Like Semmelweis himself, Nuland's book is short, intense and single-minded, and these larger themes and implications are left teeming underneath the text, for readers to peer in closely and uncover. ''To receive his due of honor,'' Nuland writes, Semmelweis ''had to be rediscovered.'' The Doctors' Plague succeeds for exactly that reason: in telling the story of childbed fever, Nuland has managed to rediscover a critical moment in the history of medicine, the anxieties of which, although somewhat attenuated, persist today.
In 1847, one out of every six women who delivered a baby in the First Division at the Allgemeine Krankenhaus hospital in Vienna died of childbed fever, a situation mirrored at other medical facilities in Europe and the U.S. Bestselling author Nuland (How We Die), a clinical professor of surgery at Yale, details in lively descriptive writing just how Ignac Semmelweis, an assistant physician at Allgemeine Krankenhaus, uncovered the origin of this devastating epidemic. Although theories were advanced that attributed it to unhealthy conditions in the expectant mother's body, Semmelweis launched his own investigation. He traced the high mortality rate from this fever in the First Division to the medical doctors, who went straight from dissecting cadavers to delivering babies without washing their hands; they were, in fact, infecting their own patients. Semmelweis's doctrine was controversial in medical circles, Nuland explains, partly because the eccentric physician's self-destructive personality alienated possible supporters. Drawing on careful research, the author convincingly argues that, contrary to popular myth, Semmelweis was not a persecuted victim but, despite his brilliance, was his own worst enemy. He was committed to a public mental institution and, according to Nuland, probably suffered from Alzheimer's and died from beatings administered by hospital personnel. In this engrossing story, Nuland shows how Semmelweis's groundbreaking discovery of how childbed fever was transmitted was later validated by the work of Louis Pasteur and Joseph Lister. (Oct.) FYI: This volume is the first in Norton's Great Discoveries series, which highlights scientific achievement. Copyright 2003 Reed Business Information.
At a time when diseases were attributed to "miasmata" or "effluvia," a brilliant young Hungarian doctor deduced why postpartum women's death rates were so staggeringly high even in the best of Europe's hospitals: the doctors charged with their care often went to their patients' bedsides straight from the autopsy laboratories. Although the germ theory of disease was to be confirmed by Pasteur, Lister, and Koch later in the 19th century, Ignac Semmelweis was the first to propose that many women would be saved from infection if these doctors merely improved their sanitary practices. Insulted, most of his colleagues reacted with outrage or indifference. Young women continued to die, and Semmelweis died in obscurity. Nuland, winner of the 1994 National Book Award for How We Die, is a distinguished biographer for Semmelweis. Continuing his research first published in a 1979 journal article, Nuland skillfully places Semmelweis in the context of 19th-century politics and scientific knowledge, and explores the probable sources of the physician's mysterious mental breakdown and death in an asylum. The Doctor's Plague is a thoughtful rediscovery of a significant medical pioneer and should be on the shelves of larger public and academic libraries. [Previewed in Prepub Alert, LJ 6/15/03; this book and David Foster Wallace's Everything and More are the debut entries in the new "Great Discoveries" series, copublished by Atlas Books and Norton.-Ed.]-Kathleen Arsenault, Univ. of South Florida at St. Petersburg Lib. Copyright 2003 Reed Business Information.
In the first of Norton's New Discoveries series on scientific breakthroughs, NBA-winner Nuland (How We Die, 1994, etc.) puts into proper historical context the achievements of a pioneering obstetrician. The author has turned his considerable narrative talents to a signal moment in the history of medicine. Nuland (Surgery/Yale School of Medicine) opens with the dramatic account of a young woman's death after delivering her first child at a hospital in mid-19th-century Vienna. He then turns to the cause of her death, childbed fever, vividly showing its horrific effects on the body and detailing several erroneous, now laughable theories doctors had come up with to explain its origin. Enter Ignac Semmelweis, an outsider from Hungary with a poor accent who had turned to obstetrics after failing to win appointment to his first- and second-choice positions at the hospital. A trained observer, Semmelweis analyzed obstetric procedures and claimed that childbed fever was caused by the transfer of invisible "putrid cadaver particles" from the hands of students and attending physicians. To prevent the disease, he insisted that every medical attendant wash in a chloride solution before examining a woman in labor. Nuland provides enough medical history to show how Semmelweis's 1847 accomplishment reflected the revolutionary teachings in scientific logic then being introduced by the hospital's chief of surgical pathology and how these were opposed by the old guard. When Semmelweis was refused reappointment to his position, he fled Vienna for his native Buda-Pest, having failed to perform experiments substantiating his claim, to make use of the microscope, or even to explain his work in a medicaljournal. He left support of his theory to others, though in 1861 he published a confused, angry, and essentially unreadable defense of his ideas that was largely ignored or rejected. Dementia preceded his death a few years later. A revealing account of a time, a place, and an unfortunate individual depicted here as his own worst enemy.