Why Was a Doctor Once Ridiculed for Recommending Hand Washing?

And that, dear listener, is how we begin the strange and sad story of Ignatz Smilvis, a nineteenth century doctor sometimes called the father of infection control some of weis was born in Hungary in eighteen eighteen, and after graduating from medical school, he started a job at Vienna General Hospital in Austria in eighteen forty six. There he became a ghast at the mortality rate of new mothers in

one of the hospital's wards. In this ward, up to eighteen percent of new mothers were dying from what was then called child bed fever or pure pearl fever. We know today that this is a fever caused by infection of the reproductive or urinary tract in new mothers. Yet in another of the hospital's wards, where midwives instead of doctors, delivered all of the babies. Only about two percent of mothers died of this then mysterious fever. Zemolweiss began reasoning

his way to the root of the problem. He considered climate and crowding, but eventually ruled those factors out. In the end, the midwives themselves seemed to be the only real difference between the two wards. Then Zemovieis had an epiphany. One of the hospital's doctors, a pathologist, accidentally nicked himself with a scalpel that he had used during an autopsy of one of these unfortunate mothers. The doctor was sickened

with childbed fever, and he died. Zemoweis made the connection that doctors were performing autopsies on patients who had died of childbed fever and then immediately afterward going to deliver babies without stopping to wash their hands. He suspected that this was the sore of the deadly problem. But we spoke via email with Dana Tolozievski, a philosophy professor at Purdue University whose name I hope I am pronouncing correctly.

She explained basically his hypothesis here was that it was cadaveric matter from the scalpel that entered the pathologist's blood and caused the infection, and that same material could be transferred to the women on the hands of the doctors, because the doctors would do autopsies and then go straight to examine the women who had given birth without washing their hands, changing their clothes, or basically taking any hygienic

measures at all. He then tested this hypothesis by requiring people who had performed autopsies to wash their hands with chloride of lime, a disinfectant, before attending the women, and after this the mortality rate in the first clinic fell to that of the second. You'd think that Simulweis's fellow doctors would have lauded him for this discovery, but you'd be wrong. You see, in the eighteen forties, germ theory hadn't been conceived yet. That's the theory that diseases are

caused by organisms not visible to the naked eye. People still suspected that diseases transferred from one person to another via toxic odors, not bacteria or viruses. This was called miasthma theory. In washing their hands They probably wanted to be rid of whatever was causing a bad odor, not to kill germs that might wreak havoc on them or someone else. We also spoke ya email with Michael Millinson,

an adjunct professor of medicine at Northwestern University. He said physicians of Zimbovice's time simply did not understand or believe that something microscopic could be wreaking such havoc on their patients. They literally believed their own eyes. Lest we feel too smug, consider how many people currently embrace a lack of COVID nineteen deaths among people like me geographically, racially, economically, or otherwise as evidence that scientists are overestimating the pandemics risk.

Better handwashing regiments dramatically improved death rates at the maternity ward, but some of vices colleagues were at best miffed at the implication that their ignorance was killing their own patients, and perhaps the implication that midwives were better at delivering babies than they were. It didn't help that Zemmolwei's essentially laid the deaths of the ward's mothers at the feet

of his superiors. His own supervisor countered that the hospital's new ventilation system must be the reason for the decline in maternity deaths. Also, Zemmoweiss was a Hungarian in Austria, a foreigner working in a country in the throes of xenophobia. So those doctors rejected his theories and Smovie's himself as being inferior. They opted to stick with their miasma theory, and for good measure, in eighteen forty nine did not

renew Zemmelweis's appointment. Zemoviis eventually got a medical position in Budapest, where he, according to the British Medical Journal Quote, publicly harangued doctors and nurses about handwashing and reduced paternal mortality. He eventually published a book on this object some fourteen years later, but it was poorly written and poorly received. Possibly experiencing a mental disorder or extreme stress from his rejection by the medical establishment, Zemmoweis ended up a patient

in an asylum in eighteen sixty five. Weeks later, he was dead of an infection from a wound that he received in the facility. He was just forty seven years old. Zemoweiss left behind a monumental legacy, but the tragedy of his story has made it garner a few myths, one of those being that Zemmoweiss was the first to suggest a theory about doctors transmitting germs. Galiziaski said he wasn't

really a pioneer. Other people before Zemalweiss had hit upon the idea that child bed fever could be transmitted from doctor or midwife to patient. For example, Alexander Gordon of Aberdeen showed in sevent that childhood fever was almost always transmitted by doctors or midwives, and also that it was connected to a kind of strupp, a cockle skin rash. He so thought that the best treatment was copious bleeding.

In the States, famously, there was Oliver Wendell Holmes, who was a physician but is now much better known as a poet, who wrote a very elegant essay called the Contagiousness a Pureborough Fever in eighteen forty three, a year before Zemowis even completed his m d. Another misunderstanding is that doctors of his time outright rejected Zemoviss's ideas about handwashing.

They didn't entirely, They just attributed coming down childbed fever to a range of variables such as predisposition, environment, and many other factors. To Liziski said, because people already had such a long list, adding cadaverick or decomposing animal matter really wasn't a big deal to them, and lots of people, some of them pretty big shots, did add this to their list and started disinfecting their hands, so it's just

not true that that part was universally rejected. Later in the eighteen sixties, Louis Pasteur started working on what would eventually become the theoretical explanation behind Zimbilvice's observations, and in the eighties, thanks to the pioneering work of Joseph Lister and others, people started using antiseptic techniques in surgical and maternity wards, which is when mortality rates from child bed fever really began to fall, along with many other inhospital

mortality rates. But even after scientists realized that Zimilvis had been right all along about hand washing, this simple act still remains a challenge throughout society. That's partially because even though we now know that germs are there, we human beings still sometimes trust what we see and discount what we can't. A January poll found fort of Americans don't always wash their hands after going to the bathroom, Even doctors and nurses may rationalize their own behavior has nothing

to do with spreading disease. Millinson said, patients get infections for many reasons. They come into contact with many people and many objects, and have compromised immune systems, and by definition, those who forget to wash or don't do it properly don't know that they forgot or were ineffective. Millinsen points out that there is still no requirement that hospitals reach a certain threshold on hand hygiene, only that they have

a program in place to improve it. He said, almost as bad, the US Centers for Disease Control doesn't monitor a national hand hygiene rate in hospitals, which often hovers in the ten to forty percent range. On average, US healthcare providers clean their hands less than half the times that they should, according to the most recent CDC study,

which was eighteen years ago. It's too soon to have numbers on how the COVID nineteen pandemic has affected hand hygiene in hospitals, though anecdotal evidence suggests it's put healthcare providers on high alert during this time, semovices even seeing a resurgence in pop culture. He was honored with a Google doodle in March, and an opera about him, which

premiered Ineen, was live streamed in May. Finally, there's this bright spot, Millinson equipped I like to tell provider audiences the good news is that we've made significant progress since Samuel Vis's time. We no longer put people who insist on doctors washing their hands into an insane asylum. Today's episode was written by Nathan Chandler and produced by Tyler Clang. For more on this and lots of other topics, visit how stuff works dot com. Brain Stuff is production of

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