‘Epoch-making’ paper on importance of handwashing goes to auction

After the last year, handwashing is anything but a novelty. But a 19th-century Hungarian doctor’s “epoch-making” – and controversial – announcement on the importance of clean hands is going up for auction.

Ignaz Semmelweis was a young house officer at the first obstetrical clinic of the Vienna General Hospital’s teaching unit. In 1847, he spotted that there was an extremely high rate of maternal and neonatal mortality in one of the hospital’s maternity wards – around 13% – while in the others the death rate was only 2%. The first clinic was used as a teaching facility for medical students, while the second was used to teach midwives. Semmelweis concluded that the medical students were carrying infections from the autopsy dissection rooms into the delivery rooms, and instigated a policy of strict handwashing using chlorinated limewater. The mortality rate subsequently dropped dramatically, to around 1%.

Semmelweis delivered a lecture about his discovery, The Origin of Puerperal Fever, in 1849. His colleague Ferdinand von Hebra published details of Semmelweis’s discovery in the journal of the Society of Viennese Doctors the following year, comparing it in importance to the discovery of the smallpox vaccine and urging others in the medical community to bring in their own handwashing procedures. A first edition of the journal will be auctioned by Christie’s next week, with a guide price of £12,000 to £18,000.

Semmelweis’s ideas were met with resistance during his lifetime. He eventually lost his job and died in a psychiatric institution at the age of 47 in 1865. His story wastold by Louis-Ferdinand Céline in his book Semmelweis: A Fictional Biography. And last year, the actor Mark Rylance planned to bring his life to the stage, until Covid got in the way.

Ahead of the auction, Christie’s called Semmelweis’s discovery “epoch-making”, and “one of the greatest achievements in the history of medicine”.

“The discovery by Dr Ignaz Semmelweis of the role of handwashing in preventing the spread of disease is now undisputed, but his methods were dismissed and ridiculed at the time,” said Christie’s specialist Mark Wiltshire. “His genius lay in noticing what nobody else did.”

Christie’s is also set to auction a letter from Edward Jenner, the English surgeon who discovered the smallpox vaccine, with a guide price of £4,000-£6,000. In the letter, Jenner apologises to one Mr Long – mostly likely William Long, a doctor in London – for the delay in shipping supplies of his new vaccine.

“Dr Jenner presents his compliments to Mr Long and is sorry it is not in his power to send him today any vaccine virus he can depend upon, but Mr Long may be assured of its being sent as soon as possible,” writes Jenner in the 1801 letter, adding: “Dr J is happy to find his little Patient has gone thro’ the Cowpox so pleasantly.”

Five years earlier, Jenner had spotted that milkmaids who had contracted cowpox were immune to the deadlier smallpox. On 14 May 1796, he scratched fluid from a cowpox blister into the arm of his gardener’s son, shortly afterwards injecting him with smallpox. No disease developed, and Jenner went on to carry out further trials, including on his 11-month-old son, publishing details of his discovery two years later.

Wiltshire said the two documents, particularly Jenner’s apology for a delay in vaccine supply, “feels particularly familiar at this moment in time”.

“These books and manuscripts are incredibly pertinent to today’s international situation – they take us to the origins of discoveries that are central to the battle against Covid-19,” he said. “In each case, these discoveries were founded upon an extraordinary perceptiveness and a determined application of the scientific method. Given their significance to the global battle against Covid-19, the giant leaps made by Dr Jenner and Dr Semmelweis now seem greater than ever.”