"The Discovery"  and "Introduction of Antisepsis" as reported by Semmelweis in his "Etiology, Understanding and Prevention of Childbed Fever."*

     Discovery: "On the 20th of March of the same year (1847), a few hours after my return to Vienna, I resumed with renewed energies the duties of the post of assistant in the First Obstetric Clinic, but I was soon shocked by the sad news that Professor Kolletschka, whom I held in the highest honour, had died in the meantime." The following is the history of the case: Kolletschka, professor of medical jurisprudence, often performed post-mortem examinations in medico-legal cases with the assistance of his students. In the course of one such examination he received a puncture wound of the finger from the knife of one of the pupils. Professor Kolletschka thereupon became affected with lymphangitis, phlebitis in the same upper extremity, and he died from pleurisy pericarditis, peritonitis, and meningitis, and a few days before his death metastasis occurred in one of the eyes.
     …In the excited condition in which I then was, it rushed into my mind with irresistible clearness that the disease from which Kolletschka had died was identical with that from which I had seen so many hundreds of lying-in women die. The puerperae also died from phlebitis, lymphangitis, peritonitis, pleuritis, meningitis and in them also metastases sometime occurred.
     "Day and night the vision of Kolletschka's malady haunted me, and with ever increasing conviction I recognized the identity of the disease from which Kolletschka died with the malady which I had observed to carry off so may lying-in women."
     The former conclusions with regard to the identity of the fatal disease of new-born infants with that childbed fever so fatal to the mothers also recurred to the mind, and supported the conviction with regard to the malady of Kolletschka." The cause of the fatal illness of Kolletschka was well known: it was the wound produced by a dissecting scalpel which was foul with cadaveric particles. It was not the wound, but the wound rendered unclean by cadaveric material, which had produced the fatal result; and Kolletschka was far from being the first to die in this manner. If then it be granted that the disease by which Kolletschka lost his life and that from which so many lying-in women died, are identical, the cause of the disease in the lying-in women and that of Kolletschka must be the same. In the case of Kolletschka the cause of the disease was cadaveric material carried into the vascular system: I must therefore put this question to myself: Did then the individuals whom I have seen die from an identical disease also have cadaveric matter carried into the vascular system? To this question I must answer, Yes!"
     Owing to the anatomical tendency of the Vienna School of medicine, professors, assistants, and students had frequently occasion to come into contact with the cadaver. According to the usual method of washing the hands, merely with soap and water, the cadaveric particles adhering to the hands were never completely removed, a fact demonstrated by the cadaveric odour which the hands retained for a long or short time after washing. In examinations of pregnant, parturient, and puerperal women, the hand made unclean by cadaveric material was brought into contact with the genitals, hence the possibility of resorption and by resorption the convey of cadveric matter in the vascular system of the patient. In this way was produced in the lying-in woman the same disease as that from which Kolletschka died.
     If this theory that the cadaveric material adhering to the hand can produce the same disease as the cadaveric particles adhering to the scalpel be correct, then if the cadaveric material on the hands can be completely destroyed by chemical agencies, and the genitals of the woman in labour or in the lying-in state, be brought into contact with the clean fingers only, and not simultaneously with cadaveric particles, then the disease can be prevented to the extent to which it originated by the presence of cadaveric material on the examining fingers (ed. !).

Introduction of Antisepsis: "In order to destroy the cadaveric material adhering to the hands, I began about the middle of May, 1847, to employ chlorina liquida with which every student was required to wash his hands before making an examination.  After a short time a solution of chlorinated lime was substituted because it was not so expensive.  In the month of May, 1847, the mortality in the first Clinic still amounted to over 12 per cent, with the remaining seven months it was reduced in very remarkable degree."  In the first seven months mortality was 3 per cent compared to 11.4 per cent prior to introduction of antisepsis.  This compared to 2.7 per cent in the Second Division.  In 1848 the mortality fell to 1.27 per cent versus 1.3 percent in the Second Division.  "In 1848 there were two months, March and August, in which not one single death occurred among the patients of the First Division."

* from "Semmelweis, His Life and his Doctrine", W.J.Sinclair, Manchester University Press,1909, p. 48-51.

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