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The following is an article from the Spring 1983 issue of "Women and Revolution" that may have some historical interest for old "new leftists", perhaps, and well as for younger militants interested in various cultural and social questions that intersect the class struggle. Or for those just interested in a Marxist position on a series of social questions that are thrust upon us by the vagaries of bourgeois society. I will be posting more such articles from the back issues of "Women and Revolution" during Women's History Month and periodically throughout the year.
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Women and Revolution has chosen International Women's Day this year as an occasion to commemorate Ignaz Philipp Semmelweis. As an obstetrician in mid-19th century Europe Dr. Semmelweis searched for, found and tried to apply the cure for puerperal (childbed) fever. For his actions he was ridiculed, forced out of his practice in Vienna and eventually driven to insanity. While his discoveries preceded those of Louis Pasteur and John Lister and were superior to the earlier work of Oliver Wendell Holmes, Semmelweis is little remembered today—even by many in the medical profession. Yet his simple concern for his female patients resulted in the saving of millions of women, in his lifetime as an originator of current medical procedure.
Semmelweis was born in Hungary in 1818. By 1844 he had begun work as an obstetrician in the First Maternity Division of the Vienna General Hospital, a facility for charity cases and the poor. An estimated 1,800 women a year died there of childbed fever, an extremely contagious and painful microbial infection which led to* certain death within days after childbirth. Indeed, the First Maternity ward was notorious for these statistics, and women went to incredible ends to avoid it, sometimes even trying to hold off labor pains until they could be admitted to the Second (midwives') Maternity Division. When Semmelweis met his first patient she was shaking with fear, but he somewhat arrogantly assured her that the doctors' ward was certainly superior. She soon became one of the many thousand dead, and he was jolted. He checked the records of deaths at both wards for the previous six years and found a nearly ten percent mortality rate at the First and less than two percent at the Second.
For the next two years, Semmelweis devoted himself to researching the likely causes of the disease, nagging his rather uninterested superiors, unsuccessfully trying every conceivable corrective measure. He wrote, "I was like a drowning man grabbing at straws. Everything was questionable, everything inexplicable, only the great number of dead was an undoubted actuality" (quoted in Men Against Death, Paul de Kruif). In March of 1847 the assistant pathologist at the hospital died after cutting himself during the autopsy of a puerperal patient. Semmelweis noticed that his disease was identical to those of women who died in his ward after childbirth. He realized then that, unlike the midwives, doctors went straight from surgical and autopsy rooms to the maternity ward where they examined each woman in turn. This led him to the discovery that puerperal fever was not some unknown, cosmically-caused disorder emanating from within the childbearing woman (as was commonly believed at the time) but rather an infection that was conveyed to them by their doctors.
He immediately instituted the practice of doctors washing their hands in calcium chloride solution
before entering the maternity ward (and eventually between examining each patient). In April of 1847,18 of every 100 women had died of childbed fever. By June of 1847, one month after Semmelweis' discovery, one out of every 100 women died, less than the mortality rate in
the midwives' ward.
Semmelweis' findings were not exactly embraced by his colleagues and superiors. He had, after all, proved that doctors themselves were responsible for these deaths. More importantly, his discovery ran counter to the prevalent medical philosophy of his day. German medicine in the first half of the 19th century reflected the extreme idealism of intellectual thought generally. It was dominated by the Nature-Philosophy school, whose leading light, a naturalist named Lorenz Oken, was as inept as he was fanciful. Oken went so far as to declare, "Ideally every child should be a boy" (quoted in History of Medicine, Fielding Garrison). This doctrine, along with several equally mystical offshoots, was shattered as a result of the 1848 revolution. But its successor, the New Vienna School in which Semmelweis was trained, hung on longer. It subscribed to the theory of "therapeutic nihilism," taking great pains to diagnose and describe disease without any expectation of curing it. Patients were regarded merely as objects of investigation, and the humane aspects of medical practice were ignored. When it came to treatment, the leading clinician of the school, Josef Skoda, would shrug and say, "Ah, it's all the same!" (ibid).
Hospital conditions reflected this attitude. No one used gloves or washed hands. Instruments and bandages were not disinfected, linen was not changed from one patient to the next, and open windows let in the putrid air of adjacent morgues. In an article entitled "Madness" in the 16 December 1982 New York Review of Books, Princeton University professor of history Lawrence Stone commented:
"It is now credibly believed that hospitals were lethal death traps before Pasteur demonstrated the importance of a sterile environment. It is now also generally recognized that doctors—presumably unwittingly—have killed more patients than they cured, certainly before the
early nineteenth century, and maybe before the invention of anti-biotics in the mid-twentieth.”
"
Semmelweis began to make changes in these conditions, and the medical profession retaliated. While some—notably Dr. Skoda—stood by him, he became an object of derision. His boss finally had him demoted by having it brought to the attention of the medical authorities that Semmelweis had worn the plumed hat of a revolutionary in 1848 (which, if true, is certainly an honorable statement). Semmelweis returned to Budapest where he was again scorned and ignored. Yet he continued his fight, first as an unpaid obstetrician at St. Rochus Hospital and then as a professor at Budapest University. It was there that he published a treatise on his work and a scathing attack on his fellow obstetricians with the refrain, "This murder must stop." Semmelweis' anguish over and obsession with the needless number of deaths overwhelmed him, and he died in a public insane asylum of massive infection in 1865. It was not until the work of Pasteur and Lister that his breakthrough was accepted. Feminists will doubtless denounce us for saluting the work of a man on International Women's Day, just as in the past we have been assailed for upholding and implementing the revolutionary work of "old men with white beards." We are not champions of "sisterhood" but rather seek to strengthen the ranks of the working class in struggle against capitalist society, including the reactionary nuclear family which enslaves women. Semmelweis was hardly a Marx or Engels nor is the medical profession now, despite greatly increased knowledge, a humane champion of women and the oppressed. What we share with Semmelweis is his desire to make childbirth an easy and safe procedure. The reality of having children with real choice, without the certain knowledge that motherhood means a life of mindless drudgery and the fear for the lives and livelihoods of one's children, awaits the socialist future. And it is the development of technology, not least through scientific achievements of such men as Dr. Semmelweis, which has laid the basis for a society with the resources to replace the family structure and ultimately liberate women."
Dr. Semmelweis and the Revolutions of 1848
Postscript
For our International Women's Day 1983 editorial we wrote a piece honoring Dr. Ignaz Semmelweis, the 19th century Hungarian doctor who discovered the cause of and preventive cure for puerperal (childbed) fever, which had caused the deaths of thousands of women (see "A Man Who Saved Millions of Women," W&R No. 26, Spring 1983). His discovery—that doctors themselves were spreading the disease because they came directly from the morgue, bearing deadly bacteria, and examined woman after woman without washing their hands—caused intense hostility from his supervisors. As we noted, "His boss finally had him demoted by having it brought to the attention of the medical authorities that Semmelweis had worn the plumed hat of a revolutionary in 1848 (which, if true, is certainly an honorable statement)."
It is true. We recently came across an article from the Militant (5 July 1948), the newspaper of the then-Trotskyist Socialist Workers Party, titled "Semmelweis—Forgotten Martyr," which noted that:
"The revolution that swept over Europe in 1848 gave Klein [Semmelweis' supervisor in the Vienna General Hospital] the opportunity he was looking for. In Vienna the people drove the Emperor from the city. Semmelweis, an ardent revolutionist, belonged to the famous 'Academic Battalion/ composed of intellectuals, artists, professionals and students. When reaction triumphed, Klein secured his assistant's dismissal and banishment from Austria. Returning to Budapest, Semmelweis found the revolution still in power there; he embraced it with enthusiasm. But this upsurge of the people, too, was defeated."
The revolutions of 1848 were defeated by the rotting absolutist powers of Europe at the time—yet they provided inspiration for new generations of revolutionaries: the Paris Commune of 1871, then the triumphant Bolshevik Revolution of 1917. Semmelweis himself, his life-saving discovery largely ignored in his lifetime, died in a madhouse of a massive infection. Yet his pioneering work ultimately won out.
We are pleased to honor Ignaz Philipp Semmelweis again, then, not only as a man who fought to obliterate the death agonies of women he treated in his "professional capacity" as a doctor, but as a comrade in the more than century-long struggle for social revolution."
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