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Title: The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis (Great Discoveries) by Sherwin B. Nuland ISBN: 0-393-05299-0 Publisher: W.W. Norton & Company Pub. Date: October, 2003 Format: Hardcover Volumes: 1 List Price(USD): $21.95 |
Average Customer Rating: 4.8 (5 reviews)
Rating: 4
Summary: Politics, Personality, and Childbed Fever
Comment: Sherwin B. Nuland looks at the strange story of Ignac Semmelweis, the man who discovered the simple means of preventing childbed fever which saved countless lives. The tragedy of his life was that he never went on to elaborate on a form of germ theory that was backed up experimentation or cogent writings (although he did eventually publish a rambling account of his theories that did more harm than good to his reputation). The author is best at setting the scene of women dying in lying-in hospitals in all of its graphic and horrific detail, and in demonstrating the ways in which Semmelweis's own intractable personality and the conservative politics of the hospital's at the time worked against him. The truly great achievment of this man is put into its proper context within its historical time period in a brilliantly succint manner. A nice addition to the Great Discoveries series.
Rating: 5
Summary: Almost Getting To the Germ Theory
Comment: Wash your hands to keep the germs away. Even though we aren't really very good at following this rule, and have to be reminded (with questionable results) during flu season, it seems so very obvious. It is hard to imagine the time when people did not know this, when their mommies did not instill it into them so that it was something like an instinct. And yet, even the best medical professionals of the mid-nineteenth century had to be convinced of it, and until they were convinced, they literally killed their patients because they were not washing their hands. _The Doctors' Plague: Germs, Childbed Fever, and the Strange Story of Ignác Semmelweis_ (Norton) by Sherwin B. Nuland tells the story of how doctors learned to wash their hands. It was a surprisingly difficult lesson for them to learn.
The problem, for those who could see it was a problem, manifested itself most dramatically in maternity wards. The world had not learned about germs yet, but the doctors did not lack for explanations of what is known as puerperal ("childbearing") fever. Unseen spirits were blamed, as well as miasma, a mysterious condition of stale or unhealthful air. For us, it is obvious what was happening, once we know that doctors doing autopsies were going directly to the bedsides of mothers about to deliver, without the use of rubber gloves or handwashing. But only the young Hungarian obstetrician Ignác Semmelweis could see it initially. Semmelweis could make a clear case for a "cadaver factor" being the cause of the death of so many women. His solution was simple: hands were to be scrubbed with disinfectant between patients. It worked, and Semmelweis had the figures to show it.
Unfortunately, Semmelweis turns out to be a deeply flawed hero for this book. He was abrupt, sarcastic, and bullying when he tried to get the doctors to clean up regularly, and he alienated many from his ideas by his abusive personality. He was not only a difficult person to get along with, he inexplicably refused to document his findings in writing and he performed only the most primitive of experiments for verification. He ignored those colleagues who had supported him by fleeing to Hungary when he felt neglected. When he finally did publish, it was in a big, impenetrable book that contained the sort of invective for his foes that he displayed personally. He came astonishingly close to playing a key role in the definition of the germ theory of disease, but simply because of his personality, he had no such influence. He has been pictured before as the upright physician fighting the establishment, and this is somewhat true; but the better picture, given here, is that his own flaws meant that he would not win such a fight. Eventually, he became more obsessed and unreasonable, and his wife had to trick him into confinement at a mental hospital. He seems to have perished there by a beating from the attendants. Nuland's fascinating story shows how an "obvious" medical solution had to be discovered and promulgated more successfully by others, and leaves unasked the question of what current "obvious" solutions we may be neglecting as we climb the crooked ladder of medical progress.
Rating: 5
Summary: Another fine, short, and concise piece of medical history.
Comment: I went through this book in a couple of days. I have always been interested in medical history since medical school, and this was another satisfying excursion into the discovery of so much medical phenomenon in the 1800s. In most ways, it was better for a woman to have her baby at home through help with her neighbors and midwives. America had the luck to be established through pioneers who learned to handle these things on their own, and even in cities, much was done to avoid being placed in hospitals, because it was well-known that if you went into any type of medical institution, you probably were not coming back out. (as proven with Helen Keller's 'Teacher' Annie who was placed with her consumptive brother in such a medical institution...her brother died there).
I had heard of Semmelweis before, I think in one of Roy Portland's history. I found his story incredibly sad, because it is often true that we are our own worst enemies, and he was definitely his. Politics in medicine and in education sounds very much the same, unfortunately, and you have to have the ability to bite your tongue sometimes when you want to lash out at people for their stupidity. This was a concept that Semmelweis seemed to be unable to learn, and his running away from Vienna pretty much sealed his fate as per his true theory of puerpeural disease in women.
One thing I felt was important that Nuland forgot to take into account, is the standing of women in society, both in Europe and in America. I am not a feminist, but it is goofy to ignore the fact that the care of women was not considered as important medically, as the care of men. This is imperative to remember, that in the politics as played out in Vienna and throughout the world with Semmelweis discovery, not only was obstetrics a relatively new field to male physicians (it had been in the realm of midwives before), but women were important for the bearing of children, but that was about it. More importance was placed on saving the children, then on the women...because a husband/father could get a wet nurse for the child, and remarry again with no stigma attached because he had a child to care for. One thing Semmelweis should be lauded for is placing more importance on the saving of women, and that was different from his colleagues in that they were more interested in their own careers and prestige.
I agree with Nuland's critique of the disease that caused Semmelweis mental deterioration as being presenile dementia, rather than tertiary syphillis. Semmelweis was not a man to have gotten syphillis. He was too fastidious, and too busy trying to save lives.
Karen Sadler,
Science education,
University of Pittsburgh
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Title: Mavericks, Miracles, and Medicine: The Pioneers Who Risked Their Lives to Bring Medicine into the Modern Age by Julie M. Fenster ISBN: 0786712368 Publisher: Carroll & Graf Pub. Date: September, 2003 List Price(USD): $25.00 |
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Title: Doctors : The Biography of Medicine by Sherwin B. Nuland ISBN: 0679760091 Publisher: Vintage Pub. Date: 15 January, 1995 List Price(USD): $16.00 |
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Title: The Great Influenza: The Epic Story of the Deadliest Plague In History by John M. Barry ISBN: 0670894737 Publisher: Viking Press Pub. Date: 05 February, 2004 List Price(USD): $29.95 |
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Title: Lost in America: A Journey with My Father by Sherwin B. Nuland ISBN: 0375412948 Publisher: Knopf Pub. Date: 07 January, 2003 List Price(USD): $24.00 |
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Title: How We Die : Reflections on Life's Final Chapter by Sherwin B. Nuland ISBN: 0679742441 Publisher: Vintage Pub. Date: 15 January, 1995 List Price(USD): $14.00 |
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