679 Speaker 1: lot of attention until it was reprinted as a pamphlet 151 00:09:14,960 --> 00:09:18,720 Speaker 1: and more widely distributed, and then the response among the 152 00:09:18,720 --> 00:09:24,440 Speaker 1: medical community was total dismissal and outright mockery. Charles D. Meigs, 153 00:09:24,520 --> 00:09:28,920 Speaker 1: an obstitution from Philadelphia, described holmes as theories and recommendations 154 00:09:28,960 --> 00:09:33,080 Speaker 1: as quote je June and fizzinless Dreamings, and claimed that 155 00:09:33,120 --> 00:09:35,760 Speaker 1: any doctor who saw an increase in child bed fever 156 00:09:36,200 --> 00:09:40,200 Speaker 1: was just unlucky. When Egna's Semilvis came to the same 157 00:09:40,240 --> 00:09:43,559 Speaker 1: conclusion that Oliver Wendell Holmes Senior had, the response from 158 00:09:43,559 --> 00:09:46,080 Speaker 1: the rest of the medical community was very much the same, 159 00:09:46,240 --> 00:09:56,320 Speaker 1: and we'll talk about it after a sponsor break. Aca 160 00:09:56,600 --> 00:10:00,920 Speaker 1: Semilviss was born on July one, eighteen and Taban area 161 00:10:00,960 --> 00:10:04,760 Speaker 1: of Buddha, Hungary. Buddha would combine with Pest in eighteen 162 00:10:04,800 --> 00:10:06,680 Speaker 1: seventy three, so that was a little bit later to 163 00:10:06,760 --> 00:10:10,440 Speaker 1: become Budapest. At the time, Hungary was part of the 164 00:10:10,480 --> 00:10:14,079 Speaker 1: Austrian Empire, and he was the fifth of ten children 165 00:10:14,200 --> 00:10:19,040 Speaker 1: born to Grosser Joseph Semmelweiss and Terresia Mueller. There's a 166 00:10:19,080 --> 00:10:23,079 Speaker 1: bit of disagreement about the family's heritage. Some accounts claim 167 00:10:23,120 --> 00:10:25,679 Speaker 1: that they were Jewish and that anti Semitism was a 168 00:10:25,720 --> 00:10:30,679 Speaker 1: factor in later parts of Semilvis's story, but Sherwin B. Newland, 169 00:10:30,800 --> 00:10:34,360 Speaker 1: author of The Doctor's Plague, Germs, child bed Fever, and 170 00:10:34,400 --> 00:10:38,679 Speaker 1: The Strange Story of Ignaz Semilwis, writes that parish registers 171 00:10:38,720 --> 00:10:41,760 Speaker 1: document that the semil Weiss family was Roman Catholic going 172 00:10:41,800 --> 00:10:45,440 Speaker 1: back to the sixteen seventies. The counter argument is that 173 00:10:45,480 --> 00:10:49,040 Speaker 1: semil Weiss and his ancestors may have been baptized for 174 00:10:49,080 --> 00:10:53,160 Speaker 1: the sake of assimilation while the family was still culturally Jewish, 175 00:10:53,520 --> 00:10:56,679 Speaker 1: but this is largely conjecture and it seems mostly just 176 00:10:56,720 --> 00:11:00,319 Speaker 1: to be based on their surname. In eighteen thirties seven, 177 00:11:00,400 --> 00:11:02,760 Speaker 1: at the age of nineteen, semul Weiss went to the 178 00:11:02,840 --> 00:11:06,600 Speaker 1: University of Vienna to study law. A year later, he 179 00:11:06,720 --> 00:11:09,640 Speaker 1: changed his course of study to medicine, and he graduated 180 00:11:09,679 --> 00:11:12,560 Speaker 1: with his m d. In eighteen forty four. He looked 181 00:11:12,559 --> 00:11:15,920 Speaker 1: for a position practicing internal medicine, but he couldn't find one, 182 00:11:16,400 --> 00:11:19,079 Speaker 1: so he changed his focus once again and looked for 183 00:11:19,120 --> 00:11:23,080 Speaker 1: a position in obstetrics. On July one, eighteen forty six, 184 00:11:23,120 --> 00:11:25,839 Speaker 1: he was granted a two year appointment as an assistant 185 00:11:25,840 --> 00:11:29,400 Speaker 1: to Professor Johann Klein, who was the director of the 186 00:11:29,600 --> 00:11:34,880 Speaker 1: Vienna Algamini Conkin House or the General Hospital. Vienna General 187 00:11:34,920 --> 00:11:38,760 Speaker 1: Hospital was a teaching hospital, so in this role, Semilviis 188 00:11:38,800 --> 00:11:42,200 Speaker 1: was both a doctor and a teacher. He supervised and 189 00:11:42,320 --> 00:11:46,880 Speaker 1: educated medical students, and he assisted with difficult deliveries. He 190 00:11:46,960 --> 00:11:49,079 Speaker 1: was also the clerk of records, which put him in 191 00:11:49,120 --> 00:11:52,360 Speaker 1: a good position to spot patterns among the patients and 192 00:11:52,440 --> 00:11:56,920 Speaker 1: their outcomes. The maternity clinic at the Vienna General Hospital 193 00:11:57,040 --> 00:11:59,079 Speaker 1: was one of the ones that had been established to 194 00:11:59,120 --> 00:12:03,720 Speaker 1: provide free medical care to impoverished patients, so patients essentially 195 00:12:03,720 --> 00:12:06,840 Speaker 1: got free care and exchanged for helping with the medical 196 00:12:06,880 --> 00:12:11,640 Speaker 1: students educations. Originally, the hospital had one maternity clinic, which 197 00:12:11,679 --> 00:12:15,000 Speaker 1: was staffed by midwives, doctors and their students, and after 198 00:12:15,080 --> 00:12:18,200 Speaker 1: a while that one clinic became so overcrowded that the 199 00:12:18,240 --> 00:12:21,040 Speaker 1: hospital opened a second one, which was still staffed by 200 00:12:21,080 --> 00:12:25,200 Speaker 1: a mix of doctors, midwives and their students. But around 201 00:12:25,240 --> 00:12:28,960 Speaker 1: eighteen forty the two clinics were separated into the first 202 00:12:29,080 --> 00:12:32,880 Speaker 1: and second clinic. The first clinic was staffed by doctors 203 00:12:32,880 --> 00:12:36,040 Speaker 1: and medical students, and the second clinic was staffed by 204 00:12:36,040 --> 00:12:41,000 Speaker 1: midwives and midwiffery students. The two clinics alternated admission days, 205 00:12:41,080 --> 00:12:44,360 Speaker 1: so if the first clinic accepted patients on Monday, the 206 00:12:44,400 --> 00:12:47,600 Speaker 1: second clinic would accept patients on Tuesday, and so on. 207 00:12:48,240 --> 00:12:51,640 Speaker 1: When the maternity clinic first opened in seventeen eighty four, 208 00:12:51,800 --> 00:12:56,240 Speaker 1: the hospital director Lucas Bore, had not included post mortem 209 00:12:56,320 --> 00:12:59,080 Speaker 1: work as part of the obstetric students course of study 210 00:12:59,200 --> 00:13:02,240 Speaker 1: because he thought it carried a risk of contagion. But 211 00:13:02,280 --> 00:13:05,400 Speaker 1: in eighteen twenty three Johann Klein took over as director 212 00:13:05,480 --> 00:13:08,600 Speaker 1: and started using autopsies as a teaching tool for the 213 00:13:08,640 --> 00:13:13,720 Speaker 1: obstetric students. By the time Semmelweis joined the hospital staff, 214 00:13:14,040 --> 00:13:16,800 Speaker 1: the rates of child bed fever at Vienna General Hospital 215 00:13:16,960 --> 00:13:21,200 Speaker 1: very dramatically between the two clinics. At the midwives clinic, 216 00:13:21,440 --> 00:13:24,760 Speaker 1: between one and two percent of patients died of child 217 00:13:24,760 --> 00:13:28,120 Speaker 1: bed fever, and at the doctor's clinic the rate varied 218 00:13:28,160 --> 00:13:32,040 Speaker 1: from five tot with an average of about ten percent. 219 00:13:32,880 --> 00:13:36,160 Speaker 1: This difference between the two clinics was so huge and 220 00:13:36,240 --> 00:13:39,560 Speaker 1: so well known that laboring patients who were told that 221 00:13:39,600 --> 00:13:42,400 Speaker 1: they were being admitted to the doctor's clinic would beg 222 00:13:42,600 --> 00:13:46,199 Speaker 1: to be sent to the midwives clinic instead. Some even 223 00:13:46,280 --> 00:13:50,000 Speaker 1: gave birth in the street outside the clinic after hearing 224 00:13:50,000 --> 00:13:52,839 Speaker 1: that it was the doctor's day for admission, and then 225 00:13:52,880 --> 00:13:54,400 Speaker 1: they would say they had been on the way to 226 00:13:54,440 --> 00:13:56,800 Speaker 1: the hospital and the baby just came before they could 227 00:13:56,880 --> 00:13:59,800 Speaker 1: get there. That way, they would still have access to 228 00:13:59,840 --> 00:14:02,600 Speaker 1: the free care at the clinic, but without the risk 229 00:14:02,679 --> 00:14:06,000 Speaker 1: of death that was associated with it. That's gotta be 230 00:14:06,040 --> 00:14:08,760 Speaker 1: a terrifying choice when you're like, no, I'm I'm just 231 00:14:08,760 --> 00:14:10,640 Speaker 1: gonna do this in the street and then I'll let 232 00:14:10,679 --> 00:14:12,720 Speaker 1: them take care of me after that. Well, and I 233 00:14:12,720 --> 00:14:15,560 Speaker 1: imagine a thing I didn't find. Um, I didn't find 234 00:14:15,600 --> 00:14:18,120 Speaker 1: sources that said this, but considering that my own mother 235 00:14:18,160 --> 00:14:20,280 Speaker 1: did this when I was born, I imagine the people 236 00:14:20,320 --> 00:14:22,680 Speaker 1: that were like, I'm in labor, but I'm not far 237 00:14:22,760 --> 00:14:25,440 Speaker 1: into labor and it's the doctor's day. I'm gonna wait 238 00:14:25,440 --> 00:14:28,680 Speaker 1: a few hours so I can go to the midwives clinic. 239 00:14:28,880 --> 00:14:31,520 Speaker 1: I imagine that was a thing to my My parents 240 00:14:31,560 --> 00:14:33,680 Speaker 1: did that because if they waited till after midnight, they 241 00:14:33,720 --> 00:14:36,960 Speaker 1: wouldn't be billed for the extra day, did not have 242 00:14:37,040 --> 00:14:40,920 Speaker 1: a ton of money. Some of us noticed that even 243 00:14:40,960 --> 00:14:44,240 Speaker 1: these births out in the street were safer than giving 244 00:14:44,240 --> 00:14:47,400 Speaker 1: birth in the doctor's clinic at the hospital. He wrote, 245 00:14:47,480 --> 00:14:51,160 Speaker 1: quote to me, it appeared logical that patients who experienced 246 00:14:51,280 --> 00:14:54,720 Speaker 1: street births would become ill at least as frequently as 247 00:14:54,760 --> 00:14:58,000 Speaker 1: those who delivered in the clinic. What protected those who 248 00:14:58,080 --> 00:15:02,680 Speaker 1: delivered outside the clinic from these destructive, unknown endemic influences. 249 00:15:03,200 --> 00:15:07,400 Speaker 1: He became completely fixated on this question. It was appalling 250 00:15:07,560 --> 00:15:09,880 Speaker 1: and deeply offensive to him that there was such a 251 00:15:09,960 --> 00:15:13,600 Speaker 1: huge difference between the doctors and the midwives clinics. So 252 00:15:13,600 --> 00:15:16,440 Speaker 1: he started trying to figure out what was different between 253 00:15:16,480 --> 00:15:19,200 Speaker 1: the two clinics, and then making adjustments to what the 254 00:15:19,280 --> 00:15:23,760 Speaker 1: doctors were doing. At the midwives clinic, patients lay on 255 00:15:23,800 --> 00:15:26,800 Speaker 1: their sides to deliver, but at the doctor's clinic they 256 00:15:26,840 --> 00:15:30,280 Speaker 1: lay on their backs. Civilized changed the procedure at the 257 00:15:30,320 --> 00:15:34,200 Speaker 1: doctor's clinic to use sideline, but that didn't make a difference. 258 00:15:35,280 --> 00:15:38,240 Speaker 1: He also noticed that anytime a patient was dying in 259 00:15:38,320 --> 00:15:41,200 Speaker 1: the doctor's clinic, the priest who was arriving to get 260 00:15:41,440 --> 00:15:44,120 Speaker 1: to give last rites basically had to walk through the 261 00:15:44,160 --> 00:15:46,840 Speaker 1: whole ward, and he rang a bell while he was 262 00:15:46,920 --> 00:15:50,280 Speaker 1: doing this. Some of vis thought maybe this bell and 263 00:15:50,320 --> 00:15:53,440 Speaker 1: what it signified was so terrifying that it was making 264 00:15:53,440 --> 00:15:56,400 Speaker 1: people sick, so he got the priest to stop it 265 00:15:56,440 --> 00:16:00,160 Speaker 1: with the bell. That did not fix the problem. He 266 00:16:00,200 --> 00:16:02,880 Speaker 1: looked at how crowded the two clinics were, and it 267 00:16:02,960 --> 00:16:07,200 Speaker 1: turned out that the midwives clinic was understandably far more crowded. 268 00:16:07,680 --> 00:16:10,240 Speaker 1: He looked at the religious practices of the people working 269 00:16:10,240 --> 00:16:13,040 Speaker 1: in each clinic. He looked at the patient's diets, and 270 00:16:13,120 --> 00:16:17,560 Speaker 1: none of these things seemed to make a difference. Then 271 00:16:17,600 --> 00:16:21,360 Speaker 1: his friend and colleague, Jacob Collecca died of what appeared 272 00:16:21,400 --> 00:16:24,680 Speaker 1: to be childbed fever after accidentally being nicked with a 273 00:16:24,760 --> 00:16:28,160 Speaker 1: scalpel while performing an autopsy on someone who had died 274 00:16:28,200 --> 00:16:32,960 Speaker 1: of it, and Collectica's own autopsy results were very similar 275 00:16:33,000 --> 00:16:38,000 Speaker 1: to those of childbed fever victims. That's when Semmelweis realized 276 00:16:38,040 --> 00:16:42,120 Speaker 1: that midwiffery students weren't performing autopsies as part of their training, 277 00:16:42,640 --> 00:16:46,200 Speaker 1: only the medical students were. Another difference was that the 278 00:16:46,200 --> 00:16:50,160 Speaker 1: medical students were performing vaginal examinations on their patients. As 279 00:16:50,200 --> 00:16:53,880 Speaker 1: a routine part of their care, while midwiffery students only 280 00:16:53,920 --> 00:16:56,640 Speaker 1: did so when there seemed to be a need for one. 281 00:16:57,000 --> 00:17:00,280 Speaker 1: Semilvis's conclusion was that some kind of cadet ever a 282 00:17:00,440 --> 00:17:04,600 Speaker 1: particles were being transmitted from the autopsies to the patients 283 00:17:04,760 --> 00:17:08,760 Speaker 1: in the doctor's clinic. In mid May of eighteen forty seven, 284 00:17:08,840 --> 00:17:12,720 Speaker 1: Samuel Weis started instructing doctors and medical students to wash 285 00:17:12,840 --> 00:17:17,119 Speaker 1: their hands after conducting autopsies. They were to use chlorinated 286 00:17:17,200 --> 00:17:20,280 Speaker 1: lime until their hands had no trace of the putrid 287 00:17:20,359 --> 00:17:23,760 Speaker 1: smell that was left behind by a decaying body. He 288 00:17:23,920 --> 00:17:26,440 Speaker 1: chose chlorinated lime because it seemed to do the best 289 00:17:26,560 --> 00:17:29,920 Speaker 1: job of getting rid of the odor. But chlorinated lime 290 00:17:30,119 --> 00:17:34,479 Speaker 1: is calcium hypochlorite, which today is sold as powdered chlorine bleach. 291 00:17:35,040 --> 00:17:40,480 Speaker 1: Chlorine bleach is, of course a disinfectant. With Samulwis's hand 292 00:17:40,480 --> 00:17:43,840 Speaker 1: washing protocol in place, the rate of child bed fever 293 00:17:43,920 --> 00:17:47,480 Speaker 1: mortality in the doctor's clinics started to drop. It had 294 00:17:47,480 --> 00:17:50,679 Speaker 1: been eighteen point three percent in April, and by June 295 00:17:51,000 --> 00:17:54,320 Speaker 1: it had dropped to two point two percent. In August 296 00:17:54,359 --> 00:17:57,000 Speaker 1: of eighteen forty seven, for the first time since the 297 00:17:57,040 --> 00:18:01,520 Speaker 1: medical students started performing autopsies. No one died of childbed 298 00:18:01,520 --> 00:18:05,840 Speaker 1: fever in the doctor's clinic. Some of us couldn't exactly 299 00:18:06,000 --> 00:18:10,160 Speaker 1: explain why this had worked. At one point, another outbreak 300 00:18:10,200 --> 00:18:12,880 Speaker 1: of childbed fever spread through the clinic, even though there 301 00:18:12,880 --> 00:18:15,840 Speaker 1: had been no autopsy to trigger it. So some of 302 00:18:15,920 --> 00:18:18,720 Speaker 1: us began to suggest that some patients might make their 303 00:18:18,760 --> 00:18:23,080 Speaker 1: own so called cadaverous particles and their own bodies, rather 304 00:18:23,160 --> 00:18:27,399 Speaker 1: than the autopsies being their only source. Later on, he 305 00:18:27,480 --> 00:18:30,840 Speaker 1: revised his hypothesis a third time, saying that the cadaverous 306 00:18:30,880 --> 00:18:34,480 Speaker 1: particles could come from any decaying animal flesh, not just 307 00:18:34,600 --> 00:18:38,399 Speaker 1: from a human body. The fact that he couldn't adequately 308 00:18:38,480 --> 00:18:42,280 Speaker 1: explain why his protocol worked became one of the arguments 309 00:18:42,320 --> 00:18:46,160 Speaker 1: against his findings. While some of his medical students agreed 310 00:18:46,200 --> 00:18:49,479 Speaker 1: with and supported his work, most of the established doctors 311 00:18:49,520 --> 00:18:54,200 Speaker 1: at the hospital dismissed him completely. Director Johann Klein insisted 312 00:18:54,240 --> 00:18:57,320 Speaker 1: that it was the clinic's new ventilation system which was 313 00:18:57,320 --> 00:19:00,960 Speaker 1: getting rid of dangerous miasmas and that should get the credit. 314 00:19:01,840 --> 00:19:05,800 Speaker 1: Other doctors also vehemently disagreed with the idea that their 315 00:19:05,920 --> 00:19:10,200 Speaker 1: own hands could have been what was spreading such a devastating, painful, 316 00:19:10,240 --> 00:19:14,840 Speaker 1: and emotionally wrenching disease. It was unfathomable to them that 317 00:19:14,960 --> 00:19:17,760 Speaker 1: a doctor could have dirty hands in the first place. 318 00:19:18,240 --> 00:19:22,280 Speaker 1: In their minds, doctors were gentleman, and a gentleman's hands 319 00:19:22,280 --> 00:19:26,080 Speaker 1: were always clean, and his word of semal vices protocol 320 00:19:26,280 --> 00:19:29,800 Speaker 1: spread beyond a hospital. Doctors were also resistant to the 321 00:19:29,840 --> 00:19:32,720 Speaker 1: idea of washing their hands because they didn't necessarily have 322 00:19:32,880 --> 00:19:36,280 Speaker 1: access to clean water where they worked, and also because 323 00:19:36,280 --> 00:19:39,760 Speaker 1: it was time consuming. I like this weird chicken in 324 00:19:39,840 --> 00:19:43,560 Speaker 1: the egg thing, where like a gentleman's hands aren't clean 325 00:19:43,640 --> 00:19:46,879 Speaker 1: because he takes such fastidious care of himself, but just 326 00:19:46,960 --> 00:19:52,600 Speaker 1: because he's a gentle yes. Uh. Later on several vice 327 00:19:52,680 --> 00:19:56,840 Speaker 1: would describe it this way quote. Most medical lecture halls 328 00:19:56,920 --> 00:20:00,480 Speaker 1: continued to resound with lectures on epidemic child d fever 329 00:20:00,880 --> 00:20:05,000 Speaker 1: and with discourse against my theories. The medical literature for 330 00:20:05,040 --> 00:20:08,439 Speaker 1: the last twelve years continues to swell with reports of 331 00:20:08,520 --> 00:20:11,760 Speaker 1: pure Borough epidemics, and in eighteen fifty four, in Vienna, 332 00:20:12,080 --> 00:20:16,160 Speaker 1: the birthplace of my theory, four hundred maternity patients died 333 00:20:16,240 --> 00:20:20,560 Speaker 1: from child bed fever. In published medical works, my teachings 334 00:20:20,600 --> 00:20:25,040 Speaker 1: are either ignored or attacked. The medical faculty at Wurtzberg 335 00:20:25,160 --> 00:20:28,439 Speaker 1: awarded a prize to a monograph written in eighteen fifty 336 00:20:28,520 --> 00:20:32,680 Speaker 1: nine in which my teachings were rejected, So he wrote 337 00:20:32,720 --> 00:20:35,040 Speaker 1: that a little bit later, and to return to this 338 00:20:35,160 --> 00:20:38,520 Speaker 1: current part of the story, Similwis did not back down 339 00:20:38,600 --> 00:20:42,040 Speaker 1: in the face of all this opposition. In eighteen forty eight, 340 00:20:42,080 --> 00:20:45,840 Speaker 1: he started requiring that medical students clean all the instruments 341 00:20:45,880 --> 00:20:49,160 Speaker 1: that were used during labor and delivery with chlorinated lime 342 00:20:49,200 --> 00:20:52,639 Speaker 1: as well. The clinic had already had a month where 343 00:20:52,720 --> 00:20:54,840 Speaker 1: there had been no deaths, and at this point the 344 00:20:54,960 --> 00:20:58,440 Speaker 1: ongoing mortality rate from child bed fever at the hospital 345 00:20:58,520 --> 00:21:03,560 Speaker 1: dropped almost to he row. As doctors continued to dismiss 346 00:21:03,640 --> 00:21:10,040 Speaker 1: his findings, Similweis became increasingly hostile and combative, and simultaneously 347 00:21:10,320 --> 00:21:14,280 Speaker 1: uprisings were sweeping through the area as people protested against 348 00:21:14,280 --> 00:21:18,600 Speaker 1: the Habsburg dynasty in the Austrian Empire. Students held a 349 00:21:18,640 --> 00:21:22,359 Speaker 1: demonstration in Vienna on March thirteenth, eighteen forty eight, and 350 00:21:22,400 --> 00:21:26,240 Speaker 1: the Hungarian Revolution of eighteen forty eight began two days later. 351 00:21:26,960 --> 00:21:30,919 Speaker 1: Although there's no evidence that Semilvii's was part of these demonstrations, 352 00:21:31,320 --> 00:21:35,200 Speaker 1: many of his student supporters were which probably inflamed tensions 353 00:21:35,480 --> 00:21:38,480 Speaker 1: between him and the rest of the faculty. As I 354 00:21:38,480 --> 00:21:41,280 Speaker 1: said earlier, that position he had at the maternity clinic 355 00:21:41,320 --> 00:21:43,639 Speaker 1: and at the hospital had been a two year appointment, 356 00:21:44,080 --> 00:21:46,919 Speaker 1: and in eighteen forty nine the hospital elected not to 357 00:21:47,040 --> 00:21:50,080 Speaker 1: renew it. He was instead offered a position that had 358 00:21:50,119 --> 00:21:54,439 Speaker 1: no contact with cadavers. In eighteen fifty he left Vienna 359 00:21:54,480 --> 00:21:58,120 Speaker 1: to return home without announcing his departure or saying goodbye 360 00:21:58,119 --> 00:22:00,400 Speaker 1: to anyone. He knew. We're going to talk talk about 361 00:22:00,400 --> 00:22:03,520 Speaker 1: Salvis's life back in Hungary after we first pause for 362 00:22:03,520 --> 00:22:14,000 Speaker 1: another sponsor break. In eighteen fifty one, Ignaz semial Weiss 363 00:22:14,119 --> 00:22:17,800 Speaker 1: was named head of obstetrics at St. Rocas Hospital. Although 364 00:22:17,920 --> 00:22:21,920 Speaker 1: this was really an honorary and unpaid position, He did 365 00:22:21,960 --> 00:22:24,639 Speaker 1: hold it for the next few years, though, during which 366 00:22:24,640 --> 00:22:28,200 Speaker 1: time the rate of childbed fever at the hospital dropped significantly. 367 00:22:29,400 --> 00:22:32,960 Speaker 1: In the mid eighteen fifties, Silvis left St. Roucas and 368 00:22:33,000 --> 00:22:37,320 Speaker 1: became a professor at Pest University. In eighteen fifty seven, 369 00:22:37,359 --> 00:22:40,040 Speaker 1: he married Maria Widenhoffer, and they went on to have 370 00:22:40,119 --> 00:22:44,480 Speaker 1: five children together. During these years, some of Wess continued 371 00:22:44,520 --> 00:22:48,280 Speaker 1: to advocate for handwashing after autopsies, and he also wrote 372 00:22:48,280 --> 00:22:51,800 Speaker 1: a series of extremely hostile open letters to the doctors 373 00:22:51,840 --> 00:22:55,880 Speaker 1: who dismissed his ideas, calling them murderers who were responsible 374 00:22:55,920 --> 00:22:59,760 Speaker 1: for the deaths of women through their negligence. This seems 375 00:22:59,800 --> 00:23:05,040 Speaker 1: to me like a very fair assessment. But but people 376 00:23:05,240 --> 00:23:08,639 Speaker 1: began to increasingly think he is just uh an angry 377 00:23:08,640 --> 00:23:11,720 Speaker 1: man that no one should listen to. He wrote things like, you, 378 00:23:11,840 --> 00:23:15,920 Speaker 1: hair professor, have been a partner in this massacre, and 379 00:23:16,400 --> 00:23:21,080 Speaker 1: should you hair halfrath, without having disproved my doctrine, continue 380 00:23:21,119 --> 00:23:24,159 Speaker 1: to train your pupils against it. I declare before God 381 00:23:24,200 --> 00:23:27,280 Speaker 1: and the world that you are a murderer, and the 382 00:23:27,359 --> 00:23:30,040 Speaker 1: history of child bed fever would not be unjust to 383 00:23:30,200 --> 00:23:34,719 Speaker 1: you if it memorialized you as a medical nero. In 384 00:23:34,800 --> 00:23:38,240 Speaker 1: eighteen fifty eight, after years of his supporters telling him 385 00:23:38,240 --> 00:23:41,800 Speaker 1: he should publish his work, he published The Ideology of 386 00:23:41,880 --> 00:23:46,199 Speaker 1: Child bed Fever. Another work, The Difference in Opinion between 387 00:23:46,200 --> 00:23:50,399 Speaker 1: Myself and the English Physicians regarding child bed Fever, followed 388 00:23:50,400 --> 00:23:53,880 Speaker 1: in eighteen sixty and in eighteen sixty one he published 389 00:23:53,880 --> 00:23:57,359 Speaker 1: a book called The Ideology, the Concept and the Prophylaxis 390 00:23:57,440 --> 00:24:00,600 Speaker 1: of child bed Fever in places Is. This was a 391 00:24:00,680 --> 00:24:03,960 Speaker 1: clear and well written treatise on child bed fever, but 392 00:24:04,320 --> 00:24:07,879 Speaker 1: large portions were actually diatribes against his critics, some of 393 00:24:07,880 --> 00:24:13,880 Speaker 1: them rambling, repetitive, and almost nonsensical. Ignaz Semmelweis had been 394 00:24:13,880 --> 00:24:17,760 Speaker 1: described as abrasive, dogmatic, and even rude for most of 395 00:24:17,800 --> 00:24:20,240 Speaker 1: his career, but by the time this book came out, 396 00:24:20,320 --> 00:24:24,240 Speaker 1: he was also starting to behave erratically. This got worse 397 00:24:24,359 --> 00:24:28,280 Speaker 1: in the early eighteen sixties, and on July eighteen sixty five, 398 00:24:28,640 --> 00:24:31,800 Speaker 1: he returned home from a family outing and was behaving 399 00:24:31,880 --> 00:24:35,000 Speaker 1: so bizarrely that his wife became convinced that something was 400 00:24:35,080 --> 00:24:38,880 Speaker 1: seriously wrong with him. And then, on July twenty one, 401 00:24:39,040 --> 00:24:41,399 Speaker 1: he went to a meeting at his job, where, among 402 00:24:41,520 --> 00:24:44,679 Speaker 1: other things, he was supposed to talk about candidates for 403 00:24:44,800 --> 00:24:49,200 Speaker 1: a vacant lecturers post, and, according to his former assistant, 404 00:24:49,400 --> 00:24:52,720 Speaker 1: instead he read a piece of paper containing the midwives 405 00:24:52,760 --> 00:24:57,280 Speaker 1: Oath of Practice. Clearly unaware that he was doing anything amiss, 406 00:24:58,640 --> 00:25:01,600 Speaker 1: Similsize planned to go to a spa and take water 407 00:25:01,680 --> 00:25:04,320 Speaker 1: treatments there, and he departed with his wife and some 408 00:25:04,400 --> 00:25:08,240 Speaker 1: attendants on July twenty nine, but the next day, for 409 00:25:08,320 --> 00:25:11,920 Speaker 1: reasons that aren't entirely clear, he was instead committed to 410 00:25:11,960 --> 00:25:15,719 Speaker 1: a public institution, where he died on August thirteenth, eighteen 411 00:25:15,760 --> 00:25:18,920 Speaker 1: sixty five, at the age of forty seven. He was 412 00:25:19,000 --> 00:25:23,159 Speaker 1: buried in Vienna two days later. There are some conflicting 413 00:25:23,200 --> 00:25:27,080 Speaker 1: reports about what happened at the institution. In some accounts, 414 00:25:27,080 --> 00:25:29,960 Speaker 1: he became so violent that he had to be restrained, 415 00:25:30,040 --> 00:25:33,240 Speaker 1: and during that encounter he was injured, but in others, 416 00:25:33,280 --> 00:25:36,480 Speaker 1: he was severely beaten by guards and then left without 417 00:25:36,480 --> 00:25:40,280 Speaker 1: any kind of medical treatment. Regardless of exactly what happened, 418 00:25:40,440 --> 00:25:43,240 Speaker 1: an injury to his finger that he either had when 419 00:25:43,240 --> 00:25:45,840 Speaker 1: he got to the hospital or sustained in the incident 420 00:25:45,880 --> 00:25:50,280 Speaker 1: became infected. An autopsy that was performed at Vienna Algamini 421 00:25:50,320 --> 00:25:54,760 Speaker 1: crunkin House diagnosed quote paralysis of the brain as his 422 00:25:54,840 --> 00:25:58,239 Speaker 1: cause of death. Today, it seems likely to have been 423 00:25:58,280 --> 00:26:01,760 Speaker 1: sept to semia, but the autopsy also revealed that he 424 00:26:01,840 --> 00:26:05,159 Speaker 1: had severe injuries that do suggest that he had been beaten. 425 00:26:06,359 --> 00:26:09,560 Speaker 1: It's also not clear what caused his behavior to become 426 00:26:09,600 --> 00:26:13,080 Speaker 1: so erratic in the last years of his life. Theories 427 00:26:13,200 --> 00:26:16,400 Speaker 1: range from the continual stress of being such a pariah 428 00:26:16,400 --> 00:26:20,360 Speaker 1: in the medical community to early onset Alzheimer's to late 429 00:26:20,359 --> 00:26:23,359 Speaker 1: stage syphilis, which was an occupational hazard of being an 430 00:26:23,400 --> 00:26:27,520 Speaker 1: obstetrician at a busy hospital at this point in history. 431 00:26:27,640 --> 00:26:31,240 Speaker 1: In the later years the civil Vices life, other doctors 432 00:26:31,320 --> 00:26:34,480 Speaker 1: were also working on ideas that were related to contagion 433 00:26:34,720 --> 00:26:38,320 Speaker 1: and the germ theory of disease. In eighteen fifty, two, 434 00:26:38,359 --> 00:26:42,640 Speaker 1: years after Simil Vice instituted handwashing at the Vienna General Hospital, 435 00:26:43,160 --> 00:26:47,080 Speaker 1: James Young Simpson of Scotland published a detailed description of 436 00:26:47,080 --> 00:26:50,760 Speaker 1: how materials more by could be introduced into the body 437 00:26:50,840 --> 00:26:54,199 Speaker 1: during labor and delivery, and how the postpartum body was 438 00:26:54,320 --> 00:26:58,440 Speaker 1: primed for infection and because of the dilation and abrasion 439 00:26:58,480 --> 00:27:02,439 Speaker 1: sustained during birth. He even made the comparison between the 440 00:27:02,480 --> 00:27:06,359 Speaker 1: attendants fingers and the ivory points that were that had 441 00:27:06,400 --> 00:27:11,280 Speaker 1: been used to administer smallpox vaccinations by transferring material from 442 00:27:11,280 --> 00:27:16,120 Speaker 1: a cowpox lesion to a person's skin. In the eighteen 443 00:27:16,160 --> 00:27:21,080 Speaker 1: fifties and sixties, Louis Pasteur was studying how micro organisms 444 00:27:21,119 --> 00:27:25,000 Speaker 1: caused beer and wine to spoil. In eighteen sixty seven, 445 00:27:25,119 --> 00:27:29,000 Speaker 1: Joseph Lister began publishing work on preventing infection during surgery, 446 00:27:29,359 --> 00:27:34,040 Speaker 1: which included hygiene and handwashing with carbolic Ten years prior 447 00:27:34,080 --> 00:27:36,960 Speaker 1: to that, in eighteen fifty seven, Robert Coke made the 448 00:27:36,960 --> 00:27:41,679 Speaker 1: connection between the anthrax disease and the anthrax bacterium, and 449 00:27:41,800 --> 00:27:45,199 Speaker 1: later he helped articulate four criteria to prove that a 450 00:27:45,280 --> 00:27:48,720 Speaker 1: disease is caused by a specific micro organism, which are 451 00:27:48,720 --> 00:27:53,680 Speaker 1: called Coke's postulates today. These criteria are that the microorganism 452 00:27:53,800 --> 00:27:56,800 Speaker 1: is always associated with the disease, that it can be 453 00:27:56,840 --> 00:27:59,280 Speaker 1: taken from a diseased animal and grown in a culture, 454 00:28:00,040 --> 00:28:02,560 Speaker 1: that the cultured organism can cause the disease in a 455 00:28:02,600 --> 00:28:05,919 Speaker 1: healthy animal, and that the same micro organism can be 456 00:28:05,960 --> 00:28:09,720 Speaker 1: collected from the newly diseased animal. So, based on the 457 00:28:09,720 --> 00:28:13,440 Speaker 1: work of Louis Pasteur, Joseph Lister, Robert Coke, and others, 458 00:28:13,600 --> 00:28:17,240 Speaker 1: infection control finally became a routine part of obstetrics in 459 00:28:17,280 --> 00:28:21,040 Speaker 1: the eighteen eighties. But these researchers don't appear to have 460 00:28:21,119 --> 00:28:23,840 Speaker 1: been influenced by semial Vices work at all. In a 461 00:28:23,840 --> 00:28:26,600 Speaker 1: lot of cases, they hadn't even heard of him until 462 00:28:26,680 --> 00:28:30,880 Speaker 1: long after they did their first groundbreaking work. He faded 463 00:28:30,960 --> 00:28:34,760 Speaker 1: into obscurity after his death until a Hungarian doctor published 464 00:28:34,760 --> 00:28:39,120 Speaker 1: a paper about him in eighteen eight seven. Today there 465 00:28:39,160 --> 00:28:43,080 Speaker 1: are lots of hospitals and clinics named after Igno's Semilvis, 466 00:28:43,080 --> 00:28:46,840 Speaker 1: along with the semil Vice Medical Historical Museum in Budapest, 467 00:28:47,560 --> 00:28:50,920 Speaker 1: and at some point some unknown person coined the simil 468 00:28:51,000 --> 00:28:55,040 Speaker 1: vized reflex to describe a rejection of new information because 469 00:28:55,080 --> 00:28:59,320 Speaker 1: it contradicts established norms. Even though pure pearl fever is 470 00:28:59,440 --> 00:29:01,360 Speaker 1: much less of an issue for a lot of the 471 00:29:01,400 --> 00:29:05,040 Speaker 1: world today than it was in nineteenth century Europe, hospital 472 00:29:05,080 --> 00:29:08,440 Speaker 1: acquired infections are still an issue even in the most 473 00:29:08,560 --> 00:29:13,240 Speaker 1: affluent parts of the world. Known as nascomal infections, they're 474 00:29:13,240 --> 00:29:17,480 Speaker 1: the most common complication in hospitalized people. They happen in 475 00:29:17,520 --> 00:29:20,960 Speaker 1: between five and ten percent of acute care patients, and 476 00:29:21,200 --> 00:29:25,360 Speaker 1: handwashing is a huge part of preventing them. Yea for 477 00:29:25,520 --> 00:29:29,560 Speaker 1: hand washing, Yes, please wash your hands. This uh, This 478 00:29:29,600 --> 00:29:31,800 Speaker 1: story reminds me a little bit of fritz Wiki, where 479 00:29:31,880 --> 00:29:35,840 Speaker 1: somebody is really clearly onto something and their contemporaries you're 480 00:29:35,880 --> 00:29:38,400 Speaker 1: like nope, nope, nope, and it makes them frustrated and 481 00:29:38,480 --> 00:29:43,200 Speaker 1: it's a little bit mad having to fight against that 482 00:29:43,240 --> 00:29:45,600 Speaker 1: all the time. Yes, some of the some of the 483 00:29:46,680 --> 00:29:48,360 Speaker 1: things that I read about him that have been written 484 00:29:48,360 --> 00:29:53,800 Speaker 1: more recently almost have a victim blamey aspect to them. 485 00:29:54,000 --> 00:29:55,960 Speaker 1: They they're sort of like, if he hadn't been such 486 00:29:55,960 --> 00:29:58,080 Speaker 1: a jerk about it, people might have listened to him. 487 00:29:58,080 --> 00:30:01,520 Speaker 1: And I'm like, women were lit really dying, and he 488 00:30:01,640 --> 00:30:04,760 Speaker 1: was like, who cares how it works? Washing your hands 489 00:30:04,880 --> 00:30:09,760 Speaker 1: keeps the women from dying? Why won't you just do it? 490 00:30:10,360 --> 00:30:15,760 Speaker 1: And like, I'm like that understandably made him really angry. Well, 491 00:30:15,760 --> 00:30:20,160 Speaker 1: and it is kind of hard to understand how like 492 00:30:20,280 --> 00:30:23,680 Speaker 1: people were not getting the pattern recognition of everywhere he 493 00:30:23,760 --> 00:30:29,080 Speaker 1: went and instituted his practices, mortality went down, and so 494 00:30:29,240 --> 00:30:32,720 Speaker 1: clearly something was correct. Uh. So it seems weird that 495 00:30:32,720 --> 00:30:34,600 Speaker 1: they would continue to be like, Nope, nope, nope, no 496 00:30:34,800 --> 00:30:39,080 Speaker 1: my hands. I'm a gentleman. Uh. Do you have less 497 00:30:39,120 --> 00:30:45,800 Speaker 1: infuriating listener mail? I do? This is from Taylor. Uh. 498 00:30:45,840 --> 00:30:50,280 Speaker 1: It is about our one thousandth episode two parter on 499 00:30:50,480 --> 00:30:54,960 Speaker 1: Sadako Sasaki, and Taylor says, Hi, Tracy and Holly, I 500 00:30:55,000 --> 00:30:58,520 Speaker 1: just finished listening to your wonderful two parter on Sadako Sasaki. 501 00:30:59,000 --> 00:31:02,240 Speaker 1: This is a particular interests, interest and significance to me 502 00:31:02,280 --> 00:31:04,400 Speaker 1: because I've been living in Japan for a little over 503 00:31:04,600 --> 00:31:08,240 Speaker 1: a year now as an English teacher. Taylor goes on 504 00:31:08,280 --> 00:31:11,440 Speaker 1: to talk about living close enough to Hiroshima to be 505 00:31:11,440 --> 00:31:13,840 Speaker 1: able to get there pretty quickly buy bullet train and 506 00:31:13,920 --> 00:31:17,560 Speaker 1: going to the museum and the Atomic Bomb Dome. Uh. 507 00:31:17,600 --> 00:31:21,440 Speaker 1: The Memorial Museum is, as you can imagine, horrifying, but 508 00:31:21,560 --> 00:31:24,640 Speaker 1: by the end it is hopeful, featuring, as of last year, 509 00:31:24,720 --> 00:31:27,400 Speaker 1: a crane on display made by President Obama, as well 510 00:31:27,440 --> 00:31:29,680 Speaker 1: as a visitor book where you can leave thoughts and 511 00:31:29,760 --> 00:31:32,360 Speaker 1: messages about the need for peace for all and for 512 00:31:32,400 --> 00:31:35,920 Speaker 1: all countries to do away with nuclear warfare. There's a 513 00:31:35,920 --> 00:31:39,960 Speaker 1: good display in the museum on Sadako featuring a timeline 514 00:31:39,960 --> 00:31:42,280 Speaker 1: of her life and several of her cranes, including some 515 00:31:42,360 --> 00:31:45,320 Speaker 1: of those very tiny ones folded by pins. It was 516 00:31:45,360 --> 00:31:47,960 Speaker 1: surreal and very poigant to see them. And when you 517 00:31:48,000 --> 00:31:50,200 Speaker 1: exit the museum into the Peace Park there is the 518 00:31:50,240 --> 00:31:53,680 Speaker 1: statue of Sadako holding a crane, and then surrounding the 519 00:31:53,720 --> 00:31:57,160 Speaker 1: bell you mentioned are display cases full of cranes sent 520 00:31:57,240 --> 00:31:59,360 Speaker 1: usually by school children from all over the world to 521 00:31:59,440 --> 00:32:02,880 Speaker 1: honor Sida co of all colors and sizes, many just 522 00:32:03,000 --> 00:32:06,600 Speaker 1: strung together in bunches of a thousand, but sometimes arranged 523 00:32:06,640 --> 00:32:10,240 Speaker 1: into artwork pieces. I've attached some photos from my trips. 524 00:32:10,480 --> 00:32:12,560 Speaker 1: I'm sure they look the same as any photo you 525 00:32:12,600 --> 00:32:15,200 Speaker 1: could google, but their breathtaking. When you go to the 526 00:32:15,440 --> 00:32:17,920 Speaker 1: Memorial Museum, along with your ticket, you were giving a 527 00:32:18,000 --> 00:32:22,160 Speaker 1: postcard with paper made out of recycled cranes from these displays. 528 00:32:22,560 --> 00:32:24,840 Speaker 1: Most big shrines I've gotten to visit in Japan have 529 00:32:24,880 --> 00:32:27,840 Speaker 1: at least one area where strings of cranes are displayed 530 00:32:28,080 --> 00:32:30,560 Speaker 1: for good health and healing and good fortune, and of 531 00:32:30,600 --> 00:32:34,120 Speaker 1: course with SATCO in mind. Another quick note about the 532 00:32:34,200 --> 00:32:37,000 Speaker 1: terrain and weather in the specific region of Japan. It 533 00:32:37,120 --> 00:32:40,160 Speaker 1: is very hilly slash mountainous. It depends on how you 534 00:32:40,200 --> 00:32:43,479 Speaker 1: define a mountain. I've described this terrain to friends and 535 00:32:43,520 --> 00:32:47,520 Speaker 1: family as pretty visually similar to West Virginia. Presumably this 536 00:32:47,520 --> 00:32:49,680 Speaker 1: would have made it pretty difficult to flee the city 537 00:32:49,720 --> 00:32:52,800 Speaker 1: after the bombing as many dead, especially in August when 538 00:32:52,800 --> 00:32:55,640 Speaker 1: the heat and humidity are very oppressive. I've gone hiking 539 00:32:55,640 --> 00:32:57,280 Speaker 1: in the summer and the commidity gets up to a 540 00:32:57,360 --> 00:32:59,920 Speaker 1: hundred percent sometimes and it feels like you're trying to 541 00:33:00,000 --> 00:33:04,120 Speaker 1: breathe underwater. It's really unlike anything I've experienced in the USA. 542 00:33:04,760 --> 00:33:08,320 Speaker 1: The same goes weatherwise for Nagasaki, being much further southwest. 543 00:33:09,160 --> 00:33:11,840 Speaker 1: One lasted them to a very long email. On a 544 00:33:11,920 --> 00:33:15,120 Speaker 1: recent trip to Kyoto, I learned by a tour guide 545 00:33:15,160 --> 00:33:17,880 Speaker 1: that the reason this city's hundreds of temples, shrines and 546 00:33:17,960 --> 00:33:21,360 Speaker 1: historical sites, some very ancients survived World War two was 547 00:33:21,440 --> 00:33:24,040 Speaker 1: the fact that the United States recognized the historical and 548 00:33:24,080 --> 00:33:27,040 Speaker 1: cultural significance that these sites held and thus did not 549 00:33:27,160 --> 00:33:30,160 Speaker 1: fire bomb Kyo. Two. Haven't verified this information, but it's 550 00:33:30,480 --> 00:33:34,600 Speaker 1: but it's fascinating. Taylor goes on to offer up some thanks. 551 00:33:35,080 --> 00:33:37,840 Speaker 1: Um so thank you Taylor. So I wanted to read 552 00:33:37,840 --> 00:33:39,360 Speaker 1: this for a couple of reasons. One is that we 553 00:33:39,400 --> 00:33:42,120 Speaker 1: have gotten a lot of really great email after those 554 00:33:42,160 --> 00:33:44,680 Speaker 1: two part episodes. A lot of people who either live 555 00:33:44,720 --> 00:33:48,040 Speaker 1: in Hiroshima, or have visited Hiroshima, or have done crane 556 00:33:48,040 --> 00:33:50,720 Speaker 1: folding projects with their classes, so many of them have. 557 00:33:50,720 --> 00:33:53,000 Speaker 1: They have been so wonderful to read. And these pictures 558 00:33:53,280 --> 00:33:56,960 Speaker 1: that Taylor sent are beautiful. Thank you so much. And 559 00:33:57,000 --> 00:33:59,640 Speaker 1: I also did want to follow up on the point 560 00:33:59,720 --> 00:34:05,120 Speaker 1: made it out Kyoto, so um, it is interesting that 561 00:34:05,640 --> 00:34:08,760 Speaker 1: when they were choosing where to drop the atomic bomb, 562 00:34:09,120 --> 00:34:11,640 Speaker 1: Kyoto was actually at the top of the list for 563 00:34:11,680 --> 00:34:15,600 Speaker 1: a long time because of its cultural significance, like it 564 00:34:15,640 --> 00:34:18,280 Speaker 1: had not been touched by fire bombing until that point. 565 00:34:18,320 --> 00:34:21,200 Speaker 1: But the train of thought was, Oh, it would be 566 00:34:21,280 --> 00:34:25,479 Speaker 1: so culturally devastating to destroy such a historically important city 567 00:34:25,520 --> 00:34:29,160 Speaker 1: with all of these very important religious sites and historical buildings. 568 00:34:29,360 --> 00:34:32,759 Speaker 1: Maybe we should drop the bomb there. But the Secretary 569 00:34:32,800 --> 00:34:37,920 Speaker 1: of War, Henry Stempson, had visited Kyoto with his wife 570 00:34:38,000 --> 00:34:41,640 Speaker 1: earlier in his lifetime, and he kept insisting that it 571 00:34:41,719 --> 00:34:45,280 Speaker 1: was too beautiful to protect and they should not drop 572 00:34:45,320 --> 00:34:47,760 Speaker 1: the bomb on it. And the rest of the committee 573 00:34:47,760 --> 00:34:50,600 Speaker 1: that was making these decisions kept being like, but seriously, dude, 574 00:34:50,680 --> 00:34:53,440 Speaker 1: that will be the most devastating place. And so it 575 00:34:53,480 --> 00:34:57,040 Speaker 1: was not so much the United States recognized the cultural 576 00:34:57,120 --> 00:35:02,359 Speaker 1: value of Kyoto. It was that uh Henry Stumpson objected 577 00:35:02,400 --> 00:35:04,880 Speaker 1: to what his committee was telling him was the best 578 00:35:04,880 --> 00:35:07,920 Speaker 1: plan and eventually got them to choose a different place. 579 00:35:08,560 --> 00:35:11,000 Speaker 1: So if you'd like to write to us about this 580 00:35:11,160 --> 00:35:13,760 Speaker 1: or any other podcast where History podcast, that How Stuff 581 00:35:13,760 --> 00:35:16,640 Speaker 1: Works dot Com and then we're on all over social 582 00:35:16,640 --> 00:35:19,719 Speaker 1: media at missed in History, so you can find us 583 00:35:19,719 --> 00:35:24,399 Speaker 1: on Facebook and Pinterest and Instagram and Twitter. You can 584 00:35:24,960 --> 00:35:27,239 Speaker 1: come to our website, which is missing history dot com, 585 00:35:27,239 --> 00:35:29,560 Speaker 1: where you will find show notes for all the episodes 586 00:35:29,600 --> 00:35:31,719 Speaker 1: Holly and I have ever done together. There's a search 587 00:35:31,760 --> 00:35:33,080 Speaker 1: bar up at the top where you can look for 588 00:35:33,120 --> 00:35:36,120 Speaker 1: episodes that are interesting to you. There's also an archive 589 00:35:36,200 --> 00:35:38,400 Speaker 1: of every episode we have ever done, and you can 590 00:35:38,440 --> 00:35:41,840 Speaker 1: subscribe to our show on Apple Podcasts, Google Play and 591 00:35:41,880 --> 00:35:48,920 Speaker 1: wherever else do you find a podcasts. For more on 592 00:35:49,000 --> 00:35:51,480 Speaker 1: this and thousands of other topics, is it how Stuff 593 00:35:51,480 --> 00:36:00,440 Speaker 1: Works dot com