meeting him at the Vienna train station and asking him to visit a private
sanitarium. They eventually took Semmelweis to a state-run insane
asylum, where he was forcibly restrained and incarcerated. Within two
weeks, on August 13, 1865, Semmelweis died, his body being transported
to the Allgemeine Krankenhaus, and was autopsied in the very deadhouse
and on the same table as Kolletschka. The cause of death? Infection,
sepsis, and a large collection of pus in this chest—the selfsame illness that
he had decrypted twenty years before. Most scholars believe his lethal
infection originated from trauma and open wounds sustained during his
apprehension and restraint, not unusual for 19th century “madhouse”
patients. His was a sadly ironic end for the man who first showed the
world the value of handwashing and who set the stage for antisepsis and
broad acceptance of the germ theory.
As Semmelweis was dying in a Vienna insane asylum in 1865, one
thousand miles away in Glasgow, Scotland, the English surgeon Joseph
Lister was preparing a clinical experiment that was elegantly simple, but
profoundly important. An eleven-year-old boy was brought to the Glasgow
Royal Infirmary with a fractured tibia, the result of being run over by a
horse-drawn cart. His fracture was “compound,” or as we say today,
“open,” with the bone protruding through the skin. Open fractures have
always carried an alarmingly high complication rate, including loss of
limb and death. When shattered bones shear through the skin, a significant
degree of soft tissue destruction occurs, which devitalizes the skin,
potentiates bone infection (osteomyelitis), and complicates skin healing.
In 1865, almost no one had considered that putrefied post-traumatic
wounds were the byproduct of germs; Joseph Lister (independent of
Semmelweis) had already contemplated that possibility and was poised to
prove it to himself. Therefore, the day before Semmelweis died in Austria,
surgical antisepsis was begun in Scotland when Lister, instead of
reflexively amputating the boy’s leg, cleansed the wounds with carbolic
acid and applied a dressing doused with the same. In time, the boy’s
wounds healed, the bones knit themselves together, and the leg was saved.
Perhaps animalcules were real.