It is as Simple as Washing Your Hands

Sanitation was very much lacking in old medical practices. Mortality resulted in infections that sometimes led to mortality. One person who made a very important milestone in the sanitation for medical treatment was Ignaz Semmelweis. Known as the “father of infection control”, Dr Ignaz, or Ignac, Semmelweis was a Hungarian born physician who received his MD degree in Vienna in 1844.

Ritual hand-washing has appeared to have come with public health implications. During the Black Death of the 14th century, for instance, the Jewish population of Europe had a distinctly lower rate of death than other demographics. Researchers believe that hand-washing prescribed by their religion probably served as protection during the epidemic.

Hand-washing as a health care prerogative did not really surface until the mid-1800s, when Ignaz Semmelweis, a physician, performed an important observational study at Vienna General Hospital.

After becoming disillusioned with the study of law, Semmelweis moved to the study of medicine, graduating with a medical degree from the University of Vienna in 1844. Having graduated from this prestigious institution, he believed he would be able to pursue a choice practice. He applied for positions in pathology and then medicine, but received rejections in both.

Semmelweis then turned to obstetrics, a relatively new area for physicians, previously dominated by midwifery, which was less prestigious and where it was easier to obtain a position. He began working in the obstetrics division of the Vienna Hospital on July 1, 1846.

The leading cause of maternal mortality in Europe at that time was puerperal fever, an infection, now known to be caused by the streptococcus bacterium, that killed postpartum women.

Prior to 1823, about 1 in 100 women died in childbirth at the Vienna Hospital. But after a policy change mandated that medical students and obstetricians perform autopsies in addition to their other duties, the mortality rate for new mothers suddenly jumped to 7.5%. The goal now was to figure out why.

Eventually, the Vienna Hospital opened a second obstetrics division, to be staffed entirely by midwives. The older, First Division, to which Semmelweis was assigned, was staffed only by physicians and medical students. Rather quickly it became apparent that the mortality rate in the first division was much higher than the second.

Semmelweis set out to investigate. He examined all the similarities and differences of the two divisions. The only significant difference was that male doctors and medical students delivered in the first division and female midwives in the second.

Semmelweis noticed that doctors and students rarely washed their hands and that gloves were not commonplace. Realizing that chloride solution rid objects of their odors, Semmelweis mandated hand-washing across his department. Starting in May 1847, anyone entering the First Division had to wash their hands in a bowl of chloride solution. The incidence of puerperal fever and death subsequently dropped precipitously by the end of the year.

Ignaz Semmelweis set a precedent in the medical world that saved people’s lives. Sometimes all we are taught about medical practices are the milestones in technology and cure. We are not taught about the milestones that are not as technologically advanced. However, the mandate that Semmelweis institutes is just as important, or even more. This is because without this practice, those procedures we learn about, would not be as successful.