History of Antiseptics - Ignaz Semmelweis

The Battle for Handwashing and Antiseptic Technique

Antiseptic technique and the use of chemical antiseptics is a recent development in the history of surgery and medical treatment. This isn't surprising since the discovery of germs and Pasteur's proof that they could cause disease didn't occur until the last half of the 19th century.

Ignaz Semmelweis - Wash Your Hands

Hungarian obstetrician Ignaz Philipp Semmelweis was born July 1, 1818 and died August 13, 1865.

While working at the maternity department of the Vienna General Hospital in 1846, he was concerned with the rate of puerperal fever (also called childbed fever) among the women who gave birth there. This was often a deadly condition.

The rate for puerperal fever was five times higher in the ward that was staffed by male doctors and medical students and lower in the ward staffed by midwives. Why should this be? He tried eliminating various possibilities, from the position of giving birth to eliminating a walk-through by a priest after patients died. These had no effect.

In 1847, Dr. Ignaz Semmelweis's close friend, Jakob Kolletschka, cut his finger while doing an autopsy. Kolletschka soon died of symptoms like those of puerperal fever. This led Semmelwiss to note that the doctors and medical students often performed autopsies, while the midwives did not. He theorized that particles from the cadavers were responsible for transmitting the disease.

He instituted washing hands and instruments with soap and chlorine. At this time, the existence of germs was not generally known or accepted. The miasma theory of disease was the standard one, and chlorine would remove any ill vapors. The cases of puerperal fever dropped dramatically when doctors were made to wash after doing an autopsy.

He lectured publicly about his results in 1850. But his observations and results were no match for the entrenched belief that disease was due to an imbalance of humours or spread by miasmas. It also was an irritating task that put blame on spreading disease on the doctors themselves. Semmelweis spent 14 years developing and promoting his ideas, including publishing a poorly-reviewed book in 1861.  In 1865, he suffered a nervous breakdown and was committed to an insane asylum where he soon died from blood poisoning.

Only after Dr. Semmelweis's death was the germ theory of disease developed, and he is now recognized as a pioneer of antiseptic policy and prevention of nosocomial disease.

Joseph Lister: Antiseptic Principle

By the middle of the nineteenth century, post-operative sepsis infection accounted for the death of almost half of the patients undergoing major surgery. A common report by surgeons was: operation successfully but the patient died.

Joseph Lister had been convinced of the importance of scrupulous cleanliness and the usefulness of deodorants in the operating room; and when, through Pasteur's research, he realized that the formation of pus was due to bacteria, he proceeded to develop his antiseptic surgical method.

The Legacy of Semmelweis and Lister

Handwashing between patients is now recognized as the best way to prevent spreading illness in health care settings. It still is difficult to get full compliance from doctors, nurses and other members of the health care team. Using sterile technique and sterile instruments in surgery has had better success.