Semmelweis, 1848 – 1863: He studied puerperal sepsis in Vienna over the protestations of his chief; he noted that the sepsis rate was three times higher in Division 1 than in Division 2; Divisions identical except medical students taught in Division 1, Midwives in Division 2.
Death of a friend following infection of an autopsy-related wound led to his primary hypothesis that the infection was transported from the autopsy room to uninfected patients by the students.
Semmelweis - Experimental Design:
Students to wash hands in chlorinated lime solution.
Mortality rate dropped from 18.3% to 1.3% per year; in some months in 1848 the mortality rate was 0%.
His chief did not believe his data; one year later he was fired.
He returned to Budapest, Hungary where he was placed in charge of an obstetrical unit plagued with an epidemic of puerperal sepsis. He repeated his earlier experiment and again the mortality rate declined precipitously (mortality remained less than 1% during his six-year tenure vs. 10 to 15% in Vienna and Prague).His major paper, “The etiology, understanding, and prevention of puerperal sepsis” was rejected by the Vienna Medical Journal and he ultimately had to pay to get his work published.
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