Blood and Guts by Richard Hollingham Page A

rate the 'atmospheric-cosmicterrestrial
conditions of Vienna' were blamed for spreading disease
– a 'miasma' was pervading the wards. The authorities struggled,
though, to explain why, if there was something in the air, more
women died in the First Clinic than the Second.
    The patients themselves were blamed. These women were often
the poorest in society; the wealthy would usually give birth at home
(where the mortality rate was less than 1 per cent). Perhaps it was to
do with the mothers' temperament or their slack morals? Many of
them were fallen women. In an eventual admission of defeat, the
authorities changed the days of admission, so women no longer
knew which clinic they would end up in. It became, in effect, a
lottery as to how likely they were to die.
    There was one major difference between the clinics that the
commission had failed to spot or perhaps considered unimportant.
In order to refine their skills, the doctors had access to the bodies
of the recently deceased. The midwives were forbidden by law to
practise on cadavers, and had to make do with wax mannequins and
porcelain models. As a result, the doctors and medical students
spent much of their time in the mortuary. When needed, they
returned to the wards to attend to their patients, the sweet smell of
cadavers still on their hands. Some students even claimed that the
scent was attractive to women.
    In 1847 a twenty-nine-year-old Hungarian physician called Ignaz
Semmelweis was appointed as first assistant to the professor of obstetrics
at the hospital. He had responsibility for the First Clinic and saw
for himself the horrible ravages of childbed fever. An intense yet
kind young doctor, Semmelweis became obsessed with solving the
mystery of all these deaths. Driven by the knowledge that for every
ten patients he treated, two would die, he set out to find a solution.
    As well as conducting autopsies on his deceased patients,
Semmelweis pursued every theory he could think of. He suggested
the disease was something to do with the position of the women
when they were giving birth. Childbed fever seemed to affect firsttime
mothers more than others – perhaps this was something to do
with their labour being more prolonged. Could it be fear of the
doctors that was causing the deaths? Being examined for the
instruction of male students was surely offending their modesty. If
the women were already predisposed to puerperal fever, maybe
their fear of being examined led to the onset of the disease? Of
course, their modesty could be offended in many ways, so this
theory was quickly dismissed.
    Semmelweis observed that a priest was passing among the
women – usually to administer the last rites. Maybe the disease
was something to do with a man of the cloth spreading the fear
of death? Certainly the priest had more cause to visit the First
Clinic than the Second. He was very understanding when asked
not to ring the little bell he carried around with him. But even if
fear was a factor in the women's deaths, this would not explain
the deaths of the infants.
    Nothing seemed to work. Every theory Semmelweis came up
with failed to answer the fundamental question: why were more
women dying in the First Clinic than in the Second? Obsession
turned to frustration and anger as he failed to solve the mystery. His
superiors noted that he was behaving oddly, making lots of bizarre
changes to little effect. Semmelweis needed a holiday – for everyone's
sake.
    In March 1847 he and two colleagues set off for Venice. The
Italian city was part of the Austrian Empire and had, once again,
become a popular tourist destination. This was in part because it was
much easier to get to than it had been previously, thanks to the new
railway line speeding through the Austrian countryside – a wonder
of the age. It was hoped that seeing the art treasures of Venice would
revive Semmelweis's spirits, and it did seem to have the desired
effect. He headed back to Vienna reinvigorated, ready to