Semmelweis and Gordon’s Work on Childbed Fever

Semmelweis and Gordon’s Work on Childbed Fever

Semmelweis and Gordon’s Work on Childbed Fever

Maternity wards, once plagued by a deadly fever known as puerperal fever or Childbed fever, underwent a remarkable transformation thanks to the groundbreaking work of Ignaz Semmelweis and Alexander Gordon.

While Semmelweis faced rejection and tragic circumstances, Gordon’s discoveries were largely overlooked in his lifetime.

This blog post delves into the stories of these two remarkable individuals and their contributions to modern obstetrics.

Childbed or Puerperal Fever

Puerperal fever, historically known as childbed fever or postpartum infection, is a severe and often life-threatening bacterial infection that can occur in women shortly after childbirth, typically within the first few days to weeks after delivery. This infection primarily affects the reproductive and pelvic organs, including the uterus (womb) and surrounding tissues.

Puerperal fever is usually caused by bacteria entering the woman’s body through the genital tract during childbirth or postpartum. Common causative bacteria include Streptococcus pyogenes (Group A Streptococcus), Streptococcus agalactiae (Group B Streptococcus), Escherichia coli (E. coli), and various other bacteria. These bacteria can lead to localized uterine infections (endometritis) or spread to other body parts, causing more severe systemic infections.

Symptoms of puerperal fever can vary in severity but may include:

  • Fever and chills
  • Abdominal pain or tenderness, especially in the lower abdomen.
  • Vaginal discharge that may be foul-smelling.
  • Increased heart rate.
  • Fatigue and weakness.
  • Elevated white blood cell count, indicating an infection.

Puerperal fever can progress rapidly, and if left untreated, it can lead to severe complications, including septic shock, organ failure, and death. Prompt diagnosis and appropriate medical treatment with antibiotics are essential to manage the infection effectively.

Historically, puerperal fever was a major cause of maternal mortality, especially without proper hygiene practices during childbirth. The work of medical pioneers like Ignaz Semmelweis and Alexander Gordon played a crucial role in recognizing the importance of hygiene in preventing puerperal fever and improving maternal outcomes. In modern healthcare, the risk of puerperal fever has significantly decreased due to better hygiene, aseptic techniques, and the use of antibiotics when necessary.

Hospitals for Childbirth

Hospitals for childbirth became common in the 17th century in many European cities. These “lying-in” hospitals were established at a time when there was no knowledge of antisepsis, and patients were subjected to crowding, frequent vaginal examinations, and the use of contaminated instruments, dressings, and bedding.

The first recorded epidemic of puerperal fever occurred at the Hôtel-Dieu de Paris in 1646. Hospitals throughout Europe and America consistently reported death rates between 20% to 25% of all women giving birth with intermittent epidemics with up to 100% fatalities of women giving birth in childbirth wards

Ignaz Semmelweis:

Ignaz Semmelweis: A Hungarian Obstetrician and Whistle-blower

The Doctor Who Championed Hand-Washing And Briefly Saved Lives : Shots - Health News : NPR

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

In the 19th century, a silent killer haunted maternity wards across the globe. Puerperal fever, or childbed fever, was an insidious infection that claimed the lives of countless mothers after childbirth. During this perilous era, two remarkable individuals, Ignaz Semmelweis and Alexander Gordon, emerged as champions of maternal health, armed with groundbreaking discoveries and unwavering determination. However, their pioneering work was met with scepticism and resistance, painting a tragic yet inspiring chapter in medical history.

Born in 1818 in Buda, Hungary, Ignaz Semmelweis dedicated his life to improving the conditions of maternity wards. Childbed fever was a formidable adversary, inflicting devastating mortality rates due to unhygienic practices and a lack of understanding about disease transmission. Semmelweis’s commitment to changing the status quo set him on a transformative path within obstetrics.

Semmelweis joined the Vienna General Hospital in 1844, where he made a startling observation. Maternity wards attended by doctors exhibited significantly higher childbed fever mortality rates than wards managed by midwives. This disparity ignited his quest for answers. His meticulous investigation led him to a groundbreaking theory – the post-mortem room, visited by doctors who conducted autopsies, might unknowingly carry harmful substances to labouring women.

Driven by this revelation, Semmelweis implemented a simple yet revolutionary protocol. He mandated that all medical staff wash their hands thoroughly with chlorinated lime before attending to patients, and the wards were cleaned with calcium chloride to minimize contamination. The impact was immediate, leading to a substantial reduction in childbed fever deaths.

However, Semmelweis’s findings faced formidable resistance from the medical establishment. In the mid-19th century, the prevailing belief attributed childbed fever to “poison air” or miasma, deeply entrenched despite a lack of scientific evidence. Semmelweis’s emphasis on hand hygiene and cleanliness challenged these ingrained notions. Despite compelling evidence and statistical support, his groundbreaking ideas were ridiculed and dismissed by many.

Semmelweis’s unwavering commitment to patient safety inspired future generations of medical professionals, eventually leading to his acceptance of his ideas and modern hygiene practices.

Semmelweis Monument, Budapest | National Infectious Disease Prevention Initiative

 

Alexander Gordon – Obstetrician 1752-1799

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

The Scottish physician Alexander Gordon embarked on a journey to revolutionize the understanding and prevention of childbed fever. His upbringing and education laid the foundation for his future endeavours. After studying in Leiden, Gordon attended physicians’ ward rounds at the Aberdeen Infirmary, enriching his medical knowledge despite the absence of a formal medical school in the city.

Gordon’s naval career provided adventure and financial support for further medical training. Upon retiring from the Royal Navy, he immersed himself in medical practice, becoming a physician at the city Dispensary in Aberdeen. His meticulous record-keeping skills allowed him to observe and document cases thoroughly.

Gordon’s observations revealed a significant pattern – mothers attended by midwives from the city, where childbed fever was rampant, were more likely to develop the disease. Conversely, those attended by midwives from rural areas, unaffected by the infection, had a lower risk. This observation led him to implicate midwives in transmitting the infection.

Despite his compelling evidence, Gordon’s discoveries faced rejection from the medical community. The prevailing belief in “poison air” and the hierarchical nature of the profession contributed to the resistance. Personal biases and rivalries further hindered acceptance. Gordon’s ideas, implicating doctors and midwives, challenged the established order.

The rejection of Gordon’s work had significant consequences. It was only in subsequent decades, with the work of pioneers like Oliver Wendell Holmes and Ignaz Semmelweis, that hygiene practices gained acceptance. Gordon’s pioneering contributions were finally acknowledged, emphasizing the tragedy of his rejection and the missed opportunities to save lives.

 

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

 

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

Conclusions:

The rejection of Alexander Gordon’s discoveries serves as a sobering reminder of the resistance that can accompany paradigm-shifting ideas, even in the face of compelling evidence. It underscores the importance of open-mindedness, scientific inquiry, and the willingness to challenge established beliefs to pursue improved healthcare practices. Gordon’s work is a testament to medical pioneers’ resilience and the lasting impact they can have, even in the face of adversity.

The tireless efforts of Ignaz Semmelweis and Alexander Gordon revolutionized the practices in maternity wards and saved countless lives. While Semmelweis’s tragic fate and subsequent recognition highlight the challenges faced by early medical pioneers, Gordon’s pioneering work deserves greater acknowledgement. Their stories serve as reminders of the importance of embracing new ideas and the significant impact one individual can make in transforming medical practices for the better.

Sources:http://www.med-chi.co.uk/heritage/people/alexander-gordon.html#nav

 

Pioneering Discoveries on Puerperal Fever Met with Scepticism and Resistance

 

 

 

Princess Anne –  Her Dysfunctional Family and More!

Princess Anne – Her Dysfunctional Family and More!

Discover the compelling life of Princess Anne, Princess Royal, born into a dysfunctional family in 1709. Follow her journey through political feuds, a challenging marriage, and her reign as the Staadholder of the Netherlands. A remarkable woman who defied the odds and laid the foundation for the Dutch royal family.

A Dysfunctional Family

Princess Anne was born into what we would call a dysfunctional family in May 1709. (For more information about her grandmother and the House of Hanover read my blog on 15th November.) Anne was a remarkable woman in many ways; criticised and praised by contemporary chroniclers for her arrogance and her accomplishments in equal measure.

Anne was born at Herrenhausen Palace, Hanover, five years before her paternal grandfather, Elector George Louis, succeeded to the British throne as George I.

Her parent’s relationship with King George I was a troubled one.

Her mother, Caroline of Ansbach, was brought up in the Prussian Court where she was treated as a surrogate daughter and was well educated. It is difficult to know to what extent her experience of life at the boorish and brutal Hanoverian Court influenced her opposition to George I in England.

One cannot help wondering did Caroline suspected her father-in-law of having her mother-in-law’s lover killed? Did she support her husband’s desire to set his mother free from her imprisonment at Ahlden? Whatever the cause,  their relationship was not good and Anne’s parents left Hanover in 1714 and did not return.

Political Differences

Political differences between father and son led to factions in the court in Hanover from the late 1710s.

These disagreements carried over to the British court and came to a head following the birth of George and Caroline’s second son, Prince George William in 1717.

At the baby’s christening, Anne’s father publicly insulted the Duke of Newcastle. This so infuriated George I he banished his son and daughter-in-law from St James’s Palace.

The king kept their children, including Anne under his guardianship at Leicester House.

The family rift was healed, in part at least, in 1720 when Anne’s brothers were returned to the care of her parents but she and the other girls remained the wards of the King.

Princess Anne Ravaged by Smallpox

That year, 1720, Anne’s body was ravaged by smallpox. It is estimated the disease killed an estimated 400,000 Europeans a year during the closing years of the 18th century.

This near-death experience and her parent’s experience of the disease at the beginning of their marriage led Anner to support her mother’s efforts to test the practice of variolation (an early type of immunisation against smallpox). The practice of variolation was witnessed and recorded by Lady Mary Wortley Montagu and Charles Maitland while they were in Constantinople.

 

Ophan Guinea-pigs

At the direction of her mother, Queen Caroline, six prisoners condemned to death were offered the chance to undergo 18th Century Monarchy instead of execution. The prisoners all took the offer and they all survived, as did six orphan children given the same treatment as a further test. (There were no medical ethics committees then). Convinced of variolation’s safety, the Queen had her two younger daughters, Amelia and Caroline, inoculated. Royal patronage practice spread the demand for inoculation amongst the upper classes.

Family Feud Continues

On 22 June 1727, George I died while in Germany, making Princess Anne’s father king.

The following year, her elder brother, Frederick, who had been educated in Germany, returned to England. Father and son had not seen one other in 14 years and when they did the fireworks began. Their relationship was even more tempestuous than the one between George I and George II, especially after 1733 when Frederick purchased Carlton House and set up what George II considered to be a rival court.

Princess Anne’s Marriage Prospects

Anne’s sister, Princess Caroline

Anne’s sisters, Princess Caroline (1713-1757) left,
Princess Amelia (1711-1786), right.

As a daughter of the future British King Anne’s marriage was always going to be a dynastic one. As a princess requiring a Protestant marriage, her options were limited. The government hit on the idea of a marriage with the rather lowly William, Prince of Orange-Nassau to sure up their anti-French alliance.

George II was not enamoured with the proposal and Anne was concerned too because William had a well-known physical deformity. To find out more she dispatched Lord Hervey, a close confidant, to report on its extent.

First Sight of the Hunchback

Hervey reported that although William was no Adonis and his body was as bad as possible; William suffered from a pronounced curvature of the spine, probably the result of sclerosis-like the English King Richard III; he had a pleasing face.

Despite his deformity and the inferiority of his territory, Anne decided she would take him. She was already 25 years old and did not want to end up an old maid surrounded by her warring relatives. When they married in 1734, her mother and sisters wept through the ceremony. Lord Hervey described the marriage as more sacrifice than celebration.

Princess Anne Marries William, Prince of Orange-Nassau

As an outsider and British, Anne was not popular in the Netherlands. Her life must have been a lonely one as she did not get along with her mother-in-law and her husband was frequently on campaign protecting the states of the Dutch Republic from its enemies. In these lonely years, Anne concentrated her efforts on literature and playing the harpsichord; she was an accomplished artist, musician, and lifelong friend of her music teacher George Frederic Handel.

 

Willem Karel Hendrik Friso van Oranje-Nassau, 1751

Willem Karel Hendrik
Friso van Oranje-Nassau, 1751.

Princess Anne’s Stillborn Baby

Producing the required heir was problematic too. In 1736, Anne gave birth to a stillborn daughter and then another in 1739. Her first live birth came in 1743 with the arrival of Princess Carolina of Orange-Nassau who was followed by another daughter, Princess Anna two years later. Her only son arrived in 1748 when she was 39 years old.

When her husband died three years later in 1751 at the age of 40, Anne was appointed regent for her 3-year-old son, Prince William V.

 

 

 

Princess Anne is Widowed

Anne was given all prerogatives normally given a hereditary Stadtholder of the Netherlands, with the exception of the military duties of the office, which were entrusted to Duke Louis Ernest of Brunswick-Lüneburg.

The Princess Takes the Tiler of Government

To say that she took to the role like a duck to water would not be an exaggeration. Finally free to exercise some power, in true Hanoverian style, Anne used her wit and her determination to secure her personal power base and with it the dominance of her family and the Orange dynasty.

Anne was hard-working but remained unpopular. The commercial rivalry between the Dutch and the British East India Companies was part of the cause. Another reason was the constitution of the United Provinces. But what made her most unpopular was that she seized the opportunity to centralise power in the office of the hereditary Stadtholder over the traditional rights of the Dutch states particularly the State of Haarlem. Her foreign policy was also a source of vexation for the Dutch as she favoured a British-German alliance over an alliance with the French.

All a Woman Could Do

Ultimately, as a woman, she was reliant on the men around her and it is fair to say that her husband and her son were fighting a losing battle against the tide of history at the end of the 18th century and Anne with all her skills could not realise the ambitions of the House of Orange on her own. She ruled the Netherlands for eight years dying of dropsy in 1759 when her son was 12. She was replaced as regent by her mother-in-law, Marie Louise of Hesse-Kassel and when she died in 1765,  Anne’s daughter, Carolina, was made regent until William V turned 18 in 1766.

The Remarkable Princess Anne

Anne was a remarkable woman. With her beauty shredded by smallpox, she took on the world and won. (I am sure she took the opportunity to show herself in the best light in her self-portrait above.) Anne accepted and made a success of her marriage which on the face of it held little prospect for personal happiness. An intelligent if haughty woman she endured many years of loneliness, the pain of 2 stillborn children and widowhood. As Stadholder (chief executive of the Dutch Republic) she was as effective as any man and laid the foundations of the Dutch royal family. Her grandson, William I became the first king of the Netherlands in 1815.

Sources:

George II: King and Elector By Andrew C. Thompson, 2011, Yale University Press.

https://en.wikipedia.org/wiki/Anne,_Princess_Royal_and_Princess_of_Orange

Photo credits.