Semmelweis, drawing by Aharon Gluska
excerpts from SEMMELWEIS, THE WOMEN'S DOCTOR
The name Semmelweis suggests that he was Jewish. For the legions of enemies Ignaz Semmelweis would attract to himself, the fact that his name sounded Jewish was quite enough. Had not Empress Maria Theresa herself proclaimed, forty years before Semmelweis was born:
"I know of no greater plague than this race, which on account of its deceit, usury and avarice is driving my subjects into vagary. Therefore, as far as possible, the Jews are to be kept away and avoided."
Semmelweis refused to be kept away. He made himself unavoidable.
"Early on I developed an innate aversion to anything which can be called writing."--Semmelweis
His aversion to the study of law and writing and conversing in formal German guided him to a course of study with a language all of its own, that of the human body and its makeup, of health and sickness, of human beings in pain. A course of study restricted, at that time, to the called few.
One gets the impression that for the two years that Semmelweis resided and worked in Vienna, he did not leave the hospital grounds. Not a pleasant walk outside the flowering grounds or a visit to a colleague or acquaintance. There's no hint of an amorous life. He dwelled within the space of the disease he would conquer. The life of Semmelweis emerges in a purely claustrophobic manner, tied irrevocably to one new mother after another, hundreds upon hundreds of them, many of whom lived to see how their children turned out, many not. When he slept, the odor of decomposing animal matter played around his nostrils. The nocturnal tinkling of the priest's ominous bell tormented him. In this way, Dr. Ignaz Semmelweis resembles the obsessive Captain Ahab, in the end entangled forever to the back of the unfathomable white whale of his quest. Semmelweis marches into medical history and lore tied to the back of a new mother afflicted with puerperal fever.
It is Tuesday 27 February 1836--Dr. Ignaz Semmelweis' first day of work as Assistant Obstetrician. Footsteps sound on the gravel path, bordered by flowers. Take in the fragrant edelweiss!
Here are Semmelweis' duties as Assistant.
At the crack of dawn perform autopsies on patients who died during the night. Death so close upon dreams, upon awakening. His sun rises on the wings of a new mother's death, a newborn's cries. The sights and smell of it in Autopsy. Examine patients in preparation for Director Johann Klein's rounds. Prepare summary reports in his best German. Supervises difficult deliveries. The labor and joy of life commingle with death. Teach a course in obstetrics. For the first time, look out into the faces of students and feel their eyes watching, ears listening, hearts soaring…hear himself. According to his colleague and best friend, Lajos Markusovszky, who attended his lectures, Semmelweis "was gruff…did not suffer fools lightly…passionate at the rostrum…expounded his teaching with conviction…not only fights for the truth but vouches for it with his life." He held practical operative exercises on cadavers before the afternoon rounds at four p.m. because, in the morning, students were otherwise engaged. For such exercises to follow the afternoon rounds, it was already too dark. Much of Semmelweis' practical work occurred during the daylight hours, his nocturnal hours reserved for personal torment. Lastly but perhaps most important in regard to his discoveries, Semmelweis served as Clerk of Records.
Clerk of Records! Admit and register each and every pregnant woman who has come to Vienna Hospital to give birth! Look into each and every face! Hear each and every voice! Record each and every name and background! They are mostly single teenagers from the "comfortless classes," Semmelweis described them, in need and suffering, deprived of emotional support and had led generally "unhappy and dissolute lives." They earned their bread throughout pregnancy by hard work. Cut off from family, alone, often living on the street. Vienna, then, was the center of Austria's railway network, and the capital city had become the hub of migrant railway workers and their offspring. Term would come upon many of these women suddenly. There was no time to entertain any option other than to be taken to the Imperial Hospital…placed in one or the other of its maternity clinics. At the same time, these young pregnant women knew what was what. The number of deaths by the Fever traveled through the streets like wild fire. They could smell death. The stench of it, of decaying putrid organic matter emanating from the lying-in wards' sick room and the morgue, was a major factor in the early history of the field of obstetrics.
Medical students and visiting physicians examined the women in the First Clinic, from the time they arrived, throughout labor and delivery.
An experiment strikes him: exchange the midwives of the Second Clinic with the students of the First! He received permission to make the switch, most likely through Joseph Skoda's influence. Now midwives worked in the First Clinic while medical students attended in the Second.
Again Semmelweis waits…two weeks, a month…
Finally, results! From June through December (1847), of the 1,841 deliveries in the First Clinic, 56 new mothers died. The mortality rate of 3% is comparable to the death rate of the Second Clinic!
Death had followed the students!
Letterboxes, postage stamps, telegraph stations and mail delivery by rail had recently come into use. These correspondences of great importance were carried by mail-coaches, pulled by horses. They were delivered to Drs. Tilanus in Amsterdam, Simpson in Edinburg, Schmidt in Berlin, Scanzoni in Würtsburg, Seyfert in Prague.
Ferdinand Hebra confessed to a colleague:
"We could not doubt that, far from local jealousies and malice, we were going to receive the complete approval of those who could not fail to find Semmelweis's experiments completely conclusive."
"We attending physicians, our hands, even our shirtsleeves, he is saying, have come into contact with this decayed animal matter in autopsy and then carried upon our person while examining women in term…!
"How dare this Jewish Hungarian Assistant declare that we physicians, appointed by the Austrian Minister of Education, most of us tenured before Semmelweis was born, are the cause of the spread of puerperal fever! We have been, and remain, powerless in the face of the scourge!"
He was now thirty-eight years of age, bald, stocky, and his character at this time has been described as "intense," "brusque," "tactless," "gruff," "lacks small talk and pleasantries." Traits hardly enticing for a romance.
Nevertheless, he met and fell in love with a young, beautiful Hungarian woman. And she, him. Her name was Maria Wiedenhoffer and she was the daughter of a prosperous Buda-Swabian merchant, just like her father-in-law. She and Naci shared the same culture, language, spices. The courtship lasted a year and then, in June 1857, they married.
Recently, Dr. Bokai reports, Semmelweis had taken a lover who is a prostitute.
Consorting with a favorite prostitute, perhaps, was a fleeting moment of sheer pleasure, outside the pale of viewing a woman as pregnant, as an agent of propagating the race, a momentary reprieve from saving her from infection. All those diseased new mothers he looked down upon in the Dead Room and Dissection flash before his eyes. Now, in their places, lying with a woman paid, this woman of the night, her health not of immediate concern.
"Now he wandered with the mad, into the absolute, into those glacial solitudes where our passions no longer awaken echoes…"—Dr. Destouches
Late at night, in the privacy of his room, he takes up charcoal and paper and creates a manifesto! He writes quickly in large black letters, in perfect Hungarian.
"Fathers of families! Do you know what it means to call to the bedside of your wife in labor a doctor or a midwife? It means you are voluntarily forcing her to run the risk of losing her life, so easily avoided by these measures…"
He copies his manifesto a handful of times and then, clutching his sheets, steals into the street—not a soul in view—and hurriedly pastes them up on one wall, then another.…
On his way home from pasting up copies of his manifesto, suddenly, he bursts out running… looking back over his shoulder. He darts into the anatomy theater, which he still recognizes. A dissection lesson is underway, corpse in the center surrounded by instructor and students.
"Make way!" and Semmelweis pushes through, knocking over chairs…picks up a scalpel. Everyone knows who he is, enough of his specter remains, but no one looks him in the eye. Before he can be restrained from cutting deep into the putrid tissues, he slices off shreds of muscle and then tosses them hither and yon! Blood splattering, tissue flying! He's mumbling, seeking to explain. At this point, no one is even trying to understand him. Then, with the scalpel blade and his fingers, he rummages around in a cavity reeking with liquefaction. Dr. Destouches continues with this phase of Semmelweis' madness:
"With a movement more convulsive than before, he cut himself deeply. His wound bled. He cried out. He made threats. He was disarmed. A crowd gathered around him. But it was too late… As Kolletschka not long since, he had just infected himself fatally."
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thanks, AV