---
title: The Dissenter & Father of Hand Hygiene Ignaz Semmelweiss turns 195!
description: The Dissenter & Father of Hand Hygiene Ignaz Semmelweiss turns 195!
---

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## The Dissenter & Father of Hand Hygiene Ignaz Semmelweiss turns 195!

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acd5fd63b5f29287909/1498845305001//img.png.com/static/595689fc9de4bbc892200518/t/59568acd5fd63b5f2928790a/1498843853312/1000w/>

It's true, I'm not always known to be a conformist.  I can be difficult and occasionally disagree  
 in matters of opinion (the definition of a dissenter).  The next time someone comments about my lack  
 of conformity, I'll quote Professor Cass Sunstein from the University of  
 Chicago "Dissenters benefit others while conformists benefit  
 themselves." 

Semmelweiss was the quintessential dissenter.  He challenged the conformists' accepted  
 wisdom and sought answers to problems that, in his mind, had not be suitably  
 explained.  But for challenging the norm,  
 he was ostracized, condemned, and driven to a state of near insanity that led  
 to an early death.  July 1st marked what  
 would have been Ignaz Semmelweiss' 195th birthday.  His legacy of positive dissent, benefited  
 patients not just in his lifetime, but has been essential to patient safety  
 ever since.  It seems fitting to pay  
 homage to the man who, through his "difficult" manner and positive  
 dissent from accepted wisdom in the introduction of antiseptic hand hygiene,  
 has saved the lives of millions of patients.

The General Hospital of Vienna boasted quite favorable  
 conditions for its time.  Unlike its  
 contemporaries of the early part of the 19th century who often had 3 or 4  
 patients/bed, the General Hospital of Vienna's policy was 1 patient/bed.  They further segregated patient care by  
 class: a section for the wealthy, a section for patients who were able to pay a  
 small sum for care and a third section and certainly the largest for those who  
 were unable to pay.  The indigent  
 patients were permitted free care with the understanding that some of that care  
 would be seen to by medical students and midwives in training.

In the indigent section of the hospital there were two  
 maternity clinics that admitted patients to one or the other on alternate  
 days.  One clinic was largely for  
 training of midwives while the second was for training of doctors.  When Semmelweiss was appointed assistant to  
 the Professor of the First Obstetrical Clinic some of his first observations  
 were of women desperately weeping and begging to be admitted to the Second  
 Obstetrical Clinic rather than the First and for a very good reason, the First  
 clinic had a deadly reputation.

In the First Clinic, maternal mortality rates due to  
 Childbed Fever (a form of septicemia) rarely dipped below 10% of admissions and  
 in some months climbed as high as 30%.   
 Conversely, in the Second Clinic where the midwives were in training,  
 the mortality rate rarely climbed above 2%.   
 Physicians and governmental authorities were more than aware of the  
 ravages of Childbed Fever to the point that they were often referred to as  
 "houses of death", but causes were most often attributed to miasmas  
 (foul air), improper diet, strong liquors or violent mental emotions.

Haunted by the higher rates of Childbed Fever in the  
 First Clinic, Semmelweiss was unwilling to accept the conformist view.  The only difference between the two clinics  
 were the people working there.  After  
 eliminating all factor that were consistent between the two clinics he  
 eventually concluded that the medical students were carrying "cadaverous  
 particles" (e.g. microbes) on their person to the First Clinic after performing  
 autopsies of patients who had died from Childbed Fever.  When his best friend and fellow physician  
 died after being cut by a student during an autopsy he was compelled to  
 act.  He was convinced the cause of  
 transmission was from contaminated hands of physicians and students.

Semmelweiss demanded that all students and physicians  
 clean their hands with a chlorinated lye solution before attending patients in  
 the First Clinic in order to remove or destroy the invisible cadaverous  
 particles.  The strategy worked and  
 deaths attributable to Childbed Fever rapidly dropped to below that of the  
 Second Clinic where the midwives had always kept their hands clean and did not  
 attend autopsies.  Unfortunately, rather  
 than celebrations and change in practice the culture of conformity triumphed  
 and Semmelweiss was forced to resign his position and subsequently the  
 mortality rates in the First Clinic returned to pre-intervention levels.

As we know, Semmelweiss' ideas were eventually accepted  
 and he has become widely recognized as the "Father of Hand  
 Hygiene".  In celebration of his  
 195th birthday, I hope the next time you sing "Happy Birthday" while  
 washing your hands, you'll remember Ignaz Semmelweiss!

*Bugging Off!*

Nicole

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