THE DOCTORS’ PLAGUE

In the first of Norton’s New Discoveries series on scientific breakthroughs, NBA-winner Nuland (How We Die, 1994, etc.) puts into proper historical context the achievements of a pioneering obstetrician.

The author has turned his considerable narrative talents to a signal moment in the history of medicine. Nuland (Surgery/Yale School of Medicine) opens with the dramatic account of a young woman’s death after delivering her first child at a hospital in mid-19th-century Vienna. He then turns to the cause of her death, childbed fever, vividly showing its horrific effects on the body and detailing several erroneous, now laughable theories doctors had come up with to explain its origin. Enter Ignac Semmelweis, an outsider from Hungary with a poor accent who had turned to obstetrics after failing to win appointment to his first- and second-choice positions at the hospital. A trained observer, Semmelweis analyzed obstetric procedures and claimed that childbed fever was caused by the transfer of invisible “putrid cadaver particles” from the hands of students and attending physicians. To prevent the disease, he insisted that every medical attendant wash in a chloride solution before examining a woman in labor. Nuland provides enough medical history to show how Semmelweis’s 1847 accomplishment reflected the revolutionary teachings in scientific logic then being introduced by the hospital’s chief of surgical pathology and how these were opposed by the old guard. When Semmelweis was refused reappointment to his position, he fled Vienna for his native Buda-Pest, having failed to perform experiments substantiating his claim, to make use of the microscope, or even to explain his work in a medical journal. He left support of his theory to others, though in 1861 he published a confused, angry, and essentially unreadable defense of his ideas that was largely ignored or rejected. Dementia preceded his death a few years later.

A revealing account of a time, a place, and an unfortunate individual depicted here as his own worst enemy.