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Semmelweis' method

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Disinfection of the hands of the obstetrician or midwife with chloride or lime, as well as clean bedsheaths for the patient, in order to prevent puerperal fever.

Description

Disinfection of the hands of the obstetrician or midwife with chloride or lime, as well as clean bed sheaths for the patient, in order to prevent puerperal fever. The hand washing was introduced by Semmelweis in 1847.

The first to advance as a definite hypothesis the contagious nature of puerperal fever, thus preceding Holmes and Semmelweis by half a century, was Alexander Gordon (1752-1799) of Aberdeen, Scotland. Oliver Wendell Holmes (1809-1894) of Cambridge, Massachusett, was the first to establish the contagious nature of puerperal fever. His essay on the subject took a strong line against opinions thus prevailing, stirring up violent opposition among the obstetricians of Philadelphia.

Bibliography

  • Hippocrates:
    Epidemics 1, case 4. In: [Works] with an English translation by W. H. Jones. London, W. Heinemann, 1923, 1: 193-195.
  • John Burton (1697-1771):
    An essay towards a complete new system of midwifery, theoretical and practical.
    London, J. Hodges, 1751.
    Burton was the first to suggest that puerperal fever is contagious, and the first to give a detailed discussion of Caesarean section.
  • John Leake (1729-1792):
    Practical Observations on the Child-bed Fever: also on the Nature and Treatment of Uterine Hæmorrhages, Convulsions, and Such Other Acute Diseases, as are Most Fatal to Women During the State of Pregnancy.
    London: Printed for J. Walters, . . . . [et al.], [1772]. Many later editions.
    Reprinted, London, Sydenham Society, 1949.
    John Leake, physician to the Westminster Lying-in Hospital, insisted on the contagious nature of puerperal fever.
  • Charles Powell White (1728-1813):
    A Treatise on the Management of Pregnant and Lying-in women.
    London, E. & C. Dilly, 1773.
    White was the first to state clearly in a text on midwifery the necessity of absolute cleanliness in the lying-in chamber, the isolation of infected patients, and adequate ventilation. He instituted the principle of uterine drainage, placing his patients in a sitting position shortly after delivery using a special bed and chair. In this he preceded Fowler. White was also the first after Hippocrates to make any substantial contributions towards the solution of the aetiology and management of puerperal fever.
  • A. Gordon:
    A treatise on the epidemic puerperal fever of Aberdeen.
    London, G. G. & J. Robinson, 1795.
  • O. Wendell Holmes:
    The contagiousness of puerperal fever.
    New England Quarterly Journal of Medicine and Surgery, April 1843, 1: 503-530.
    Reprinted in Medical Classics, 1936, 1: 211-243.
  • Puerperal fever, as a private pestilence. Boston, Ticknor & Fields, 1855.
    Reprinted in Medical Classics, 1936, 1: 245-268.
    Because his first paper had been published in a short-lived journal with very small circulation, Holmes enlarged his famous essay on the contagiousness of puerperal fever, and in the reiteration mentioned the steps already taken by Semmelweis.
  • Ferdinand von Hebra:
    Höchst wichtige Erfahrungen über die Aetiologie der in Gebäranstalten epidemischen Puerperalfieber.
    Zeitschrift der kaiserlich-königlichen Gesellschaft der Ärzte zu Wien, 1847, 4, pt. 2: 242-244.
    Zeitschrift der kaiserlich-königlichen Gesellschaft der Ärzte zu Wien, 1849, 5: 64-65.
    Ferdinand von Hebra wrote these two articles for Semmelweis.
  • I. P. Semmelweis:
    Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers.
    Pest-Wien-Leipzig, 1861.
    Reprinted with a new introduction by A. F. Guttmacher. New York-London, 1966. Translated into English by F. R. Murphy as The Etiology, the Concept and Prophylaxis of Childbed Fever, in Medical Classics, 1941; 5: 350-773.
    Semmelweis had no literary style and his book is difficult reading; it had an overwhelming mass of badly-presented statistics. Sir W. J. Sinclair, his biographer, said of him that "if he could have written like Oliver Wendell Holmes, his "Aetiology" would have conquered Europe in 12 months".
  • Louis Pasteur (1822-1895):
    Septicémie puerpérale.
    Bulletin de l'Académie de médecine, Paris, 1879, 2. série, 8: 505-508.
    Description of the streptococcus of puerperal sepsis.
  • Albert Sigmund Gustav Döderlein (1860-1941):
    Das Scheidensekret und seine Bedeutung für das Puerperalfieber.
    Leipzig, O. Durr, 1892. A classic description of the vaginal secretion in relation to puerperal fever. Includes the first description of ”Döderlein’s bacillus”.
  • Josef von Halban (1870-1937):
    Die pathologische Anatomie des Puerperalprozesses.
    Wien, Leipzig, W. Braumüller, 1919.
  • Eugen Anselm:
    Unsere Erfahrungen mit Prontosil bei Puerperalfieber.
    Deutsche medizinische Wochenschrift, 1935, 61: 264 (only).
    First report of the use of a microbial agent in the treatment of obstetric infections.
    Eugen Anselm was a member of the SS and an active participant in the NAZI politics of "racial cleaning".

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