Study on the 19th century puerperal fever epidemic: Semmelweis-an often neglected pioneer epidemiologist / 中华流行病学杂志

Puerperal fever was a major cause of maternal death in Europe in the 19th century.Many efforts were made to investigate the cause of the epidemic but failed.In 1846,Semmelweis,a young obstetrician in Vienna General Hospital,started his historical investigation.His breakthrough was largely due to his doctor friend's accidental injury during autopsy and his consequential death.Semmelweis found the pathological findings in his friend's post mortem examination were very similar to puerperal fever.He postulated his friend's death might be caused by "cadaverous particles"from cadavers and further inferred that puerperal fever might also be caused by the cadaverous particles that doctors brought to the delivering women after autopsy classes.He advocated hand-washing with chlorinated lime solution to wash off those particles,which rapidly reduced the maternal mortality in his department by 80％ (from 10.65％ to 1.98％).However,what his unprecedented work brought him was only denial,mockery and career setback rather than support,honor and compliments.Under substantial psychological pressure,he had a mental breakdown and died in a psychiatry asylum at the age of 47.He was a pioneer in epidemiological investigations before John Snow and in aseptic techniques before Joseph Lister,but his work is still often neglected.

Study on the 19th century puerperal fever epidemic: Semmelweis-an often neglected pioneer epidemiologist / 中华流行病学杂志

Puerperal fever was a major cause of maternal death in Europe in the 19th century.Many efforts were made to investigate the cause of the epidemic but failed.In 1846,Semmelweis,a young obstetrician in Vienna General Hospital,started his historical investigation.His breakthrough was largely due to his doctor friend's accidental injury during autopsy and his consequential death.Semmelweis found the pathological findings in his friend's post mortem examination were very similar to puerperal fever.He postulated his friend's death might be caused by "cadaverous particles"from cadavers and further inferred that puerperal fever might also be caused by the cadaverous particles that doctors brought to the delivering women after autopsy classes.He advocated hand-washing with chlorinated lime solution to wash off those particles,which rapidly reduced the maternal mortality in his department by 80％ (from 10.65％ to 1.98％).However,what his unprecedented work brought him was only denial,mockery and career setback rather than support,honor and compliments.Under substantial psychological pressure,he had a mental breakdown and died in a psychiatry asylum at the age of 47.He was a pioneer in epidemiological investigations before John Snow and in aseptic techniques before Joseph Lister,but his work is still often neglected.

La ofensiva de Ignaz Semmelweis contra los miasmas ineluctables y el nihilismo terapéutico / The offensive of Ignaz Semmelweis against ineluctable miasms and the therapeutic nihilism

Resumen A Semmelweis, la posteridad sólo le reconoce la introducción del lavado antiséptico de manos para reducir la infección hospitalaria, lo acusa de haber sido incapaz de superar las dificultades epistémicas para levantar el statu quo imperante, se lo denuesta por defender con fervor sus ideas, por su tosquedady torpeza en las relaciones con sus colegas, y por la rudeza de sus escritos. Su cometido se centraba en desarrollar prácticas obstétricas seguras, valorativas de la vida de la madre y cumplidoras del imperativo ético para el médico, por sobre todo no hacer daño. La deuda que se tiene con Semmelweis es el reconocimiento de su altura moral. (Acta Med Colomb 2014; 39: 90-96).

Abstract Posterity only recognizes to Semmelweis the introduction of antiseptic hand washing to reduce hospital infection, and accuses him of have been unable to overcome the epistemic difficulties for lifting the prevailing status quo, and is decried for fervently defend his ideas, for his crudeness and awkwardness in the relationships with his colleagues, and the rudeness of his writings. His role focused on developing safe delivery practices, valorative of the life of the mother and in compliance with the ethical imperative for the physician, above all do no harm. The debt owed to Semmelweis is the recognition of his moral height. (Acta Med Colomb 2014; 39: 90-96).

Semmelweis: de médicos: estetoscopios: corbatas y otros atuendos / Semmelweis: about physicians: athetoscopes: neckties and other garments

Por la heroica historia de Ignaz Semmelweis (1818-1865), los médicos hemos sido aconsejados a lavarnos las manos cada vez que examinamos un paciente. Deberíamos hacerlo antes y después, y estar seguros de que él nos viera… Una manifiesta y justificada cruzada a favor de la limpieza de los estetoscopios y contra del uso de batas blancas. Corbatas y otras prendas de vestir, ha venido expresándose en ambientes médicos, primero en forma tímida y ahora con mayor fuerza, al aportarse pruebas convenientes acerca de la inconveniencia de llevarlas. La consigna es la eliminación de las corbatas durante la visita o revistas médicas al considerárselas como diseminadoras de infecciones adquiridas en el hospital. Las corbatas más que un probable reservorío de gérmenes son prendas innecesarias por lo que el médico debe reconocer su eventual riesgo. Las nuevas guías de la Brithish Medical Association incluyen un mayor énfasis en el lavado de las manos y de acuerdo a ella, “es la intervención más importante en el control de las infecciones”. Igualmente, se aboga por un mejor diseño de las salas de hospitalización, mejor provisión de lavamanos o geles antisépticos, políticas más inteligentes en la prescripción de antibióticos y eliminar el uso de ítems tales como corbatas, a veces usadas continuamente y por semanas y solo por raridad enviadas a la lavandería

Since the heroic history of Ignaz Semmelweis (1818´1865), we doctors have been advised to wash our hands every time we examine a patient. We should have to do it before and sfter, and be sure that the patients is seeing us… An overt and warranted crusade in favor of cleaning stethoscopes and against the use of medical gowns, neckties and other clothing items has begun expressing itselfin medical spheres, first in timed form and now with greater force, thanks to convincing test regarding the inconvenience of their use. The main message is the alimination of neckties during examinations or medical rounds, considering that these are vehicles of infection acquired in the hospital. Neckties, more than probable reservoirs of germs, are unnecessary clothing items, reason why doctors must recognize their possible risk. The new guidelines of the Medical Brithish Association include a greater emphasis on the washing of hands and according to it, “(it) is the most important intervention in the control of infections”. Also, it pleads for a better design of hospital rooms, better provision of sink and/or antiseptic gels, more intelligent policies for antibiotic prescriptions and the elimination of the use of items such as neckties, sometimes used continuously and for weeks and only rarely washed

Semmelweis y su aporte científico a la medicina: Un lavado de manos salva vidas / Semmelweis and his outstanding contribution to Medicine: Washing hands saves lives

Ignaz Semmelweis was a Hungarian obstetrician who in the nineteenth century, preceding the discoveries of Pasteur and Lister, proposed the infectious etiology of puerperal sepsis. With a simple antiseptic procedure, he achieved marked reduction of the prevalence of this disease. However, he needed to fight against the reluctancy of his colleagues who didn't accept his observations although they were for the first time in the history of Science, supported by statistical significance analysis. This report describes biographical data of this revolutionary physician and the circumstances of his strange death based on information not often revealed.

Ignaz Semmelweis, fue un obstetra húngaro que a mediados del siglo XIX, precediendo los hallazgos de Pasteur y Lister, logró descubrir la naturaleza infecciosa de la fiebre puerperal, logrando controlar su aparición con una simple medida de antisepsia. Debió luchar con la reticencia de sus colegas que no aceptaron sus observaciones que, por primera vez en la historia, fueron apoyadas con datos estadísticos. Esta comunicación describe datos biográficos de este trascendente científico y las circunstancias que rodearon su extraña muerte, apoyada en información infrecuentemente divulgada.

Semmelweis's Work: Hand-washing Lowered Maternal Death Rate Dramatically / 병원감염관리

Semmelweis correctly concluded that puerperal fever could be spread from necrotic discharge from living patients, as well as autopsy material. And maternal death rate was decreased dramatically by washing hands in chlorinated lime. Semmelweis may be credited with having for the first time constructed a statistically tested system of asepsis (keeping germs away from the patient) before the germ theory had arrived.