knife. With little delay, Kolletschka became ill, eventually succumbing to
a massive infection. His body was dissected by his grieving coworkers,
who encountered pus throughout his abdominal cavity and organs in a
pattern all too familiar. Semmelweis was understandably traumatized by
the grisly nature of his friend’s death, reading and rereading the autopsy
transcript, when a shock wave of insight came over him. A decade later he
wrote:
Totally shattered, I brooded over the case with intense
emotion until suddenly a thought crossed my mind; at once it
became clear to me that childbed fever, the fatal sickness of
the newborn and the disease of Professor Kolletschka were
one and the same, because they all consist pathologically of
the same anatomic changes. If, therefore, in the case of
Professor Kolletschka general sepsis arose from the
inoculation of cadaver particles, then puerperal fever must
originate from the same source. Now it was only necessary to
decide from where and by what means the putrid cadaver
particles were introduced into the delivery cases. The fact of
the matter is that the transmitting source of those cadaver
particles was to be found in the hands of the students and
attending physicians.^6Semmelweis realized that his dedicated practice of daily morning
cadaver inspection, in an era of no handwashing and prior to the invention
of rubber or latex gloves, was leading to the introduction of “cadaver
particles” to his own obstetric patients. He concluded, “puerperal fever
was nothing more or less than cadaveric blood poisoning.”^7 In a slight
twist to the convention of the day, disease was not caused by the smell in
the air, but was instead triggered by the particles from the cadavers that
generated foul-smelling air. What Athanasius Kircher guessed were
“invisible living corpuscula” in 1658^8 and what Leeuwenhoek referred to
as “animalcules” he had visualized with his crude microscopes in 1677,^9
were microscopic creatures that had now become Semmelweis’s enemy.
Already in the 19th century Westerners were using chloride solutions to
rid homes and workplaces of the noxious odors of putrid materials;