March 21, 2018 • 36 mins
Ignaz Semmelweis made a connection between hand hygiene and the prevention of childbed fever in the 19th century. He wasn’t taken seriously then, but today he’s known as everything from the father of infection control to the conqueror of childbed fever.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to steph you missed in history class from how
Stuff Works dot Com. Hello, and welcome to the podcast.
I'm Tracy V. Wilson and I'm Holly fry So. Holly,
I think a lot of people take for granted the
idea that you need to wash your hands to prevent disease. Yes,
(00:26):
but also some people discount it well. And there's also
a lot of research that even though this is a
pretty ubiquitous and standard idea, a lot of people don't
actually wash their hands nearly as much as they should.
But regardless of all of that, it was not taken
for granted in nineteenth century Europe, including among doctors, that
you needed to wash your hands to prevent disease. And
(00:48):
today we are going to talk about Ignaz Semmel Vice,
who was one of the people who made this connection
between hand washing and disease prevention. The disease that he
was preventing was childbed fever, and even though it was
not taken seriously at the time, like people wrote him
off entirely, today he's known as everything from the father
of infection control and the savior of mothers and the
(01:12):
conqueror of child bed fever, which is a lot of
I mean, very lofty pronouncements, and he did do amazing work,
but it did not last past his lifetime. Uh. This episode. Also,
to be clear, it's about medicine in nineteenth century Europe
and to a lesser extent in North America. And we're
definitely aware that religions and cultures all over the world
(01:33):
have their own practices about everything from handwashing to delivering babies.
It is not about that at all. This is not
a global overview of hand hygiene and how it relates
to medicine. We're really looking at how the practice of
obstetrics and formal medical training collided in the eighteenth and
nineteenth centuries. And this is also a listener request we've
gotten from several people, including Margaret Tom and Ashley Child.
(01:58):
Bed fever, also known as pew a pearl fever, is
a postpartum infection of the uterus or the vaginal canal,
and it's often caused by a streptococcal infection, but it
can come from other pathogens as well. Today, these infections
are largely preventable through hygiene and infection control procedures during
labor and delivery, and when they do happen, they're usually
(02:19):
treatable with antibiotics, so in places where competent care, clean water,
and antibiotics are readily available, pure pearl fever isn't very common.
This was not the case before the germ theory of
disease or the discovery of antibiotics. Until the late nineteenth century,
childbed fever was one of the most common complications of childbirth.
(02:40):
Within about three days of giving birth, patients developed abdominal pain, fevers, abscesses,
and other signs of infection, and this would often progress
to blood poisoning and death. Sometimes incidents of child bed
fever were sporadic, and between twenty and thirty of those
sporadic infections were fatal. But when an epidemic of child
(03:01):
bed fever swept through a community or a hospital, it
tended to be a lot deadlier, with seventy two with
a seventy to eighty percent mortality rate, and a lot
of prominent women died of child bed fever throughout history,
including Mary Wolston Craft, Henry the Eighth Wife, Jane Seymour,
and possibly recent podcast subject Phyllis Wheatley. Obviously, a lot
(03:24):
of ordinary women did to you that aren't in the
history books. It was something both expecting parents and their
doctors and midwives dreaded and feared. Child bed fever was
described in medical literature all the way back to Hippocrates
in the fourth century BC, and in the years before
evidence based medicine. People blamed it on a range of
(03:44):
causes based on whatever medical theories were in use at
the time, so everything from a balance an imbalance in
the four Humors to myasthmas or bad air. By the
eighteenth century, doctors were devoting a lot of writing to
arguing about whether it was an inflammatory or a putrefying disease.
(04:04):
In the eighteenth and nineteen centuries, a few things happened
in tandem that led to a big increase in child
bed fever epidemics. One was that more babies were being
delivered in hospitals rather than at home. In some cases,
these hospitals were part of social programs. The idea was
to provide free care before and after delivery to try
(04:25):
to stop infanticide among families that were living in poverty.
Some of these hospitals employed midwives and others of them
employed doctors, and this was also a change. Before this
point doctors and surgeons, who were almost exclusively male had
really only been involved in delivering babies when there were
really serious complications. It was so unusual for a man
(04:47):
to be involved in delivery that in some places these
doctors were called man midwives, So the idea that a
doctor would be involved in the routine delivery of a
baby was fairly new in the seventeen hundreds. Also fairly
knew was the widespread use of autopsies as part of
medical education. Although autopsies existed well before this point, it
(05:09):
was only in the mid seventeen hundreds that the field
of medicine really started using them to try to improve
on medical knowledge and teach medical students. In the late
eighteenth and early nineteenth centuries, doctors started using autopsies of
childbed fever victims, specifically to try to learn more about
the disease. All of this together meant that at about
(05:30):
the same time, more people were giving birth in hospitals
assisted by doctors, and more doctors and medical students were
handling and dissecting cadavers as part of medical study, including
the bodies of people who had died of childbed fever.
Because illnesses were blamed on things like myasthmas and imbalanced
humors rather than on pathogens. These post mortem examinations were
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being conducted with bare hands, and those bare hands were
not usually washed before working with living patients. Surgical gloves
weren't even invented yet. That wouldn't happen until the late
eighteen hundreds, and when those gloves were invented, they were
really about protecting the hands from chemicals, not protecting the
patients from the spread of disease or the doctors from
(06:17):
contracting diseases from the patients. The result of all of
this was a dramatic increase in epidemics of child bed fever,
particularly in hospitals. One swept through the Paris Hotel Dieu
in seventeen in seventeen forty six, another struck the British
lying In hospital in seventeen sixty. These were frequent and
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widespread enough that hospitals weren't usually thought of as safe
places to give birth. There were definitely doctors who spotted
the connection between autopsies and child bed fever, or who
suspected that the disease could be spread from patient to
patient by the doctors who were treating them. These doctors
published treatises and journal articles about what they thought was
(07:00):
causing childbed fever and how to stop it. In sv
Alexander Gordon of Aberdeen, Scotland wrote his treatise on the
Epidemic of Pure Pearl Fever, and in it he theorized
that doctors who had treated a patient with childbed fever
could pass it on to other patients. He recommended burning
the patient's bedclothes, along with thorough handwashing and fumigating all
(07:24):
of the clothing of the doctors and nurses who were
involved in the infected patient's care. In eighteen twenty nine,
when an epidemic of childbed fever struck the rotun To
Hospital in Dublin, Ireland, hospital chief Robert Collins tried to
stop it with a forty eight hour chlorine fumigation. He
also ordered that all the floors and walls be scrubbed
(07:45):
down with chlorinated lime and all the linen's be heat treated.
The number of childbed fever cases at the hospital dropped
almost to zero after he did all this. In eighteen
forty three, Oliver Wendell Holmes Sr. Delivered a paper are
called the Contagiousness of Pure pearl fever to the Boston
Society of Medical Improvement. In it, he said, quote, the
(08:07):
disease known as pure pearl fever is so far contagious
as to be frequently carried from patient to patient by
physicians and nurses. He then went on to describe a
number of steps to try to prevent the spread of
the disease. These included that obstetricians should never conduct autopsies
on patients who died of childbed fever, and if for
(08:28):
some reason an obstetrician had to, he should very thoroughly
clean himself, change all of his clothes, and abstain from
patient treatment for at least twenty four hours. Holmes went
on to recommend that if a doctor treated a patient
who then contracted childbed fever, he should consider all of
the patients that he went on to treat to also
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be at risk until significant time had passed without anybody
else being infected, and if two of his patients developed
childbed fever in close proximity to one another, he should
remove himself from metical practice and bring in a substitute
for at least a month. Holmes's paper made recommendations that
would have been both useful and effective for preventing the
(09:09):
spread of child bed fever, but it didn't get a
lot of attention until it was reprinted as a pamphlet
and more widely distributed, and then the response among the
medical community was total dismissal and outright mockery. Charles D. Meigs,
an obstitution from Philadelphia, described holmes as theories and recommendations
as quote je June and fizzinless Dreamings, and claimed that
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any doctor who saw an increase in child bed fever
was just unlucky. When Egna's Semilvis came to the same
conclusion that Oliver Wendell Holmes Senior had, the response from
the rest of the medical community was very much the same,
and we'll talk about it after a sponsor break. Aca
(09:56):
Semilviss was born on July one, eighteen and Taban area
of Buddha, Hungary. Buddha would combine with Pest in eighteen
seventy three, so that was a little bit later to
become Budapest. At the time, Hungary was part of the
Austrian Empire, and he was the fifth of ten children
born to Grosser Joseph Semmelweiss and Terresia Mueller. There's a
(10:19):
bit of disagreement about the family's heritage. Some accounts claim
that they were Jewish and that anti Semitism was a
factor in later parts of Semilvis's story, but Sherwin B. Newland,
author of The Doctor's Plague, Germs, child bed Fever, and
The Strange Story of Ignaz Semilwis, writes that parish registers
document that the semil Weiss family was Roman Catholic going
(10:41):
back to the sixteen seventies. The counter argument is that
semil Weiss and his ancestors may have been baptized for
the sake of assimilation while the family was still culturally Jewish,
but this is largely conjecture and it seems mostly just
to be based on their surname. In eighteen thirties seven,
at the age of nineteen, semul Weiss went to the
(11:02):
University of Vienna to study law. A year later, he
changed his course of study to medicine, and he graduated
with his m d. In eighteen forty four. He looked
for a position practicing internal medicine, but he couldn't find one,
so he changed his focus once again and looked for
a position in obstetrics. On July one, eighteen forty six,
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he was granted a two year appointment as an assistant
to Professor Johann Klein, who was the director of the
Vienna Algamini Conkin House or the General Hospital. Vienna General
Hospital was a teaching hospital, so in this role, Semilviis
was both a doctor and a teacher. He supervised and
educated medical students, and he assisted with difficult deliveries. He
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was also the clerk of records, which put him in
a good position to spot patterns among the patients and
their outcomes. The maternity clinic at the Vienna General Hospital
was one of the ones that had been established to
provide free medical care to impoverished patients, so patients essentially
got free care and exchanged for helping with the medical
students educations. Originally, the hospital had one maternity clinic, which
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was staffed by midwives, doctors and their students, and after
a while that one clinic became so overcrowded that the
hospital opened a second one, which was still staffed by
a mix of doctors, midwives and their students. But around
eighteen forty the two clinics were separated into the first
and second clinic. The first clinic was staffed by doctors
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and medical students, and the second clinic was staffed by
midwives and midwiffery students. The two clinics alternated admission days,
so if the first clinic accepted patients on Monday, the
second clinic would accept patients on Tuesday, and so on.
When the maternity clinic first opened in seventeen eighty four,
the hospital director Lucas Bore, had not included post mortem
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work as part of the obstetric students course of study
because he thought it carried a risk of contagion. But
in eighteen twenty three Johann Klein took over as director
and started using autopsies as a teaching tool for the
obstetric students. By the time Semmelweis joined the hospital staff,
the rates of child bed fever at Vienna General Hospital
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very dramatically between the two clinics. At the midwives clinic,
between one and two percent of patients died of child
bed fever, and at the doctor's clinic the rate varied
from five tot with an average of about ten percent.
This difference between the two clinics was so huge and
so well known that laboring patients who were told that
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they were being admitted to the doctor's clinic would beg
to be sent to the midwives clinic instead. Some even
gave birth in the street outside the clinic after hearing
that it was the doctor's day for admission, and then
they would say they had been on the way to
the hospital and the baby just came before they could
get there. That way, they would still have access to
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the free care at the clinic, but without the risk
of death that was associated with it. That's gotta be
a terrifying choice when you're like, no, I'm I'm just
gonna do this in the street and then I'll let
them take care of me after that. Well, and I
imagine a thing I didn't find. Um, I didn't find
sources that said this, but considering that my own mother
did this when I was born, I imagine the people
(14:20):
that were like, I'm in labor, but I'm not far
into labor and it's the doctor's day. I'm gonna wait
a few hours so I can go to the midwives clinic.
I imagine that was a thing to my My parents
did that because if they waited till after midnight, they
wouldn't be billed for the extra day, did not have
a ton of money. Some of us noticed that even
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these births out in the street were safer than giving
birth in the doctor's clinic at the hospital. He wrote,
quote to me, it appeared logical that patients who experienced
street births would become ill at least as frequently as
those who delivered in the clinic. What protected those who
delivered outside the clinic from these destructive, unknown endemic influences.
(15:03):
He became completely fixated on this question. It was appalling
and deeply offensive to him that there was such a
huge difference between the doctors and the midwives clinics. So
he started trying to figure out what was different between
the two clinics, and then making adjustments to what the
doctors were doing. At the midwives clinic, patients lay on
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their sides to deliver, but at the doctor's clinic they
lay on their backs. Civilized changed the procedure at the
doctor's clinic to use sideline, but that didn't make a difference.
He also noticed that anytime a patient was dying in
the doctor's clinic, the priest who was arriving to get
to give last rites basically had to walk through the
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whole ward, and he rang a bell while he was
doing this. Some of vis thought maybe this bell and
what it signified was so terrifying that it was making
people sick, so he got the priest to stop it
with the bell. That did not fix the problem. He
looked at how crowded the two clinics were, and it
turned out that the midwives clinic was understandably far more crowded.
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He looked at the religious practices of the people working
in each clinic. He looked at the patient's diets, and
none of these things seemed to make a difference. Then
his friend and colleague, Jacob Collecca died of what appeared
to be childbed fever after accidentally being nicked with a
scalpel while performing an autopsy on someone who had died
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of it, and Collectica's own autopsy results were very similar
to those of childbed fever victims. That's when Semmelweis realized
that midwiffery students weren't performing autopsies as part of their training,
only the medical students were. Another difference was that the
medical students were performing vaginal examinations on their patients. As
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a routine part of their care, while midwiffery students only
did so when there seemed to be a need for one.
Semilvis's conclusion was that some kind of cadet ever a
particles were being transmitted from the autopsies to the patients
in the doctor's clinic. In mid May of eighteen forty seven,
Samuel Weis started instructing doctors and medical students to wash
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their hands after conducting autopsies. They were to use chlorinated
lime until their hands had no trace of the putrid
smell that was left behind by a decaying body. He
chose chlorinated lime because it seemed to do the best
job of getting rid of the odor. But chlorinated lime
is calcium hypochlorite, which today is sold as powdered chlorine bleach.
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Chlorine bleach is, of course a disinfectant. With Samulwis's hand
washing protocol in place, the rate of child bed fever
mortality in the doctor's clinics started to drop. It had
been eighteen point three percent in April, and by June
it had dropped to two point two percent. In August
of eighteen forty seven, for the first time since the
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medical students started performing autopsies. No one died of childbed
fever in the doctor's clinic. Some of us couldn't exactly
explain why this had worked. At one point, another outbreak
of childbed fever spread through the clinic, even though there
had been no autopsy to trigger it. So some of
us began to suggest that some patients might make their
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own so called cadaverous particles and their own bodies, rather
than the autopsies being their only source. Later on, he
revised his hypothesis a third time, saying that the cadaverous
particles could come from any decaying animal flesh, not just
from a human body. The fact that he couldn't adequately
explain why his protocol worked became one of the arguments
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against his findings. While some of his medical students agreed
with and supported his work, most of the established doctors
at the hospital dismissed him completely. Director Johann Klein insisted
that it was the clinic's new ventilation system which was
getting rid of dangerous miasmas and that should get the credit.
Other doctors also vehemently disagreed with the idea that their
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own hands could have been what was spreading such a devastating, painful,
and emotionally wrenching disease. It was unfathomable to them that
a doctor could have dirty hands in the first place.
In their minds, doctors were gentleman, and a gentleman's hands
were always clean, and his word of semal vices protocol
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spread beyond a hospital. Doctors were also resistant to the
idea of washing their hands because they didn't necessarily have
access to clean water where they worked, and also because
it was time consuming. I like this weird chicken in
the egg thing, where like a gentleman's hands aren't clean
because he takes such fastidious care of himself, but just
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because he's a gentle yes. Uh. Later on several vice
would describe it this way quote. Most medical lecture halls
continued to resound with lectures on epidemic child d fever
and with discourse against my theories. The medical literature for
the last twelve years continues to swell with reports of
(20:08):
pure Borough epidemics, and in eighteen fifty four, in Vienna,
the birthplace of my theory, four hundred maternity patients died
from child bed fever. In published medical works, my teachings
are either ignored or attacked. The medical faculty at Wurtzberg
awarded a prize to a monograph written in eighteen fifty
nine in which my teachings were rejected, So he wrote
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that a little bit later, and to return to this
current part of the story, Similwis did not back down
in the face of all this opposition. In eighteen forty eight,
he started requiring that medical students clean all the instruments
that were used during labor and delivery with chlorinated lime
as well. The clinic had already had a month where
there had been no deaths, and at this point the
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ongoing mortality rate from child bed fever at the hospital
dropped almost to he row. As doctors continued to dismiss
his findings, Similweis became increasingly hostile and combative, and simultaneously
uprisings were sweeping through the area as people protested against
the Habsburg dynasty in the Austrian Empire. Students held a
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demonstration in Vienna on March thirteenth, eighteen forty eight, and
the Hungarian Revolution of eighteen forty eight began two days later.
Although there's no evidence that Semilvii's was part of these demonstrations,
many of his student supporters were which probably inflamed tensions
between him and the rest of the faculty. As I
said earlier, that position he had at the maternity clinic
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and at the hospital had been a two year appointment,
and in eighteen forty nine the hospital elected not to
renew it. He was instead offered a position that had
no contact with cadavers. In eighteen fifty he left Vienna
to return home without announcing his departure or saying goodbye
to anyone. He knew. We're going to talk talk about
Salvis's life back in Hungary after we first pause for
(22:03):
another sponsor break. In eighteen fifty one, Ignaz semial Weiss
was named head of obstetrics at St. Rocas Hospital. Although
this was really an honorary and unpaid position, He did
hold it for the next few years, though, during which
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time the rate of childbed fever at the hospital dropped significantly.
In the mid eighteen fifties, Silvis left St. Roucas and
became a professor at Pest University. In eighteen fifty seven,
he married Maria Widenhoffer, and they went on to have
five children together. During these years, some of Wess continued
to advocate for handwashing after autopsies, and he also wrote
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a series of extremely hostile open letters to the doctors
who dismissed his ideas, calling them murderers who were responsible
for the deaths of women through their negligence. This seems
to me like a very fair assessment. But but people
began to increasingly think he is just uh an angry
(23:08):
man that no one should listen to. He wrote things like, you,
hair professor, have been a partner in this massacre, and
should you hair halfrath, without having disproved my doctrine, continue
to train your pupils against it. I declare before God
and the world that you are a murderer, and the
history of child bed fever would not be unjust to
(23:30):
you if it memorialized you as a medical nero. In
eighteen fifty eight, after years of his supporters telling him
he should publish his work, he published The Ideology of
Child bed Fever. Another work, The Difference in Opinion between
Myself and the English Physicians regarding child bed Fever, followed
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in eighteen sixty and in eighteen sixty one he published
a book called The Ideology, the Concept and the Prophylaxis
of child bed Fever in places Is. This was a
clear and well written treatise on child bed fever, but
large portions were actually diatribes against his critics, some of
them rambling, repetitive, and almost nonsensical. Ignaz Semmelweis had been
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described as abrasive, dogmatic, and even rude for most of
his career, but by the time this book came out,
he was also starting to behave erratically. This got worse
in the early eighteen sixties, and on July eighteen sixty five,
he returned home from a family outing and was behaving
so bizarrely that his wife became convinced that something was
(24:35):
seriously wrong with him. And then, on July twenty one,
he went to a meeting at his job, where, among
other things, he was supposed to talk about candidates for
a vacant lecturers post, and, according to his former assistant,
instead he read a piece of paper containing the midwives
Oath of Practice. Clearly unaware that he was doing anything amiss,
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Similsize planned to go to a spa and take water
treatments there, and he departed with his wife and some
attendants on July twenty nine, but the next day, for
reasons that aren't entirely clear, he was instead committed to
a public institution, where he died on August thirteenth, eighteen
sixty five, at the age of forty seven. He was
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buried in Vienna two days later. There are some conflicting
reports about what happened at the institution. In some accounts,
he became so violent that he had to be restrained,
and during that encounter he was injured, but in others,
he was severely beaten by guards and then left without
any kind of medical treatment. Regardless of exactly what happened,
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an injury to his finger that he either had when
he got to the hospital or sustained in the incident
became infected. An autopsy that was performed at Vienna Algamini
crunkin House diagnosed quote paralysis of the brain as his
cause of death. Today, it seems likely to have been
sept to semia, but the autopsy also revealed that he
(26:01):
had severe injuries that do suggest that he had been beaten.
It's also not clear what caused his behavior to become
so erratic in the last years of his life. Theories
range from the continual stress of being such a pariah
in the medical community to early onset Alzheimer's to late
stage syphilis, which was an occupational hazard of being an
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obstetrician at a busy hospital at this point in history.
In the later years the civil Vices life, other doctors
were also working on ideas that were related to contagion
and the germ theory of disease. In eighteen fifty, two,
years after Simil Vice instituted handwashing at the Vienna General Hospital,
James Young Simpson of Scotland published a detailed description of
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how materials more by could be introduced into the body
during labor and delivery, and how the postpartum body was
primed for infection and because of the dilation and abrasion
sustained during birth. He even made the comparison between the
attendants fingers and the ivory points that were that had
been used to administer smallpox vaccinations by transferring material from
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a cowpox lesion to a person's skin. In the eighteen
fifties and sixties, Louis Pasteur was studying how micro organisms
caused beer and wine to spoil. In eighteen sixty seven,
Joseph Lister began publishing work on preventing infection during surgery,
which included hygiene and handwashing with carbolic Ten years prior
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to that, in eighteen fifty seven, Robert Coke made the
connection between the anthrax disease and the anthrax bacterium, and
later he helped articulate four criteria to prove that a
disease is caused by a specific micro organism, which are
called Coke's postulates today. These criteria are that the microorganism
is always associated with the disease, that it can be
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taken from a diseased animal and grown in a culture,
that the cultured organism can cause the disease in a
healthy animal, and that the same micro organism can be
collected from the newly diseased animal. So, based on the
work of Louis Pasteur, Joseph Lister, Robert Coke, and others,
infection control finally became a routine part of obstetrics in
(28:17):
the eighteen eighties. But these researchers don't appear to have
been influenced by semial Vices work at all. In a
lot of cases, they hadn't even heard of him until
long after they did their first groundbreaking work. He faded
into obscurity after his death until a Hungarian doctor published
a paper about him in eighteen eight seven. Today there
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are lots of hospitals and clinics named after Igno's Semilvis,
along with the semil Vice Medical Historical Museum in Budapest,
and at some point some unknown person coined the simil
vized reflex to describe a rejection of new information because
it contradicts established norms. Even though pure pearl fever is
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much less of an issue for a lot of the
world today than it was in nineteenth century Europe, hospital
acquired infections are still an issue even in the most
affluent parts of the world. Known as nascomal infections, they're
the most common complication in hospitalized people. They happen in
between five and ten percent of acute care patients, and
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handwashing is a huge part of preventing them. Yea for
hand washing, Yes, please wash your hands. This uh, This
story reminds me a little bit of fritz Wiki, where
somebody is really clearly onto something and their contemporaries you're
like nope, nope, nope, and it makes them frustrated and
it's a little bit mad having to fight against that
(29:43):
all the time. Yes, some of the some of the
things that I read about him that have been written
more recently almost have a victim blamey aspect to them.
They they're sort of like, if he hadn't been such
a jerk about it, people might have listened to him.
And I'm like, women were lit really dying, and he
was like, who cares how it works? Washing your hands
(30:04):
keeps the women from dying? Why won't you just do it?
And like, I'm like that understandably made him really angry. Well,
and it is kind of hard to understand how like
people were not getting the pattern recognition of everywhere he
went and instituted his practices, mortality went down, and so
(30:29):
clearly something was correct. Uh. So it seems weird that
they would continue to be like, Nope, nope, nope, no
my hands. I'm a gentleman. Uh. Do you have less
infuriating listener mail? I do? This is from Taylor. Uh.
It is about our one thousandth episode two parter on
(30:50):
Sadako Sasaki, and Taylor says, Hi, Tracy and Holly, I
just finished listening to your wonderful two parter on Sadako Sasaki.
This is a particular interests, interest and significance to me
because I've been living in Japan for a little over
a year now as an English teacher. Taylor goes on
to talk about living close enough to Hiroshima to be
(31:11):
able to get there pretty quickly buy bullet train and
going to the museum and the Atomic Bomb Dome. Uh.
The Memorial Museum is, as you can imagine, horrifying, but
by the end it is hopeful, featuring, as of last year,
a crane on display made by President Obama, as well
as a visitor book where you can leave thoughts and
messages about the need for peace for all and for
(31:32):
all countries to do away with nuclear warfare. There's a
good display in the museum on Sadako featuring a timeline
of her life and several of her cranes, including some
of those very tiny ones folded by pins. It was
surreal and very poigant to see them. And when you
exit the museum into the Peace Park there is the
statue of Sadako holding a crane, and then surrounding the
(31:53):
bell you mentioned are display cases full of cranes sent
usually by school children from all over the world to
honor Sida co of all colors and sizes, many just
strung together in bunches of a thousand, but sometimes arranged
into artwork pieces. I've attached some photos from my trips.
I'm sure they look the same as any photo you
could google, but their breathtaking. When you go to the
(32:15):
Memorial Museum, along with your ticket, you were giving a
postcard with paper made out of recycled cranes from these displays.
Most big shrines I've gotten to visit in Japan have
at least one area where strings of cranes are displayed
for good health and healing and good fortune, and of
course with SATCO in mind. Another quick note about the
terrain and weather in the specific region of Japan. It
(32:37):
is very hilly slash mountainous. It depends on how you
define a mountain. I've described this terrain to friends and
family as pretty visually similar to West Virginia. Presumably this
would have made it pretty difficult to flee the city
after the bombing as many dead, especially in August when
the heat and humidity are very oppressive. I've gone hiking
in the summer and the commidity gets up to a
(32:57):
hundred percent sometimes and it feels like you're trying to
breathe underwater. It's really unlike anything I've experienced in the USA.
The same goes weatherwise for Nagasaki, being much further southwest.
One lasted them to a very long email. On a
recent trip to Kyoto, I learned by a tour guide
that the reason this city's hundreds of temples, shrines and
(33:17):
historical sites, some very ancients survived World War two was
the fact that the United States recognized the historical and
cultural significance that these sites held and thus did not
fire bomb Kyo. Two. Haven't verified this information, but it's
but it's fascinating. Taylor goes on to offer up some thanks.
Um so thank you Taylor. So I wanted to read
this for a couple of reasons. One is that we
(33:39):
have gotten a lot of really great email after those
two part episodes. A lot of people who either live
in Hiroshima, or have visited Hiroshima, or have done crane
folding projects with their classes, so many of them have.
They have been so wonderful to read. And these pictures
that Taylor sent are beautiful. Thank you so much. And
I also did want to follow up on the point
(33:59):
made it out Kyoto, so um, it is interesting that
when they were choosing where to drop the atomic bomb,
Kyoto was actually at the top of the list for
a long time because of its cultural significance, like it
had not been touched by fire bombing until that point.
But the train of thought was, Oh, it would be
(34:21):
so culturally devastating to destroy such a historically important city
with all of these very important religious sites and historical buildings.
Maybe we should drop the bomb there. But the Secretary
of War, Henry Stempson, had visited Kyoto with his wife
earlier in his lifetime, and he kept insisting that it
(34:41):
was too beautiful to protect and they should not drop
the bomb on it. And the rest of the committee
that was making these decisions kept being like, but seriously, dude,
that will be the most devastating place. And so it
was not so much the United States recognized the cultural
value of Kyoto. It was that uh Henry Stumpson objected
(35:02):
to what his committee was telling him was the best
plan and eventually got them to choose a different place.
So if you'd like to write to us about this
or any other podcast where History podcast, that How Stuff
Works dot Com and then we're on all over social
media at missed in History, so you can find us
on Facebook and Pinterest and Instagram and Twitter. You can
(35:24):
come to our website, which is missing history dot com,
where you will find show notes for all the episodes
Holly and I have ever done together. There's a search
bar up at the top where you can look for
episodes that are interesting to you. There's also an archive
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(35:49):
this and thousands of other topics, is it how Stuff
Works dot com
Welcome to steph you missed in history class from how
Stuff Works dot Com. Hello, and welcome to the podcast.
I'm Tracy V. Wilson and I'm Holly fry So. Holly,
I think a lot of people take for granted the
idea that you need to wash your hands to prevent disease. Yes,
(00:26):
but also some people discount it well. And there's also
a lot of research that even though this is a
pretty ubiquitous and standard idea, a lot of people don't
actually wash their hands nearly as much as they should.
But regardless of all of that, it was not taken
for granted in nineteenth century Europe, including among doctors, that
you needed to wash your hands to prevent disease. And
(00:48):
today we are going to talk about Ignaz Semmel Vice,
who was one of the people who made this connection
between hand washing and disease prevention. The disease that he
was preventing was childbed fever, and even though it was
not taken seriously at the time, like people wrote him
off entirely, today he's known as everything from the father
of infection control and the savior of mothers and the
(01:12):
conqueror of child bed fever, which is a lot of
I mean, very lofty pronouncements, and he did do amazing work,
but it did not last past his lifetime. Uh. This episode. Also,
to be clear, it's about medicine in nineteenth century Europe
and to a lesser extent in North America. And we're
definitely aware that religions and cultures all over the world
(01:33):
have their own practices about everything from handwashing to delivering babies.
It is not about that at all. This is not
a global overview of hand hygiene and how it relates
to medicine. We're really looking at how the practice of
obstetrics and formal medical training collided in the eighteenth and
nineteenth centuries. And this is also a listener request we've
gotten from several people, including Margaret Tom and Ashley Child.
(01:58):
Bed fever, also known as pew a pearl fever, is
a postpartum infection of the uterus or the vaginal canal,
and it's often caused by a streptococcal infection, but it
can come from other pathogens as well. Today, these infections
are largely preventable through hygiene and infection control procedures during
labor and delivery, and when they do happen, they're usually
(02:19):
treatable with antibiotics, so in places where competent care, clean water,
and antibiotics are readily available, pure pearl fever isn't very common.
This was not the case before the germ theory of
disease or the discovery of antibiotics. Until the late nineteenth century,
childbed fever was one of the most common complications of childbirth.
(02:40):
Within about three days of giving birth, patients developed abdominal pain, fevers, abscesses,
and other signs of infection, and this would often progress
to blood poisoning and death. Sometimes incidents of child bed
fever were sporadic, and between twenty and thirty of those
sporadic infections were fatal. But when an epidemic of child
(03:01):
bed fever swept through a community or a hospital, it
tended to be a lot deadlier, with seventy two with
a seventy to eighty percent mortality rate, and a lot
of prominent women died of child bed fever throughout history,
including Mary Wolston Craft, Henry the Eighth Wife, Jane Seymour,
and possibly recent podcast subject Phyllis Wheatley. Obviously, a lot
(03:24):
of ordinary women did to you that aren't in the
history books. It was something both expecting parents and their
doctors and midwives dreaded and feared. Child bed fever was
described in medical literature all the way back to Hippocrates
in the fourth century BC, and in the years before
evidence based medicine. People blamed it on a range of
(03:44):
causes based on whatever medical theories were in use at
the time, so everything from a balance an imbalance in
the four Humors to myasthmas or bad air. By the
eighteenth century, doctors were devoting a lot of writing to
arguing about whether it was an inflammatory or a putrefying disease.
(04:04):
In the eighteenth and nineteen centuries, a few things happened
in tandem that led to a big increase in child
bed fever epidemics. One was that more babies were being
delivered in hospitals rather than at home. In some cases,
these hospitals were part of social programs. The idea was
to provide free care before and after delivery to try
(04:25):
to stop infanticide among families that were living in poverty.
Some of these hospitals employed midwives and others of them
employed doctors, and this was also a change. Before this
point doctors and surgeons, who were almost exclusively male had
really only been involved in delivering babies when there were
really serious complications. It was so unusual for a man
(04:47):
to be involved in delivery that in some places these
doctors were called man midwives, So the idea that a
doctor would be involved in the routine delivery of a
baby was fairly new in the seventeen hundreds. Also fairly
knew was the widespread use of autopsies as part of
medical education. Although autopsies existed well before this point, it
(05:09):
was only in the mid seventeen hundreds that the field
of medicine really started using them to try to improve
on medical knowledge and teach medical students. In the late
eighteenth and early nineteenth centuries, doctors started using autopsies of
childbed fever victims, specifically to try to learn more about
the disease. All of this together meant that at about
(05:30):
the same time, more people were giving birth in hospitals
assisted by doctors, and more doctors and medical students were
handling and dissecting cadavers as part of medical study, including
the bodies of people who had died of childbed fever.
Because illnesses were blamed on things like myasthmas and imbalanced
humors rather than on pathogens. These post mortem examinations were
(05:54):
being conducted with bare hands, and those bare hands were
not usually washed before working with living patients. Surgical gloves
weren't even invented yet. That wouldn't happen until the late
eighteen hundreds, and when those gloves were invented, they were
really about protecting the hands from chemicals, not protecting the
patients from the spread of disease or the doctors from
(06:17):
contracting diseases from the patients. The result of all of
this was a dramatic increase in epidemics of child bed fever,
particularly in hospitals. One swept through the Paris Hotel Dieu
in seventeen in seventeen forty six, another struck the British
lying In hospital in seventeen sixty. These were frequent and
(06:39):
widespread enough that hospitals weren't usually thought of as safe
places to give birth. There were definitely doctors who spotted
the connection between autopsies and child bed fever, or who
suspected that the disease could be spread from patient to
patient by the doctors who were treating them. These doctors
published treatises and journal articles about what they thought was
(07:00):
causing childbed fever and how to stop it. In sv
Alexander Gordon of Aberdeen, Scotland wrote his treatise on the
Epidemic of Pure Pearl Fever, and in it he theorized
that doctors who had treated a patient with childbed fever
could pass it on to other patients. He recommended burning
the patient's bedclothes, along with thorough handwashing and fumigating all
(07:24):
of the clothing of the doctors and nurses who were
involved in the infected patient's care. In eighteen twenty nine,
when an epidemic of childbed fever struck the rotun To
Hospital in Dublin, Ireland, hospital chief Robert Collins tried to
stop it with a forty eight hour chlorine fumigation. He
also ordered that all the floors and walls be scrubbed
(07:45):
down with chlorinated lime and all the linen's be heat treated.
The number of childbed fever cases at the hospital dropped
almost to zero after he did all this. In eighteen
forty three, Oliver Wendell Holmes Sr. Delivered a paper are
called the Contagiousness of Pure pearl fever to the Boston
Society of Medical Improvement. In it, he said, quote, the
(08:07):
disease known as pure pearl fever is so far contagious
as to be frequently carried from patient to patient by
physicians and nurses. He then went on to describe a
number of steps to try to prevent the spread of
the disease. These included that obstetricians should never conduct autopsies
on patients who died of childbed fever, and if for
(08:28):
some reason an obstetrician had to, he should very thoroughly
clean himself, change all of his clothes, and abstain from
patient treatment for at least twenty four hours. Holmes went
on to recommend that if a doctor treated a patient
who then contracted childbed fever, he should consider all of
the patients that he went on to treat to also
(08:48):
be at risk until significant time had passed without anybody
else being infected, and if two of his patients developed
childbed fever in close proximity to one another, he should
remove himself from metical practice and bring in a substitute
for at least a month. Holmes's paper made recommendations that
would have been both useful and effective for preventing the
(09:09):
spread of child bed fever, but it didn't get a
lot of attention until it was reprinted as a pamphlet
and more widely distributed, and then the response among the
medical community was total dismissal and outright mockery. Charles D. Meigs,
an obstitution from Philadelphia, described holmes as theories and recommendations
as quote je June and fizzinless Dreamings, and claimed that
(09:33):
any doctor who saw an increase in child bed fever
was just unlucky. When Egna's Semilvis came to the same
conclusion that Oliver Wendell Holmes Senior had, the response from
the rest of the medical community was very much the same,
and we'll talk about it after a sponsor break. Aca
(09:56):
Semilviss was born on July one, eighteen and Taban area
of Buddha, Hungary. Buddha would combine with Pest in eighteen
seventy three, so that was a little bit later to
become Budapest. At the time, Hungary was part of the
Austrian Empire, and he was the fifth of ten children
born to Grosser Joseph Semmelweiss and Terresia Mueller. There's a
(10:19):
bit of disagreement about the family's heritage. Some accounts claim
that they were Jewish and that anti Semitism was a
factor in later parts of Semilvis's story, but Sherwin B. Newland,
author of The Doctor's Plague, Germs, child bed Fever, and
The Strange Story of Ignaz Semilwis, writes that parish registers
document that the semil Weiss family was Roman Catholic going
(10:41):
back to the sixteen seventies. The counter argument is that
semil Weiss and his ancestors may have been baptized for
the sake of assimilation while the family was still culturally Jewish,
but this is largely conjecture and it seems mostly just
to be based on their surname. In eighteen thirties seven,
at the age of nineteen, semul Weiss went to the
(11:02):
University of Vienna to study law. A year later, he
changed his course of study to medicine, and he graduated
with his m d. In eighteen forty four. He looked
for a position practicing internal medicine, but he couldn't find one,
so he changed his focus once again and looked for
a position in obstetrics. On July one, eighteen forty six,
(11:23):
he was granted a two year appointment as an assistant
to Professor Johann Klein, who was the director of the
Vienna Algamini Conkin House or the General Hospital. Vienna General
Hospital was a teaching hospital, so in this role, Semilviis
was both a doctor and a teacher. He supervised and
educated medical students, and he assisted with difficult deliveries. He
(11:46):
was also the clerk of records, which put him in
a good position to spot patterns among the patients and
their outcomes. The maternity clinic at the Vienna General Hospital
was one of the ones that had been established to
provide free medical care to impoverished patients, so patients essentially
got free care and exchanged for helping with the medical
students educations. Originally, the hospital had one maternity clinic, which
(12:11):
was staffed by midwives, doctors and their students, and after
a while that one clinic became so overcrowded that the
hospital opened a second one, which was still staffed by
a mix of doctors, midwives and their students. But around
eighteen forty the two clinics were separated into the first
and second clinic. The first clinic was staffed by doctors
(12:32):
and medical students, and the second clinic was staffed by
midwives and midwiffery students. The two clinics alternated admission days,
so if the first clinic accepted patients on Monday, the
second clinic would accept patients on Tuesday, and so on.
When the maternity clinic first opened in seventeen eighty four,
the hospital director Lucas Bore, had not included post mortem
(12:56):
work as part of the obstetric students course of study
because he thought it carried a risk of contagion. But
in eighteen twenty three Johann Klein took over as director
and started using autopsies as a teaching tool for the
obstetric students. By the time Semmelweis joined the hospital staff,
the rates of child bed fever at Vienna General Hospital
(13:16):
very dramatically between the two clinics. At the midwives clinic,
between one and two percent of patients died of child
bed fever, and at the doctor's clinic the rate varied
from five tot with an average of about ten percent.
This difference between the two clinics was so huge and
so well known that laboring patients who were told that
(13:39):
they were being admitted to the doctor's clinic would beg
to be sent to the midwives clinic instead. Some even
gave birth in the street outside the clinic after hearing
that it was the doctor's day for admission, and then
they would say they had been on the way to
the hospital and the baby just came before they could
get there. That way, they would still have access to
(13:59):
the free care at the clinic, but without the risk
of death that was associated with it. That's gotta be
a terrifying choice when you're like, no, I'm I'm just
gonna do this in the street and then I'll let
them take care of me after that. Well, and I
imagine a thing I didn't find. Um, I didn't find
sources that said this, but considering that my own mother
did this when I was born, I imagine the people
(14:20):
that were like, I'm in labor, but I'm not far
into labor and it's the doctor's day. I'm gonna wait
a few hours so I can go to the midwives clinic.
I imagine that was a thing to my My parents
did that because if they waited till after midnight, they
wouldn't be billed for the extra day, did not have
a ton of money. Some of us noticed that even
(14:40):
these births out in the street were safer than giving
birth in the doctor's clinic at the hospital. He wrote,
quote to me, it appeared logical that patients who experienced
street births would become ill at least as frequently as
those who delivered in the clinic. What protected those who
delivered outside the clinic from these destructive, unknown endemic influences.
(15:03):
He became completely fixated on this question. It was appalling
and deeply offensive to him that there was such a
huge difference between the doctors and the midwives clinics. So
he started trying to figure out what was different between
the two clinics, and then making adjustments to what the
doctors were doing. At the midwives clinic, patients lay on
(15:23):
their sides to deliver, but at the doctor's clinic they
lay on their backs. Civilized changed the procedure at the
doctor's clinic to use sideline, but that didn't make a difference.
He also noticed that anytime a patient was dying in
the doctor's clinic, the priest who was arriving to get
to give last rites basically had to walk through the
(15:44):
whole ward, and he rang a bell while he was
doing this. Some of vis thought maybe this bell and
what it signified was so terrifying that it was making
people sick, so he got the priest to stop it
with the bell. That did not fix the problem. He
looked at how crowded the two clinics were, and it
turned out that the midwives clinic was understandably far more crowded.
(16:07):
He looked at the religious practices of the people working
in each clinic. He looked at the patient's diets, and
none of these things seemed to make a difference. Then
his friend and colleague, Jacob Collecca died of what appeared
to be childbed fever after accidentally being nicked with a
scalpel while performing an autopsy on someone who had died
(16:28):
of it, and Collectica's own autopsy results were very similar
to those of childbed fever victims. That's when Semmelweis realized
that midwiffery students weren't performing autopsies as part of their training,
only the medical students were. Another difference was that the
medical students were performing vaginal examinations on their patients. As
(16:50):
a routine part of their care, while midwiffery students only
did so when there seemed to be a need for one.
Semilvis's conclusion was that some kind of cadet ever a
particles were being transmitted from the autopsies to the patients
in the doctor's clinic. In mid May of eighteen forty seven,
Samuel Weis started instructing doctors and medical students to wash
(17:12):
their hands after conducting autopsies. They were to use chlorinated
lime until their hands had no trace of the putrid
smell that was left behind by a decaying body. He
chose chlorinated lime because it seemed to do the best
job of getting rid of the odor. But chlorinated lime
is calcium hypochlorite, which today is sold as powdered chlorine bleach.
(17:35):
Chlorine bleach is, of course a disinfectant. With Samulwis's hand
washing protocol in place, the rate of child bed fever
mortality in the doctor's clinics started to drop. It had
been eighteen point three percent in April, and by June
it had dropped to two point two percent. In August
of eighteen forty seven, for the first time since the
(17:57):
medical students started performing autopsies. No one died of childbed
fever in the doctor's clinic. Some of us couldn't exactly
explain why this had worked. At one point, another outbreak
of childbed fever spread through the clinic, even though there
had been no autopsy to trigger it. So some of
us began to suggest that some patients might make their
(18:18):
own so called cadaverous particles and their own bodies, rather
than the autopsies being their only source. Later on, he
revised his hypothesis a third time, saying that the cadaverous
particles could come from any decaying animal flesh, not just
from a human body. The fact that he couldn't adequately
explain why his protocol worked became one of the arguments
(18:42):
against his findings. While some of his medical students agreed
with and supported his work, most of the established doctors
at the hospital dismissed him completely. Director Johann Klein insisted
that it was the clinic's new ventilation system which was
getting rid of dangerous miasmas and that should get the credit.
Other doctors also vehemently disagreed with the idea that their
(19:05):
own hands could have been what was spreading such a devastating, painful,
and emotionally wrenching disease. It was unfathomable to them that
a doctor could have dirty hands in the first place.
In their minds, doctors were gentleman, and a gentleman's hands
were always clean, and his word of semal vices protocol
(19:26):
spread beyond a hospital. Doctors were also resistant to the
idea of washing their hands because they didn't necessarily have
access to clean water where they worked, and also because
it was time consuming. I like this weird chicken in
the egg thing, where like a gentleman's hands aren't clean
because he takes such fastidious care of himself, but just
(19:46):
because he's a gentle yes. Uh. Later on several vice
would describe it this way quote. Most medical lecture halls
continued to resound with lectures on epidemic child d fever
and with discourse against my theories. The medical literature for
the last twelve years continues to swell with reports of
(20:08):
pure Borough epidemics, and in eighteen fifty four, in Vienna,
the birthplace of my theory, four hundred maternity patients died
from child bed fever. In published medical works, my teachings
are either ignored or attacked. The medical faculty at Wurtzberg
awarded a prize to a monograph written in eighteen fifty
nine in which my teachings were rejected, So he wrote
(20:32):
that a little bit later, and to return to this
current part of the story, Similwis did not back down
in the face of all this opposition. In eighteen forty eight,
he started requiring that medical students clean all the instruments
that were used during labor and delivery with chlorinated lime
as well. The clinic had already had a month where
there had been no deaths, and at this point the
(20:54):
ongoing mortality rate from child bed fever at the hospital
dropped almost to he row. As doctors continued to dismiss
his findings, Similweis became increasingly hostile and combative, and simultaneously
uprisings were sweeping through the area as people protested against
the Habsburg dynasty in the Austrian Empire. Students held a
(21:18):
demonstration in Vienna on March thirteenth, eighteen forty eight, and
the Hungarian Revolution of eighteen forty eight began two days later.
Although there's no evidence that Semilvii's was part of these demonstrations,
many of his student supporters were which probably inflamed tensions
between him and the rest of the faculty. As I
said earlier, that position he had at the maternity clinic
(21:41):
and at the hospital had been a two year appointment,
and in eighteen forty nine the hospital elected not to
renew it. He was instead offered a position that had
no contact with cadavers. In eighteen fifty he left Vienna
to return home without announcing his departure or saying goodbye
to anyone. He knew. We're going to talk talk about
Salvis's life back in Hungary after we first pause for
(22:03):
another sponsor break. In eighteen fifty one, Ignaz semial Weiss
was named head of obstetrics at St. Rocas Hospital. Although
this was really an honorary and unpaid position, He did
hold it for the next few years, though, during which
(22:24):
time the rate of childbed fever at the hospital dropped significantly.
In the mid eighteen fifties, Silvis left St. Roucas and
became a professor at Pest University. In eighteen fifty seven,
he married Maria Widenhoffer, and they went on to have
five children together. During these years, some of Wess continued
to advocate for handwashing after autopsies, and he also wrote
(22:48):
a series of extremely hostile open letters to the doctors
who dismissed his ideas, calling them murderers who were responsible
for the deaths of women through their negligence. This seems
to me like a very fair assessment. But but people
began to increasingly think he is just uh an angry
(23:08):
man that no one should listen to. He wrote things like, you,
hair professor, have been a partner in this massacre, and
should you hair halfrath, without having disproved my doctrine, continue
to train your pupils against it. I declare before God
and the world that you are a murderer, and the
history of child bed fever would not be unjust to
(23:30):
you if it memorialized you as a medical nero. In
eighteen fifty eight, after years of his supporters telling him
he should publish his work, he published The Ideology of
Child bed Fever. Another work, The Difference in Opinion between
Myself and the English Physicians regarding child bed Fever, followed
(23:50):
in eighteen sixty and in eighteen sixty one he published
a book called The Ideology, the Concept and the Prophylaxis
of child bed Fever in places Is. This was a
clear and well written treatise on child bed fever, but
large portions were actually diatribes against his critics, some of
them rambling, repetitive, and almost nonsensical. Ignaz Semmelweis had been
(24:13):
described as abrasive, dogmatic, and even rude for most of
his career, but by the time this book came out,
he was also starting to behave erratically. This got worse
in the early eighteen sixties, and on July eighteen sixty five,
he returned home from a family outing and was behaving
so bizarrely that his wife became convinced that something was
(24:35):
seriously wrong with him. And then, on July twenty one,
he went to a meeting at his job, where, among
other things, he was supposed to talk about candidates for
a vacant lecturers post, and, according to his former assistant,
instead he read a piece of paper containing the midwives
Oath of Practice. Clearly unaware that he was doing anything amiss,
(24:58):
Similsize planned to go to a spa and take water
treatments there, and he departed with his wife and some
attendants on July twenty nine, but the next day, for
reasons that aren't entirely clear, he was instead committed to
a public institution, where he died on August thirteenth, eighteen
sixty five, at the age of forty seven. He was
(25:19):
buried in Vienna two days later. There are some conflicting
reports about what happened at the institution. In some accounts,
he became so violent that he had to be restrained,
and during that encounter he was injured, but in others,
he was severely beaten by guards and then left without
any kind of medical treatment. Regardless of exactly what happened,
(25:40):
an injury to his finger that he either had when
he got to the hospital or sustained in the incident
became infected. An autopsy that was performed at Vienna Algamini
crunkin House diagnosed quote paralysis of the brain as his
cause of death. Today, it seems likely to have been
sept to semia, but the autopsy also revealed that he
(26:01):
had severe injuries that do suggest that he had been beaten.
It's also not clear what caused his behavior to become
so erratic in the last years of his life. Theories
range from the continual stress of being such a pariah
in the medical community to early onset Alzheimer's to late
stage syphilis, which was an occupational hazard of being an
(26:23):
obstetrician at a busy hospital at this point in history.
In the later years the civil Vices life, other doctors
were also working on ideas that were related to contagion
and the germ theory of disease. In eighteen fifty, two,
years after Simil Vice instituted handwashing at the Vienna General Hospital,
James Young Simpson of Scotland published a detailed description of
(26:47):
how materials more by could be introduced into the body
during labor and delivery, and how the postpartum body was
primed for infection and because of the dilation and abrasion
sustained during birth. He even made the comparison between the
attendants fingers and the ivory points that were that had
been used to administer smallpox vaccinations by transferring material from
(27:11):
a cowpox lesion to a person's skin. In the eighteen
fifties and sixties, Louis Pasteur was studying how micro organisms
caused beer and wine to spoil. In eighteen sixty seven,
Joseph Lister began publishing work on preventing infection during surgery,
which included hygiene and handwashing with carbolic Ten years prior
(27:34):
to that, in eighteen fifty seven, Robert Coke made the
connection between the anthrax disease and the anthrax bacterium, and
later he helped articulate four criteria to prove that a
disease is caused by a specific micro organism, which are
called Coke's postulates today. These criteria are that the microorganism
is always associated with the disease, that it can be
(27:56):
taken from a diseased animal and grown in a culture,
that the cultured organism can cause the disease in a
healthy animal, and that the same micro organism can be
collected from the newly diseased animal. So, based on the
work of Louis Pasteur, Joseph Lister, Robert Coke, and others,
infection control finally became a routine part of obstetrics in
(28:17):
the eighteen eighties. But these researchers don't appear to have
been influenced by semial Vices work at all. In a
lot of cases, they hadn't even heard of him until
long after they did their first groundbreaking work. He faded
into obscurity after his death until a Hungarian doctor published
a paper about him in eighteen eight seven. Today there
(28:39):
are lots of hospitals and clinics named after Igno's Semilvis,
along with the semil Vice Medical Historical Museum in Budapest,
and at some point some unknown person coined the simil
vized reflex to describe a rejection of new information because
it contradicts established norms. Even though pure pearl fever is
(28:59):
much less of an issue for a lot of the
world today than it was in nineteenth century Europe, hospital
acquired infections are still an issue even in the most
affluent parts of the world. Known as nascomal infections, they're
the most common complication in hospitalized people. They happen in
between five and ten percent of acute care patients, and
(29:21):
handwashing is a huge part of preventing them. Yea for
hand washing, Yes, please wash your hands. This uh, This
story reminds me a little bit of fritz Wiki, where
somebody is really clearly onto something and their contemporaries you're
like nope, nope, nope, and it makes them frustrated and
it's a little bit mad having to fight against that
(29:43):
all the time. Yes, some of the some of the
things that I read about him that have been written
more recently almost have a victim blamey aspect to them.
They they're sort of like, if he hadn't been such
a jerk about it, people might have listened to him.
And I'm like, women were lit really dying, and he
was like, who cares how it works? Washing your hands
(30:04):
keeps the women from dying? Why won't you just do it?
And like, I'm like that understandably made him really angry. Well,
and it is kind of hard to understand how like
people were not getting the pattern recognition of everywhere he
went and instituted his practices, mortality went down, and so
(30:29):
clearly something was correct. Uh. So it seems weird that
they would continue to be like, Nope, nope, nope, no
my hands. I'm a gentleman. Uh. Do you have less
infuriating listener mail? I do? This is from Taylor. Uh.
It is about our one thousandth episode two parter on
(30:50):
Sadako Sasaki, and Taylor says, Hi, Tracy and Holly, I
just finished listening to your wonderful two parter on Sadako Sasaki.
This is a particular interests, interest and significance to me
because I've been living in Japan for a little over
a year now as an English teacher. Taylor goes on
to talk about living close enough to Hiroshima to be
(31:11):
able to get there pretty quickly buy bullet train and
going to the museum and the Atomic Bomb Dome. Uh.
The Memorial Museum is, as you can imagine, horrifying, but
by the end it is hopeful, featuring, as of last year,
a crane on display made by President Obama, as well
as a visitor book where you can leave thoughts and
messages about the need for peace for all and for
(31:32):
all countries to do away with nuclear warfare. There's a
good display in the museum on Sadako featuring a timeline
of her life and several of her cranes, including some
of those very tiny ones folded by pins. It was
surreal and very poigant to see them. And when you
exit the museum into the Peace Park there is the
statue of Sadako holding a crane, and then surrounding the
(31:53):
bell you mentioned are display cases full of cranes sent
usually by school children from all over the world to
honor Sida co of all colors and sizes, many just
strung together in bunches of a thousand, but sometimes arranged
into artwork pieces. I've attached some photos from my trips.
I'm sure they look the same as any photo you
could google, but their breathtaking. When you go to the
(32:15):
Memorial Museum, along with your ticket, you were giving a
postcard with paper made out of recycled cranes from these displays.
Most big shrines I've gotten to visit in Japan have
at least one area where strings of cranes are displayed
for good health and healing and good fortune, and of
course with SATCO in mind. Another quick note about the
terrain and weather in the specific region of Japan. It
(32:37):
is very hilly slash mountainous. It depends on how you
define a mountain. I've described this terrain to friends and
family as pretty visually similar to West Virginia. Presumably this
would have made it pretty difficult to flee the city
after the bombing as many dead, especially in August when
the heat and humidity are very oppressive. I've gone hiking
in the summer and the commidity gets up to a
(32:57):
hundred percent sometimes and it feels like you're trying to
breathe underwater. It's really unlike anything I've experienced in the USA.
The same goes weatherwise for Nagasaki, being much further southwest.
One lasted them to a very long email. On a
recent trip to Kyoto, I learned by a tour guide
that the reason this city's hundreds of temples, shrines and
(33:17):
historical sites, some very ancients survived World War two was
the fact that the United States recognized the historical and
cultural significance that these sites held and thus did not
fire bomb Kyo. Two. Haven't verified this information, but it's
but it's fascinating. Taylor goes on to offer up some thanks.
Um so thank you Taylor. So I wanted to read
this for a couple of reasons. One is that we
(33:39):
have gotten a lot of really great email after those
two part episodes. A lot of people who either live
in Hiroshima, or have visited Hiroshima, or have done crane
folding projects with their classes, so many of them have.
They have been so wonderful to read. And these pictures
that Taylor sent are beautiful. Thank you so much. And
I also did want to follow up on the point
(33:59):
made it out Kyoto, so um, it is interesting that
when they were choosing where to drop the atomic bomb,
Kyoto was actually at the top of the list for
a long time because of its cultural significance, like it
had not been touched by fire bombing until that point.
But the train of thought was, Oh, it would be
(34:21):
so culturally devastating to destroy such a historically important city
with all of these very important religious sites and historical buildings.
Maybe we should drop the bomb there. But the Secretary
of War, Henry Stempson, had visited Kyoto with his wife
earlier in his lifetime, and he kept insisting that it
(34:41):
was too beautiful to protect and they should not drop
the bomb on it. And the rest of the committee
that was making these decisions kept being like, but seriously, dude,
that will be the most devastating place. And so it
was not so much the United States recognized the cultural
value of Kyoto. It was that uh Henry Stumpson objected
(35:02):
to what his committee was telling him was the best
plan and eventually got them to choose a different place.
So if you'd like to write to us about this
or any other podcast where History podcast, that How Stuff
Works dot Com and then we're on all over social
media at missed in History, so you can find us
on Facebook and Pinterest and Instagram and Twitter. You can
(35:24):
come to our website, which is missing history dot com,
where you will find show notes for all the episodes
Holly and I have ever done together. There's a search
bar up at the top where you can look for
episodes that are interesting to you. There's also an archive
of every episode we have ever done, and you can
subscribe to our show on Apple Podcasts, Google Play and
wherever else do you find a podcasts. For more on
(35:49):
this and thousands of other topics, is it how Stuff
Works dot com
Stuff You Missed in History Class News
Hosts And Creators
Tracy V. Wilson
Holly Frey
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