Hand Washing Stops Infections—But Doctors Didn’t Realize it Until the Mid-19th Century
One of the best ways to prevent the spread of the flu and other viruses is to wash your hands. Today, this may seem like common sense to many people (even if they don’t all do it right). However, it was not until the middle of the 19th century that some doctors in the United States and Europe began to wash their hands before examining patients – and even then, only in certain cases.
One of the first supporters of hand washing was Ignaz Semmelweis, a Hungarian doctor who worked at the Vienna General Hospital between 1844 and 1848. The hospital was one of the largest in the world for teaching, and its wing Maternity Hospital was so large that it was divided into two departments: one for doctors and their students and one for midwives and their students.
However, there was a clear disparity between these services.
Between 1840 and 1846, the maternal mortality rate in the midwifery service was 36.2 per 1,000 births, while the mortality rate in the medical service was 98.4 per 1,000 births, according to one 2013 article in the Journal of the Royal Society of Medicine. Specifically, the medical service had a higher rate of “childhood fever”, now known as streptococcal infection. Semmelweis started to look for differences between services.
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One difference was that in the doctors’ division, a priest came regularly and sounded like a last sacrament to the dying, explains Dana Tulodziecki, professor of philosophy at Purdue University who wrote on Semmelweis in the newspaper Philosophy of science. Semmelweis wondered if women died because of “the psychological terror of hearing the bell – so even if you don’t actually die, you just hear the bell, you know it might be your time.” Semmelweis redirected the priest, but it made no difference.
Then, in 1847, the death of Semmelweis’ colleague Jakob Kolletschka brought him to a breakthrough. Kolletschka cut his finger on a scalpel during an autopsy and developed an infection that killed him. Semmelweis wondered if a similar type of infection could occur in the doctors’ maternity ward.
Semmelweis realized that, unlike midwives at the hospital, doctors sometimes examined women in the maternity unit after performing autopsies. In the absence of a theory of germs, Semmelweis theorized that Kolletschka had died because “cadaverous matter” had entered his body through his wound, and that women in the doctor’s room could also die because the cadaveric matter of Doctors’ hands entered their bodies through their genitals.
Although this was incorrect, Semmelweis’ response to his theory was quite good. He began to demand that doctors wash their hands with chlorinated lime after the autopsies. And it was a big improvement – between 1848 and 1859, the maternal mortality rate in the medical service fell to about the same level as that of midwives.
After that, the story becomes a bit controversial. Previous academics have argued that Semmelweis tried to convince other hospitals to adopt his policies and that they refused. Tulodziecki says the real story is more complicated. Yes, “the doctors were not happy that Semmelweis essentially hinted that they were responsible for the murder of all these women,” she said. However, “it is also true that when he finally published the etiology of childhood fever, it was not very well written; it was a kind of wandering in several parts. He was also a very stubborn person , very dogmatic. “As she says,” Overall, he could have improved his arguments. ”
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Semmelweis insisted all childhood fever was caused by cadaveric or decaying animal matter, which made no sense. Crib fever was a very old infection that appeared in home births as well as in the midwifery room of the Vienna General Hospital, where cadaverous or decaying animal matter was not a postman. Ensuring doctors washed their hands after autopsies was one way to reduce children’s fever, but Semmelweis alienated his colleagues by insisting that it was the only way – which they didn’t think was likely.
In any case, Semmelweis was not the only doctor in the middle of the 19th century to realize that the hygiene of health professionals could have a certain effect on their patients. In 1843, the American doctor Oliver Wendell Holmes published an article claiming that doctors with dirty hands could cause childhood fever in their patients. British nurse Florence Nightingale, considered the founder of modern nursing, wrote in her 1860 publication Notes on nursing “All nurses should make sure to wash their hands very frequently during the day.”
Yet the importance of handwashing for healthcare professionals has not been fully understood until scientists have investigated the germ theory – the idea that certain diseases and infections are caused by micro -organisms that we cannot even see. In particular, British surgeon Joseph Lister has significantly improved patient mortality by advocating that surgeons wash their hands and sterilize their instruments between patients.
Today, health and medical professionals regard hand washing as a critical hygiene practice for themselves and their patients. The Centers for Disease Control and Prevention, or CDC, even provides instructions on how to properly wash your hands. To properly kill the germs, the CDC recommends scrubbing them with soap for at least 20 seconds before rinsing the soap off with water. Drying them completely is also important, as wet hands spread germs more easily.
WATCH Flashback: soap the germ fighter In the 1950s, cleanliness reigned supreme. In this Flashback, learn the proper hygiene techniques from Soapy, a talking bar of soap.