The Age of Hospital Reform
During the days before Lister, the reasons for why patients died of infection were not fully understood. The risk of death especially because of surgery was greatly increased by the lack of understanding of infection and what caused it.
Cleanliness although encouraged, i.e. the floor of the ward should be clean and the beds tidy, it was a sad fact that the surgeon was the more likely spreader of disease. He was more than likely to wash his hands after the operation than before it.
The clothes and aprons worn by surgeons during operations were, to quote a source, “stiff and stinking with Pus and blood” In those days sawdust was used for soaking up the blood on the floor.
Clean practise and infection control with doctors and other staff, in wards and operating rooms was a world problem and was only really addressed by people such as Florence Nightingale, Joseph Lister and a Hungarian Doctor by the name of Ignaz Semmelweis.
This Hungarian obstetrician, discovered how to prevent puerperal fever from being transmitted to mothers, thus introducing antiseptic prophylaxis into medicine.
Born in Buda and educated at the universities of Pest and Vienna, Semmelweis became assistant professor in the maternity ward of the Vienna general hospital.
In the 1840s puerperal, or child bed fever, a bacterial infection of the female genital tract after childbirth, was taking the lives of up to 30 per cent of the women giving birth in lying-in wards, whereas most women who gave birth at home remained relatively unaffected.
Semmelweis noticed that women who were examined by student doctors who had not washed their hands after leaving the Post Mortem room had much higher mortality rates.
When a colleague who had received a scalpel cut died from infection, Semmelweis concluded that the puerperal fever was septic and contagious.
By ordering students to wash their hands with chlorinated lime before examining patients, he reduced the maternal mortality rate from 12.24 to 1.27 per cent in two years.
Semmelweis nevertheless encountered strong opposition from hospital officials, and because of his political activity as well, he left Vienna in 1850 for the University of Pest, where he became professor of obstetrics at the university hospital.
In spite of his enforcing antiseptic practices and reducing the mortality rate from puerperal fever to 0.85 per cent, Semmelweis findings and publications were resisted by hospital and medical authorities in Hungary and abroad. After suffering a breakdown, he went to a mental hospital in Vienna, where he died ironically of blood poisoning from an infection contracted during an operation he had performed earlier. 191
Hygiene is two thirds of health. 192