Recently, the COVID-19 pandemic has reminded us of the crucial importance of hand hygiene in preventing infections.
But do you know when this practice first entered the field of medicine?
In the early 19th century, most doctors and surgeons did not wash their hands at all. They often moved directly from dissecting corpses to delivering babies, without any attempt at cleaning. Surgeons wore blood-stained gowns from one operation to the next, even treating them as marks of surgical experience. Against this background, Ignaz Semmelweis’s work in Vienna marked a turning point in medical practice.
Evidence of Higher Mortality in One Clinic
Ignaz Semmelweis, a Hungarian physician (1818-1865), was transferred in 1846 to serve as an assistant at the First Obstetrical Clinic of the Vienna General Hospital. Hospital records from 1840 to 1846 revealed alarming statistics: the First Clinic, staffed by doctors and medical students, had a maternal mortality rate of nearly 98 deaths per 1,000 births. In contrast, the Second Clinic, managed primarily by midwives, recorded a much lower rate of about 36 per 1,000 births.
The difference was so stark that women often begged not to be admitted to the First Clinic. Some even chose to give birth in the streets, believing their chances of survival were higher there than under a doctor’s care. At the time, puerperal fever—a severe infection following childbirth—was the leading cause of maternal deaths. The disparity between the two clinics perplexed Semmelweis and led him to investigate further.
Hypothesis and Intervention
A turning point came with the death of his colleague, Jakob Kolletschka, who developed sepsis after sustaining a wound during an autopsy. Semmelweis recognized similarities between Kolletschka’s infection and the symptoms of puerperal fever. He proposed that “cadaverous particles” from autopsy rooms were being carried on the unwashed hands of doctors and students into the delivery ward, infecting new mothers.
To address this, in May 1847, he ordered that all staff wash their hands with a solution of chlorinated lime before examining patients.
Impact of Handwashing Protocol
The results were immediate and dramatic. Within months, maternal deaths in the First Clinic plummeted. The handwashing requirement reduced mortality from nearly 10% of births to close to 1%. This was one of the first documented instances showing that hygiene directly prevented deadly infections.
Reaction from the Medical Community
Despite this evidence, Semmelweis’s findings were met with resistance. At the time, the prevailing belief was that diseases spread through environmental factors such as bad air or general hospital conditions, rather than by direct transmission through contact. The suggestion that doctors themselves might be responsible for spreading infections was deeply uncomfortable and challenged long-held medical traditions.
As a result, Semmelweis’s recommendations were largely ignored during his lifetime. It was only later, with Louis Pasteur’s work on germ theory in the 1860s and Joseph Lister’s promotion of antiseptic techniques in surgery, that the scientific foundation for his observations was widely accepted.
Discussion on MedBound Hub
A recent discussion on MedBound Hub highlighted how Semmelweis’s work is still relevant today.
His discovery, though initially met with resistance, has saved countless lives and continues to shape infection control practices today.Devesh Chandola, B. Pharm
One of the central questions raised was, “How can we continue to promote hand hygiene and other basic preventive habits in today’s high-tech world?”
Great point despite all our advanced technology, simple practices like hand hygiene remain vital. Consistent awareness campaigns, education from a young age, and integrating reminders into daily routines can help keep these habits strong.Joshni, Biomedical Engineer
Present-Day Relevance
Semmelweis’s pioneering work laid the foundation for modern infection control practices. Today, hand hygiene remains one of the most effective measures to prevent hospital-acquired infections. The World Health Organization [2] and the Centers for Disease Control and Prevention[3] continue to emphasize handwashing as a cornerstone of safe patient care—an enduring legacy of Semmelweis’s work.
References:
Paul, N., S. Padmanabhan, A. Varghese, and R. R. Paul. “Pioneering Hand Hygiene: Ignaz Semmelweis and the Fight Against Puerperal Fever.” Cureus 16, no. 6 (June 20, 2024): e64417. https://doi.org/10.7759/cureus.64417.
World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. Geneva: WHO, 2009. https://www.who.int/publications/i/item/9789241597906.
Centers for Disease Control and Prevention. “Hand Hygiene in Healthcare Settings.” Reviewed May 17, 2024.
MSM
