Girardigasse, Giardia and Germ-Theory

Anytime I find myself in the vicinity of Mariahilfestrasse/Naschmarkt whereby I must traverse Girardigasse, it never fails to bring a smile to my face when I am reminded of the similarity between the spelling of the street-name and Giardia lamblia, a parasite which causes intestinal infections, the most common gastrointestinal disease-causing parasitic agent globally.  As a microbiologist by training, I am very familiar with Giradia and its lifecycle, the effects which range from acute inconvenience to chronic infection, and for which the successful treatment requires scrupulous standards of hygiene.  In this vein, I am led to recall the life-story of one Dr. Ignatz Semmelweis, his involvement in germ-theory and the beginnings of standardised hygiene and sanitation practices in European hospitals.

Dr. Semmelweis (1818-1865), a Hungarian by birth, studied medicine in the University of Vienna in the 1830s where he specialised in obstetrics.  In 1846, not long after graduating as a doctor, he found himself based in the Vienna General Hospital, where he was placed in charge of two obstetrical clinics: the First Clinic and Second Clinic.  It was in his role there that he encountered a medical mystery which baffled him and which he dedicated his life to solving.  Though these two clinics were operating under almost the exact same standards in the same hospital, the former had a mortality rate of approximately three times that of the second.  One of the most-feared causes of death was the so-called ‘childbirth fever’ (puerperal fever), which was commonly contracted by women who had just given birth and for which nothing could be done.  So great was this fear, that often women in Vienna would often rather give birth on the streets than to enter the feared First Clinic.

It should be kept in mind that at this point in history, medicine was very far removed from what we understand it to be today and the knowledge of doctors regarding the causes of diseases was extremely limited. The fact that large numbers of patients were dying under his care greatly distressed Dr. Semmelweis and he began to systematically rearrange practices in the units, eliminating factors in an attempt to discover what was the root cause of the fatalities. Some light was eventually shed on the mystey when a colleague of Dr. Semmelweis’s died after being cut with the scapel used in an autopsy of a patient who herself had died from puerperal fever.  Examining the evidence of the autopsy proved that the fatal agents were the same in both cases.  During this time, the Second Clinic was staffed only by midwives, whilst doctors were the only ones working in the First Clinic. Taking into account the fact that doctors were also the only ones carrying out autopsies, Dr. Semmelweis therefore concluded that the fatal agents were being transferred through the doctors from the corpses to the living.  He named these discoveries ‘cadaverous particles’ and immediately instigated a new hand-washing scheme, requiring that all staff must wash their hands in a chlorine solution before attending to new patients.  The new scheme was an instant success and the mortality rates in both clinics fell dramatically.

Sadly, however his theories were rejected entirely by his fellow doctors in the medical profession who resented the insinuation that they themselves were somehow involved in the transmission of disease.  After losing his job as a result of being discredited, Dr. Semmelweis sank into depression and was committed to a mental asylum.  Tragically, just 14 days after his admittance, he died as a result of being beaten by the wardens in the institution.  He was only 47.  A mere nineteen years later, Robert Koch formulated his famed ‘Koch’s Postulates’ theory and the acceptance of germ-theory and disease transmission became standard, along with basic notions of hygiene and sanitary practices in all hospitals.  Today, good hygiene and standardised sanitary practices are something which are practiced not only in hospitals, but in every sphere of life.  Even advanced clean-room technologies are founded upon these basic findings of germ-theory of which Dr. Semmelweis was a cornersone.  So the next time you wash your hands before a meal, enjoy the privilege of clean water or attend to your sick sibling, think on Dr. Semmelweis and give thanks for his life’s work which has helped us lead longer and healthier lives.