What comes after antibiotics? Good old hand washing!

“Back in the old days, a scraped knee could kill.”

We have heard of this adage. It is practically the slogan for antibiotics and a warning for the impending doom that awaits us when widespread drug resistance renders antibiotics useless.

Luckily, we are not so defenseless. In Phantom Plague by Vidya Krishnan (Amazon) tells the story of how the mundane act of handwashing saved countless women from dying of childbed fever.

Childbed fever is a bacterial infection of the uterus acquired during childbirth. Now we know it can be transfered through contact with contaminated objects… think medical tools… or hands….

Since bacteria are invisible to the human eye, it never occurred to health care workers a century ago to wash their hands before interacting with a patient, even after going to the bathroom, treating another patient, or performing an autopsy.

Dr. Ignaz Semmelweis worked at a busy hospital with two maternity clinics, one clinic run by doctors and the other by midwives. The clinics used the same techniques yet the pregnant women around town prayed and begged to be admitted into the second. Why?

Even though the medical techniques were the same, the doctor-run clinic had a much higher mortality rate, sometimes approaching a death rate of 1 in 5 women in some months. Giving birth on the street was less risky than that!

Dr. S made it his mission to reduce this discrepancy. He made sure that the techniques were the same, the laundry service was the same, and even the food served was the same. Yet, death rates were still different.

Demoted and disheartened, he nearly gave up.

Then, a colleague of his died unexpectedly . During an autopsy of a woman who died of child-bed fever, he was accidentally poked with a scalpel. He soon had what looked a lot like childbed fever.

That’s when it clicked. It was as if the sickness jumped from the patient to the doctor, carried by some kind of “cadaverous particle” and it occurred to Dr S that the only remaining difference between the doctors and midwives was that the doctors performed autopsies, barehanded, and didn’t wash their hands afterwards.

Dr. S enforced policies to wash hands and sterilize the medical equipment. Within months, the mortality rate in the doctor-run clinic dropped from 18% to 0%.

Even without antibiotics, simple hygiene saved lives.

The story of Dr. Ignaz Semmelweis underscores the profound impact of something as seemingly simple as handwashing in safeguarding against bacterial infections. It serves as a poignant reminder that basic hygiene practices remain one of our most powerful weapons against infectious diseases.

Next time you face a scraped knee, don't let it fester; wash it out instead of waiting for antibiotics to swoop in and save the day!

As for Dr. S, he was not praised for his discovery or for the lives he saved. He was criticized and eventually committed to an asylum (though I think that had more to do with how he disseminated his message, including yelling at young couples in the street).

More on his story and the incredible ways that tuberculosis influenced society, including women’s fashion, can be found in Phantom Plague (Amazon).