The Man Who Suffered a Brain Injury – And Helped to Change Medicine

His body rests at Cypress Lawn Cemetery near San Francisco where he died in 1860. His head sits at the Warren Anatomical Museum in Boston. Here, Terry Hamburg tells us about a man who suffered a brain injury and the changes it caused – Phineas Gage.

Phineas Gage in the time after his accident.

Phineas Gage is perhaps the most famous neurological patient in modern history, called one of the “great medical curiosities of all time” and a “living part of medical folklore.” Malcolm MacMillan of the University of Melbourne records that two-thirds of introductory psychology textbooks cover Gage and his significance: "He was the first case where you could say fairly definitely that injury to the brain produced some kind of change in personality.” At the time, study of the brain is very rudimentary. Phrenologists, who accessed personalities by calculating protrusions on the skull, are still respected. The famous case of Phineas Gage will become a critical step in modern brain science.

September 1848

The young, robust, gregarious lad is employed as munitions foreman for the Rutland & Burlingame Railroad in Vermont. It is the most dangerous job in the crew. A standard blasting procedure involves boring a hole deep into rock, stuffing it with explosive powder and fuse, then using a tamping iron to pack in sand or clay to contain and direct the blast. Proud of his profession, Gage commissions an especially large custom-made tamping rod: three feet seven inches long, 1.4″ in diameter, and weighing over thirteen pounds.

The most dreaded mishap in munitions is a premature explosion.The tamping rod rockets into the left side of Gage’s face in an upward direction just past the lower jaw angle. Traversing the upper jaw and fracturing the cheekbone, it passes behind the left eye, through the left side of the brain, and flies out the top of his skull.

Gage is catapulted, lands hard on his back, convulses for a time, but is able to speak after a few minutes. He walks with little assistance and sits upright in an oxcart for a bumpy one mile ride to his town lodgings. True to the pioneer macho man legend, Gage shrugs off the injury, announcing he is not “much hurt” and expects to be back at work in a few days. His recovery from this horrific event is one of top medical stories of the era. Doctors worldwide exchange ideas and theories on the details and implications of the accident. For the next generation, it becomes the standard against which other injuries to the brain are judged. Some refuse to believe that anyone could survive such an ordeal – it must be a fabrication or a trick.

Despite his own optimism, Gage’s convalescence is long, difficult, and uneven, which requires further attendance by his physician, John M. Harlow, who garners fame as the doctor who treats the man who should not be. By April 1849, the patient is proclaimed to be in good physical health. Gage has, however, lost vision in his left eye and sustains a large forehead scar and a deep depression on top of his head “beneath which the pulsations of the brain can be perceived,” Dr. Harlow noted. “He has no pain in his head but says it has a queer feeling which he is not able to describe.”

After recovery

For a brief time after recovery, Gage exploits his newfound fame as a one-man traveling exhibit at New England venues, including an event organized by P.T. Barnum, where he is the object of both morbid curiosity and praise. This sort of exposure is soon overexposed, and the still robust Gage continues to work at various jobs as a farmer, stable and coach service owner, and a long-distance stagecoach driver, but he suffers from occasional seizures and then epilepsy, dying in 1860 twelve years after his injury. There are many reports that he underwent dramatic and negative personality changes – becoming a dishonest, ill-tempered, brawling lout. Gage’s steady work history and other contemporary assessments suggest such claims are exaggerated.

Phrenologists contended that destruction of the mental “organs” of Veneration and Benevolence caused Gage’s behavioral changes. Harlow may have believed that the organ of Comparison was damaged as well.

Dr. Harlow requests and receives the patient’s skull. He is bequeathed the most famous tamping rod in history, which Gage carried wherever he went, inscribed: This is the bar that was shot through the head of Mr Phineas P. Gage at Cavendish, Vermont, Sept 14, 1848. He fully recovered from the injury & deposited this bar in the Museum of the Medical College of Harvard University.

These artifacts, along with a plaster cast of Phineas Gage’s head created during an 1850 examination, are the most sought-out items at the Warren Anatomical Museum on the Harvard Medical School campus.

Terry Hamburg is director emeritus of the Cypress Lawn Cemetery Heritage Foundation. His recently published book Land of the Dead: How The West Changed Death In America explores how the demands of survival and adaptation in the Gold Rush western migration changed a multitude of American customs, including the way we bury and grieve for our ancestors. California and San Francisco serve as case studies. Visit his author page: https://www.terryhamburgbooks.com.

Quack Doctors Throughout History

Throughout history, the idea of using fake cures to prevent and treat disease has thrived on the fears, vulnerabilities and a lack of scientific knowledge of the public.  A quack doctor was historically a figure intending on deceiving their customers and patients, for profit, with no skill, knowledge or equipment of the medical world, but claimed their wares could cure and treat illnesses. The reasons why these fake and unreliable treatments thrived are not as clear-cut as it appears. For example, some individuals today may seek out these quacks after desperation from not gaining support from medical professionals, their religious beliefs or superstitions and curiosity for less clinical treatments for their conditions.

Amy Chandler explains.

The Quack Doctor, a 17th century painting by Jan Victors.

The Coronavirus (COVID-19) pandemic is no exception to the rise of quack cures, treatments and ways to prevent catching the virus. Despite our society's advancement in medicine, science and technology, the same human fear and vulnerabilities prevail, such as a desire to take control of the situation. Many quack theories emerged during the pandemic suggesting drinking hot water and lemon or smoking as effective prevention. This article explores the rise of quack doctors throughout British history, with a particular focus on eighteenth-century medicine, and its impact on public health.

The rise of fake doctors and medicines

During the eighteenth century, the prospects of surviving over the age of forty for many poor and working class individuals were low. Treatments and surgery were dangerous and painful, especially with no antiseptics and anaesthetics. The rise of the industrial revolution in Great Britain, 1750 to 1850, caused a large number of people to travel to major cities like London to find better employment and improve social status. However, the reality was depressing, poverty-stricken and disease-ridden. Diseases including cholera, typhus and smallpox made death a regular occurrence. Many women did not survive childbirth due to infection and unsanitary hospitals, and if the child did survive birth, it was estimated that one in five infants died before their second birthday.(1) The streets in London were filled with rubbish, rotting food, rats and fleas, contaminated drinking water and poor living conditions that contributed to high mortality rates. Medical knowledge during this time focused on Hippocrates’ theory of the Four Humours and was later expanded by Galen. This theory suggested that the human body had four elements connected to the seasons. The elements were blood, yellow bile, black bile and phlegm. A healthy lifestyle and body meant these elements were in balance, and unbalanced humours caused illness because the body had too much of one humour. Treatments for unbalanced humours included bloodletting. Furthermore, the access to medical treatments provided by doctors was expensive for the working classes, meaning many poorer individuals resorted to consulting barber-surgeons for treatments, such as pulling teeth, amputation and blood-letting through leeches. Due to these dangerous and unsuccessful treatments, many poorer members of society would seek other forms of treatment. The rise of self-treatment and traditional remedies from apothecaries created an opportunity for quack doctors to provide miracle, cure-all medicines.

The reaction throughout Europe towards quack doctors, 'quackery' as many referred to the practice, was mixed and resentful amongst professional medical doctors, who valued science rather than superstition. Many members of the general public were quick to be drawn into the allure of quack cures and lacked the knowledge to condemn them as fake. The Buckingham Express, 1892, reported riots in Russia by peasants who attacked Russian doctors who were medically trained and favoured the quack doctors instead. This report suggested the reaction of the peasants to show “clear widespread superstition in the country” that felt more comfortable with spiritualism rather than science.  An example of a popular cure for fever was called “frogs and fright” and it was said that it was unknown if this method killed more than cure, but “it has its advantages, as it must do one or the other”.(2) This is an example of medicines and treatments not having scientific evidence but still having an impact by coincidence or a psychosomatic effect.

Furthermore, an account by Mr G A Brine, reported in the Charity Organisation Reporter, 1875, described his employment as an assistant to a quack doctor. Brine met the unnamed ‘doctor’ when sharing the same accommodation and asked if he was willing to "easily earn a couple of shillings".(3) Brine, being a “pauper in Sherborne workhouse”, accepted this offer gratefully, without much thought of what the work entailed. The next day Brine and the elusive ‘doctor’ visited the marketplace in the afternoon while the doctor was selling “virtues of his infallible medicines”, Brine played an important role in this performance to help sell the medicines. Brine was given money by the vendor to pretend to purchase “half-a-dozen boxes of the pills” and announced that he and others had “derived immense benefits from their use” and claimed he could never be without this medicine.

This account of what it was like to work with a fake doctor highlights that it's not just the customers who are fooled into buying fake medicine, but those who were involved in the practice.  Accomplices are motivated by money and the disadvantages of their socioeconomic living and working conditions. Brine is an example of an individual who worked in a workhouse, was poor and had no means of gaining money or moving beyond his social status. The allure of this mystery quack doctor offered Brine a way to earn decent money and survive at the expense of the customers. While Brine takes no responsibility for his involvement in fooling the general public, he described his involvement as a “tool at the hands of others”.(4) This idea emphasises how the key to success for many ‘doctors’ was the way they manipulated the public and played on their fears, vulnerabilities, socioeconomic situation and lack of knowledge, as a performance that drew others into the lie.

Brine was employed in the business and earned a substantial wage from his role in selling at the marketplace and collecting the ingredients for the pills and medicines. These pills were ready-made and coated with finely ground sugar and flour, dried and placed in ready-made pillboxes. This concoction was marketed as ‘American Sugar Coated pills’ containing vegetables and did not contain mercury or other poisonous substances that medically trained doctors prescribed. In some ways, the fake medicine was less dangerous than some professionally prescribed pills, as it did not contain substances like mercury. The quack doctor was skilled enough to fool various villages across England but was a “greater fool” than Brine, as he “could not read a paragraph in a newspaper, and could scarcely write his own name”.(5) This observation by Brine praises how despite having no formal education, there was skill in seeing an opportunity to benefit them.

Successful quack doctors

Many quack doctors throughout history have been called out for their fake cures and lack of medical qualifications, while a few have successfully managed to fool royalty with their miracle cures. The performance of a quack gained advantageous alliances, such as the press, with many selling their concoctions on press property and sharing the profits.(6)

Other quack doctors used the press to advertise their miracle drugs, such as Chevalier Ruspini in 1826. Historians have discovered that Ruspini was trained as a surgeon but decided to branch off into dentistry in 1758, but dentistry was not seen as a respectable career. Ruspini created an image as a surgeon dentist specialising in treatments for illnesses relating to teeth and gums. Ruspini printed an advertisement in the Public Ledger and Daily Advertiser on 31 May 1826, which “begs to inform the Nobility, Gentry and the public that he [Ruspini] has appointed Mr Charles Butler […] agent for the sale of his medicines”.(7)  This treatment was called “Dentifrice and Tincture for beautifying and preserving the teeth and gums, and fastening those teeth that are loose”.(8) The advertisement also continues by suggesting the authenticity of the product is only guaranteed by Ruspini’s name engraved onto the government stamp attached to each bottle. It is ironic that Ruspini was concerned about fake and counterfeit versions of his medicines, but implied that customers should be wary of buying fake goods. While Ruspini is regarded as completing medical qualifications, he blurs the truth with embellishments to disguise his dentistry with surgery.

In comparison, Doctor Joshua Ward, in 1733, built a reputation as a noble and miracle curer of all ailments and had a brief career in politics as an MP. Early in Ward’s career, he moved to work in Paris and developed his popular and successful Ward’s Pills and Ward’s Drops, which caused harmful side effects, such as violent sweating.(9) By 1733 he returned to England and created the successful and popular ‘Friar’s Balsams’. Due to Ward’s success, he became a recommended figure among high-ranking officials such as Lord Chief Justice Reynolds and General John Churchill. Ward’s credibility became secured when King George II sprained his thumb and called upon Ward for the “purpose of setting his majesty’s sprained thumb”.(10) It is uncertain whether Ward’s medicines were effective, but while he was attending to King George II, the King recovered, and this secured Ward’s reputation as a doctor and acquired wealthy patients. There are reports that Ward was awarded the thanks by the House of Commons and was given permission to drive his carriage through St James’s park. Endorsement from the King protected Ward from public criticism from the college of physicians.(11)

The Victoria and Albert Museum (V&A) in London displays a statue of Ward in their collection. This statue housed in the V&A was for Ward’s grave located at Westminster Abbey, and after his death in 1761, he was given an ostentatious funeral.(12) Ward’s legacy as a successful doctor overshadows the truth behind his fake cures with generally lethal side effects, but he is also noted for his philanthropic nature, such as building hospitals for the poor and generous financial donations.(13)

Parliamentary reaction

Parliament in Great Britain during the eighteenth century attempted to regulate and prevent toxic medicines from being sold to the general public by quack doctors and medically untrained merchants. As the selling and advertising of toxic, fake medicines became more frequent, Lord John Cavendish, Chancellor of the Exchequer, decided to pass the 1783 Medicine Stamp Duty tax to regulate the medicine trade by unqualified entrepreneurs and raise money.(14) This tax required all medicine sellers to purchase an annual licence, and a stamp to be attached to the packaging to show the duty had been paid. Specific groups were exempt from paying duty and licences, for example, respected professions, such as surgeons, military medical professionals and physicians. However, this tax targeted the individual that sold the medicine rather than the harmfulness of the product. This tax also did not produce as much revenue as predicted. In 1875, the tax was redefined and required every medicinal seller to pay tax on medicine, regardless of status and qualifications, and specific ingredients were taxed more than others.(15) This Act was a start toward regulating the work of quack doctors, but it would take many more centuries until the stricter regulation of medicine.

Conclusion

In conclusion, the rise of quack medicine claimed to cure all, prevent and treat disease, reached a peak in the eighteenth and early nineteenth century. Parliamentary action to regulate and manage the growing number of opportunists and entrepreneurs, who fooled the general public with their performance and allure of the exotic. The success of many quack doctors was the mystery, price and feeding on fears, vulnerabilities and lack of medical and scientific knowledge of the customer and patient. Furthermore, the accessibility of these fake medicines claiming to cure, prevent and treat all diseases was easy to access through marketplaces and shops instead of the path of a physician’s advice and prescription. The cost of a physician was not always accessible to the working and poorer classes, but the opportunity for self-treatment with miracle cures held a lot of appeal. In society today, the regulation of medicine and who can prescribe these are much stricter and ensures the health and safety of the patient. However, there are always opportunities for fake and ineffective products to surface and requires the consumer to be aware of what they buy.

What do you think of quack doctors? Let us know below.

Now read Amy’s article on the Great Stench in 19th century London here.

References

1 M. White, ‘Health, Hygiene and the rise of ‘Mother Gin’ in the 18th Century’, 2009, British Library < https://www.bl.uk/georgian-britain/articles/health-hygiene-and-the-rise-of-mother-gin-in-the-18th-century >[accessed 1 October 2022].

2 Buckingham Express, ‘Quack Cures’, Buckingham Express (20 August 1892).

3 G. A. Brine, ‘ Confessions Of A Quack Doctor’, The British Medical Journal, vol. 2 (1875),pp.111-112.

4 Ibid.,p. 112.

5 Ibid.,p. 112.

6 A. Teal, ‘The art of medicine - Quacks and hacks: Georgian medicine and the power of advertising’, The Lancet, vol. 383 (2014),p.404.

7 ‘Chevalier Ruspini’s Medicines’, 31 May 1826, Public Ledger and Daily Advertiser.

8 Ibid.

9 Science Museum Group, ‘Joshua Ward 1684 – 1761’, 2022, Science Museum Group < https://collection.sciencemuseumgroup.org.uk/people/cp119760/joshua-ward >[accessed on 23 September 2022].

10 W. Sydney, England and the English in the eighteenth century (London, Ward & Downey, 1891), p,309.

11 Ibid.

12 Westminster Abbey, ‘Joshua Ward’, Westminster Abbey, 2022 <  https://www.westminster-abbey.org/abbey-commemorations/commemorations/joshua-ward >[accessed on 23 September 2022].

13 Science Museum Group., op.cit.

14 C. Stebbings, ‘Chapter 8: Tax and Quacks: The policy of the Eighteenth Century Medicine Stamp Duty’ in: Tiley J, ed., Studies in the History of Tax Law, vol. 6 (Oxford, Hart Publishing, 2013) < https://www.ncbi.nlm.nih.gov/books/NBK293691/ >.

15 Ibid.

Bibliography

‘Chevalier Ruspini’s Medicines’, 31 May 1826, Public Ledger and Daily Advertiser.

Brine, G. A. ‘ Confessions Of A Quack Doctor’, The British Medical Journal, vol. 2,no.760, July., 1875, pp. 111-112.

Buckingham Express, ‘Quack Cures’, Buckingham Express (20 August 1892).

Science Museum Group, ‘Joshua Ward 1684 – 1761’, 2022, Science Museum Group < https://collection.sciencemuseumgroup.org.uk/people/cp119760/joshua-ward >.

Stebbings, C. ‘Chapter 8: Tax and Quacks: The policy of the Eighteenth Century Medicine Stamp Duty’ in: Tiley J, ed., Studies in the History of Tax Law, vol. 6 (Oxford, Hart Publishing, 2013) < https://www.ncbi.nlm.nih.gov/books/NBK293691/ >.

Sydney, W. England and the English in the eighteenth century (London, Ward & Downey, 1891).

Teal, A, ‘The art of medicine - Quacks and hacks: Georgian medicine and the power of advertising’, The Lancet, vol. 383, Feb., 2014,pp. 404-405.

Westminster Abbey, ‘Joshua Ward’, Westminster Abbey, 2022 <  https://www.westminster-abbey.org/abbey-commemorations/commemorations/joshua-ward >.

White, M. ‘Health, Hygiene and the rise of ‘Mother Gin’ in the 18th Century’, 2009, British Library < https://www.bl.uk/georgian-britain/articles/health-hygiene-and-the-rise-of-mother-gin-in-the-18th-century >.

Hand-washing in Hospitals: Ignaz Semmelweis’ Great Contribution to Medicine

As individuals in society, we live by structure and regimes that are either taught or acquired through our environments. The practice of hand-washing and the sterilization of surgical equipment in hospitals are procedures that we expect and universally accepted as best practices. The recent Coronavirus (COVID-19) pandemic has reminded us of the importance of sanitation and cleanliness to prevent disease and ultimately save lives. However, the importance of hand-washing was not common practice throughout many hospitals before the nineteenth century. Here, Amy Chandler explains Ignaz Semmelweis’ important discovery about hand-washing in the nineteenth century.

An 1860 copper plate picture of Ignaz Semmelweis.

Physician and gynaecologist Ignaz Semmelweis discovered the importance and life-saving impact of hand-washing within maternity wards in the 1850s. Semmelweis’ “discovery exceeded the forces of his genius. It was, perhaps, the root cause of all his misfortunes”, and in an ironic tragedy, Semmelweis died of the same illness that he devoted his career to preventing.[1]This article will explore Semmelweis’ contribution to medical practice in the nineteenth century and analyze how he failed to achieve public and international support for his discovery. Many contributing factors failed to propel Semmelweis into the sphere of revolutionizing and respecting theories in science and medicine, such as failing to publish his hand-washing theory and methodology, fleeing Vienna and the lack of support from his contemporary doctors. How did Ignaz Semmelweis simultaneously revolutionize surgical procedures and fail to convince his contemporary physicians?

17th century

During the seventeenth century, many hospitals in Europe became overwhelmed with cases of childbed fever (also known as 'puerperal fever') that women contracted during childbirth and suffered from days after birth.[2] Symptoms of puerperal fever included severe abdominal pain, fever and debility, and the result was commonly death for many women.[3] By the start of the nineteenth century, puerperal fever was a common and deadly disease that many women feared when entering maternity wards. The cause of this disease was bacteria infecting women during childbirth, but the understanding of how bacteria and disease spread was non-existent until the 1870s. Throughout history, there have been many different attempts to identify the cause of illness and disease, for example, the widely recognized theory of miasma. Miasma was considered “poisonous emanations, from putrefying carcasses, rotting vegetation or molds, and invisible dust particles inside dwellings” that was understood to be within the air that we breathe.[4] Therefore disease and illnesses were thought to be caused by ‘bad air’ or foul smells. By the end of the nineteenth century, the work of Louis Pasteur and his discovery of Germ theory replaced and progressed thinking around the cause of disease. The lack of knowledge around the causation of disease and the spread of infection made Semmelweis’ discovery imperative to progressing medical and scientific ideology. Semmelweis' ideas were often ignored, apart from support from close colleagues, which eventually led to his professional and personal demise.

Semmelweis’ discovery 

In 1846, Semmelweis was appointed as an assistant professor in the maternity ward at Vienna General Hospital. Semmelweis undertook the challenge to understand and answer why mortality rates were so high within the Vienna General Hospital. The high mortality rates in the maternity ward of Vienna General hospital represented a widespread problem across Europe. Therefore, the cause of the disease was a universal substance and not specific to Vienna medical practice but widespread malpractice of the nineteenth century.

During Semmelweis’ employment in Vienna, mortality cases continued to increase, and so did Semmelweis’ concern and desire to discover the causation of illness. The maternal ward offered two divisions of maternity clinics; male physicians controlled one division, and female midwives staffed the other clinic.[5] In 1846 both of these divisions included similar patients demographics, but the statistics present that the male-staffed clinics had 13.10% of maternal deaths from puerperal fever, while the second division only suffered 2.03% of puerperal fever deaths.[6] From these statistics, it is evident that the cause of the illness originated and increased with the medical professionals within the first division that increased mortality rates. Semmelweis undertook a methodological approach to identify and inevitably reduce mortality rates and, as a result, to improve the lives of his patients, professional practice and contribute to disease theory. Semmelweis’ position as a gynaecologist and physician placed him in an advantageous position to discover the root cause of the mortality rates and implement policies to improve practice. Semmelweis had the opportunity to conduct research, medical knowledge and resources to identify the cause of puerperal fever. Historically, midwifery was recognized as a female role that expanded in the eighteenth century, with an increased number of male physicians and surgeons becoming involved within midwifery.[7]

A turning point in Semmelweis’ thinking was when his friend and colleague, Jacob Kolletschka, died from a puerperal fever after wounding himself during a dissection.[8] The autopsy results confirmed that Kolletschka contracted the same illness that many women suffered in the maternity wards. The contemporary theory of miasma formed the foundations of Semmelweis’ theory by speculating that “decaying animal-organic matter” caused the puerperal fever.[9] The causation of infections became evident to Semmelweis after he observed that student physicians worked in the dissection rooms and then directly, without changing their clothes or sanitizing their hands, entered the maternity wards.[10] The correlation between the two clinic divisions and the student's behavior emphasized that the male physicians were the carriers, to a point, of puerperal fever on their unwashed hands and clothes. 

What did Semmelweis do with his newfound knowledge?

During this period, disinfectants that we are familiar with in contemporary society did not exist, nor was the knowledge of using chemicals to remove bacteria from surfaces. The concept of bacteria was not known or explored until many years after Semmelweis’ death. Therefore, methods to combat the unpleasant odors from miasmas included fire, sunlight, strong aromas and chemicals.[11] Semmelweis utilized his knowledge of miasma theory by attempting to eliminate foul odors transferred between the dissection room and the maternity ward by the physicians. For Semmelweis, the most potent smelling chemical available at the Vienna General Hospital was a solution of chlorinated lime. Under the supervision and authority of Semmelweis, physicians were ordered to wash their hands with this solution before entering the maternity wards. Inevitably, mortality rates in the maternity wards began to decrease, which supported Semmelweis’ theory. However, Semmelweis only understood that the solution reduced the number of cases and was unable to explain why hand-washing was so effective.

Semmelweis’ hand-washing policy was unpopular and faced opposition within the hospital, with individuals complaining of the burning sensations on their hands from vigorously washing and exposing their skin to the chlorinated lime solution.[12]Despite declining mortality rates, Semmelweis could not explain why the chlorinated solution was so effective as he did not realize hand-washing removed the bacteria causing disease. Furthermore, Semmelweis did not publish his findings or share his work for many years, which contributed to the lack of support amongst contemporary physicians for adopting the sanitation procedure. For some physicians, Semmelweis’ discovery lacked evidence to be understood fully, and in 1849 Semmelweis’ position within Vienna General Hospital was terminated. The Ministry of Education also declined the proposal to investigate Semmelweis’ theories further and gain evidence to support using chlorinated lime within medical practice.[13]

By 1851, Semmelweis left Vienna and returned to Hungary to continue his work by implementing his chlorinated lime regime and enforcing good ventilation, sterile linen, bandages and surgical equipment for his patients.[14] Eventually, in 1861, Semmelweis published his findings in The Etiology, Concept, and Prophylaxis of Childbed Fever. However, towards the end of Semmelweis’ career, his mental health began to decline, resulting in a mental breakdown in 1865, and his wife admitted Semmelweis into a mental hospital in Lazarettgasse. Unfortunately, Semmelweis died from blood poisoning after appropriate anti-septic methods were not enforced. 

Conclusion

Semmelweis’ tragic death in some way proved that his theory of using a chlorinated lime solution to avoid puerperal fever was effective in preventing severe infection. Semmelweis’ lack of willingness to share his findings with his contemporaries reduced his hand-washing theory's credibility, while also lack of evidence and widespread enforcement of hand-washing isolated his results to be limited and circumstantial. In some ways, Semmelweis’ courage to challenge popular and pre-established views placed him in a difficult and unfavorable position because he was directly criticizing the work of his contemporaries by insinuating that their practice caused the deaths of many patients. This idea in itself was that doctors who dedicated their professional careers to saving lives and being seen as saviors against diseases were also the cause and carrier of such diseases they treated. Hindsight is a valuable asset we possess after years of scientific discoveries, but we have to praise Semmelweis for his work within the boundaries of knowledge of the time. The knowledge of bacteria was non-existent therefore working within the realms of miasma theory and Semmelweis’ methodologically eliminating factors in his study was to some extent revolutionary given the circumstances and knowledge of the time. Semmelweis’ ideas were brushed aside as unsupported ramblings, which contributed to the decline of his professional career. However, Semmelweis has now gained the status that his work deserves as a pioneer of modern medicine and sanitation procedures within medical environments. Semmelweis' work continues to help save lives today.

What do you think of Ignaz Semmelweis? Let us know below.

1.              D. Pittet and  B. Allegranzi, ‘Preventing sepsis in healthcare - 200 years after the birth of Ignac Semmelweis'. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, vol .23 (2018), p.2.

[2] J. Simmons, Doctors & Discoveries: Lives that created today’s medicine (New York, Houghton Miffin Company,2002),p.167. 

[3] C. Hallett, ‘The attempt to understand puerperal fever in the eighteenth and early nineteenth centuries: the influence of inflammation theory’. Med Hist. vol. 49 (2005), p. 1. 

[4] A. Kannadan,’History of the Miasma Theory of Disease’. Essai, vol. 16 (2018),p. 41. 

[5] Simmons, op.cit.,p.166. 

[6] Ibid.,p.166.

[7] Hallett,op.cit.,p.4. 

[8] Simmons, op.cit.,p.166.

[9] Ibid.,p.166. 

[10] Ibid.,p.166.  

[11] G. Risse. ‘Before Germs: Decay, Smell, and Contagion in the Work of Ignaz Semmelweis on Puerperal Fever’,unpublished,(2015),p.3.

[12] Ibid.,p.3.  

[13] Ibid.,pp.3-4. 

[14] Simmons, op.cit.,p.167. 

Bibliography 

Hallett, C, ‘The attempt to understand puerperal fever in the eighteenth and early nineteenth centuries: the influence of inflammation theory’. Med Hist, vol.49, no.1, January 2005, pp. 1-28.

Kannadan, A, ’History of the Miasma Theory of Disease’. Essai, vol. 16, no. 18, 2018, pp.41-43.

Persson, J, ‘Semmelweis’s methodology from the modern stand-point: intervention studies and causal ontology’, Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences,vol.40, no.3, 2009, pp.204-209. 

Pittet, D and Allegranzi, B, ‘Preventing sepsis in healthcare - 200 years after the birth of Ignac Semmelweis'. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, vol. 23, no. 18, May 2018, pp.1-5. 

Risse, G. ‘Before Germs: Decay, Smell, and Contagion in the Work of Ignaz Semmelweis on Puerperal Fever’, unpublished, 2015,pp.1-8. 

Simmons, J. Doctors & Discoveries: Lives that created today’s medicine (New York, Houghton Miffin Company,2002).