In 1847, one of every six women whose babies were delivered by the medical students and supervising doctors at Allgemeine Krankenhaus (General Hospital) in Vienna died of puerperal fever (also known as childbed fever). In contrast, the incidence of this disease in women delivered by hospital midwives was dramatically lower and puerperal fever was quite rare when mothers had their babies born at home.While a few physicians (most notably Alexander Gordon and Oliver Wendell Holmes) realized that childbed fever was a contagious process, it was Semmelweis who identified the nature of the problem as stemming from the failure of obstetricians and medical students to wash their hands and change their clothing, especially after performing autopsies or doing surgery. He mandated that doctors and students wash with a disinfectant (chloride of lime) before examining any woman in labor.Despite the dramatic reduction of maternal mortality on his obstetrical unit, his ideas and methods were not well received. Semmelweis was reluctant to conduct experiments on animals to prove his theory and resisted publishing his findings in any medical journal. When he finally did write a book, The Etiology, the Concept, and the Prophylaxis of Childbed Fever, it was difficult to read and failed to impress many obstetrical experts.With his health failing and his behavior increasingly erratic and inappropriate, Semmelweis was committed to a state-run mental hospital. He died two weeks later. The official cause of death was sepsis secondary to an infection of his finger. The author is convinced, however, based on the autopsy report and findings upon exhumation of the body in 1963, that Semmelweis was beaten to death by the staff at the asylum. He may well have been suffering from Alzheimer's presenile dementia at the time.


The Doctors' Plague offers a fascinating glimpse at how politics, pride, and obstinacy can short-circuit medical progress and the public good. It is also a testament to the worth of one man, Semmelweis, who is rightfully considered one of the most prominent figures in the history of medicine. His clinical observations and ideas prefigured the work of Louis Pasteur and Joseph Lister with regards to the germ theory and the concept of antisepsis.His obsession with understanding and eliminating the scourge of childbed fever became a lifelong crusade. What could be more devastating than the death of a mother shortly after childbirth? For Semmelweis, it might be the realization that he was the instrument of death for countless young women before he discovered that doctors transmitted puerperal fever to their patients.The life of Semmelweis was punctuated by tragedy and irony. Even his death is eerie. The Doctors' Plague is a chilling reminder that sometimes physicians and their practice of medicine are hazardous. This short book is useful in any discussion of iatrogenesis as well as the personal cost of discovery.


W. W. Norton

Place Published

New York



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