Epidemiologic investigation of excess maternal and neonatal deaths and evidence-based low-cost public health interventions - Ignaz Semmelweis: the etiology, concept and prophylaxis of child bed fever[1].

aIndian Institute of Health Management Research, Jaipur, India. Correspondence to S D Gupta (e-mail: [email protected]) Introduction When I look back upon the past, I can only dispel the sadness which fall upon me by gazing into that happy future when the infection will be banished .... The conviction that such a time must inevitably sooner than later arrive will cheer my dying hour. So wrote Ignaz Semmelweis in his last days while he suffered depression due to continued criticism by medical professionals and colleagues. Semmelweis suggested that simple handwashing with chlorinated water could prevent the spread of infection and save the lives of women in maternity.2 His methods showed that maternal deaths due to puerperal fever reduced from 12.2% to 2.4% in maternity wards. He expanded his methods to washing of instruments, which altogether removed puerperal infection in the hospital. However, his observations were in serious conflict with contemporary scientific and medical opinions, which rejected his observations. His suggestion that doctors should wash their hands with chlorinated lime even offended some doctors and his colleagues. They refused to accept that they could be responsible for spreading infection. Semmelweis’s claims were thought to lack scientific basis and his practice of antiseptic use only gained acceptance years after his death, when Louis Pasteur3 invented the germ theory of disease in 1862, and Joseph Lister4 invented methods for antiseptic surgery in 1867.