Ignaz Semmelweis - Breakdown, Death and Oblivion

Breakdown, Death and Oblivion

Beginning in 1861, Semmelweis suffered from various nervous complaints. He suffered from severe depression and became excessively absentminded. Paintings from 1857 to 1864 show a progression of aging. He turned every conversation to the topic of childbed fever.

After a number of unfavorable foreign reviews of his 1861 book, Semmelweis lashed out against his critics in a series of Open Letters. They were addressed to various prominent European obstetricians, including Späth, Scanzoni, Siebold, and to "all obstetricians". They were full of bitterness, desperation, and fury and were "highly polemical and superlatively offensive" at times denouncing his critics as irresponsible murderers or ignoramuses. He also called upon Siebold to arrange a meeting of German obstetricians somewhere in Germany to provide a forum for discussions on puerperal fever where he would stay "until all have been converted to his theory.".

In mid-1865, his public behaviour became irritating and embarrassing to his associates. He also began to drink immoderately; he spent progressively more time away from his family, sometimes in the company of a prostitute; and his wife noticed changes in his sexual behavior. On July 13, 1865 the Semmelweis family visited friends, and during the visit Semmelweis's behavior seemed particularly inappropriate.

It is impossible to appraise the nature of Semmelweis's disorder. It may have been Alzheimer's disease, a type of dementia, which is associated with rapid cognitive decline and mood changes. It may have been third stage syphilis, a then-common disease of obstetricians who examined thousands of women at gratis institutions. Or it may have been emotional exhaustion from overwork and stress.

In 1865 János Balassa wrote a document referring Semmelweis to a mental institution. On July 30 Ferdinand Ritter von Hebra lured him, under the pretense of visiting one of Hebra's "new Institutes", to a Viennese insane asylum located in Lazarettgasse (Landes-Irren-Anstalt in der Lazarettgasse). Semmelweis surmised what was happening and tried to leave. He was severely beaten by several guards, secured in a straitjacket and confined to a darkened cell. Apart from the straitjacket, treatments at the mental institution included dousing with cold water and administering castor oil, a laxative. He died after two weeks, on August 13, 1865, aged 47, from a gangrenous wound, possibly caused by the beating. The autopsy revealed extensive internal injuries, the cause of death pyemia—blood poisoning.

Semmelweis was buried in Vienna on August 15, 1865. Only a few people attended the service. Brief announcements of his death appeared in a few medical periodicals in Vienna and Budapest. Although the rules of the Hungarian Association of Physicians and Natural Scientists specified that a commemorative address be delivered in honor of a member who had died in the preceding year, there was no address for Semmelweis; his death was never even mentioned.

János Diescher was appointed Semmelweis's successor at the Pest University maternity clinic. Immediately mortality rates jumped sixfold to six percent. But the physicians of Budapest said nothing; there were no inquiries and no protests. Almost no one — either in Vienna or in Budapest — seems to have been willing to acknowledge Semmelweis's life and work.

His remains were transferred to Budapest in 1891. On October 11, 1964 they were transferred once more to the house in which he was born. The house is now a historical museum and library, honoring Ignaz Semmelweis.