Semmelweis and his predecessors

Abstract

Ignaz Semmelweis is generally known for identifying puerperal fever as an infectious disease preventable by aseptic methods. While no one today would contest the importance, the practicality, or the independence of his contribution, its originality has been disputed from the beginning. However, there is a basic methodological difference between Semmelweis’ work and the work of all those who are sometimes said to have preceded him in his discovery. Semmelweis was very likely the first to identify a single necessary cause for all cases of a particular disease and to recharacterize the disease in terms of that necessary cause. This strategy, which until now has generally been regarded as a contribution of those who worked on the infectious diseases, was necessary if medicine was to become an explanatory science and it has since become pervasive in most areas of medicine. Yet it was precisely this aspect of Semmelweis’s work that his contemporaries were unable to accept. Moreover, there is no reason to think that Rokitansky and Skoda, who have been identified as the intellectual fathers of Semmelweis’s work, agreed with, adopted, or even understood this crucial strategy. Thus Semmelweis was associated with and contributed to our modern medical research tradition in a more fundamental way than any of his so-called predecessors. © 1981, Cambridge University Press. All rights reserved.