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Sándor Györfi, Ignaz Semmelweis sculplture

The Artist: Sándor Györfi

Sándor Györfi, sculptor Sándor Györfi 2

Sándor Györfi was born in the western Hungarian village of Kapolcs in 1951, into a farming family. The nearness to flora and fauna has substantially influenced his way of thinking and living, and continues to affect his artistic work to this day. In 1979, Györfi co-founded an art group, art-el and has organised a number of cultural programmes since 1991. These include the Valley of Arts Festival, Kapolcs, the Rézonences (french-hungarian) art-festival, Budapest; the AGORA Festival and  literary programmes in the Mura District of Hungary and overseas.

The Work of Art

Situated outside Building 28, the Health Cluster, the bronze bust of Ignaz Semmelweis is a major addition to the University's cultural collection being the only example of a sculpture of Semmelweis in Australia created by Sándor Györfi. The work of art is a gift from the Hungarian Government to the University of Canberra which acknowledges the University's work in health studies, the University's links through the Semmelweis Institute and strengthens our cultural links and friendship with Hungary.

Semmelweis Bust

Ignaz Semmelweis

Iganz Semmelweis was born into a Catholic German family living in Hungary on 1st July 1818. At this point, Hungary formed part of a wider state, the Austro-Hungarian Empire which comprised of ethnically diverse peoples spanning the Alps to the Balkans. 

Ignaz's father was a well-off merchant living comfortably in Buda (part of Buda-pest) and was comfortably well to do that he could send all of his sons to university. Ignaz attended the Buda Gymnasium, which he finished as 'eminens secundus (coming second of the year) in 1835. According to the desire of his father he enrolled as a law student in the University of Pest but a year later he moved to Vienna, to continue his studies. Whilst in Vienna, Semmelweis changed studies and switched to the medical faculty as he found just appealingly exciting the lectures and practices on pathology, anatomy and physiology and pondered the medical profession as the perfect invocation in order to help people.

During his studies, he kept moving between the two universities spending his third year at Pest and fourth and fifth at Vienna. He mad friendships with a number of colleagues and professors, notably the professors who were to become the shining figures of the Second Vienna Medical School.

Semmelweis qualified as a medical doctor in 1844  at Vienna but continued his studies to obtain his Masters Degree in obstetrics and surgery in 1845. In the following year, Semmelweis was appointed as a lecturer in obstetrics within the Vienna General Hospital.

Vienna General Hospital

Discovery

Childbed-fever, febris perperalis, was a widespread mortal disease during the 19th Century. Its mortality rate fluctuated between 5-15% at the Vienna General Hospital. There were two wards within the clinic, one attended by mdedical students while the other by midwives only. There was a huge difference in the mortality rates between the two wards; the average of the first was 11-15% whereas the other wasignifiicantly sless.

Childbed fever as a specific disease has been known since 1662 when the first correct description of it s symptoms appeared and when the term (febris puerpararum) was coined. By the mid 19th century there were a wide number of theories around the fever, though none came up with a plausible cause let alone cure.

Semmelweis studied the cases of the labouring women, carried out hundreds of autopsies, checked the records of the hospital and consulted patient records that could also benefit from the different mortality rates between the wards- would would be called a control group. 

Both Rokitansk's school of pathological or morbid anatomy, which was to find reasons of death via autopsies by analysing the changes in tissues and organs and establishing causative agents, and the exclusionem diagnotstic method of Joseph Skoda, which method was excluding explanations of a disease until arriving at an irrifutable diagnosis, influenced  Semmweis' mode of research. In May 1861, Semmelweis drew the right conclusions.

" Kolltschka, Professor of Forensic Medicine, often conducted autopsies for legal purposes in the company of students. During one such exercises, his finger was pricked by a student with the same knife that was being used in the autopsy. Professor Kollitschka contracted lymphangitis and plebitis in the upper extremity.Then he died of bilateral pleurisy, pericardits, peritonitis and meningitis. The maternity patients also had the same conditions. I was forced to recognise that the disease from which Kolletchka died was identical to that form which so many maternity patients died. The exciting cause of Professor Kolletschka's death was known; it was the wound by the autopsy knife that have been contaminated by cadaverous particles. It was not the wound but the contamination of the wound that caused his death.

I was forced to admit that if his disease was identical with the disease that killed so many maternity patients, then it must have originated  from the same cause that brought it on Kolletschaka.  In the examination of pregnant or delivering maternity patients, the hands, contaminated with caraverous particles, are brought into contact with the genitals of these patients.

To destroy such cadaverous matter adhering to the hands I used chlorina liquida. The practice began in the middle of May 1847. Both the students and I were required to wash before examinations. After a time, I adopted the less expensive chlorinated lime. In the remaining seven months of 1847, the mortality rate was below that of the patients int he second clinic. In these months, 1841 maternity patients cared for, only 56 died. '

According to Semmelweis puerperal fever is caused by a septic wound and is one kind of pyaemia. It is a type of sepsis, a complete body inflammation caused by an infection. Semmelweis also introduced reliable ways and means for its prevention in 1847.

Semmelweis's ideas started to proliferate across Europe through published articles, lectures and correspondence. However, political and professional changes in Semmelweis's life and within Hungary meant his ideas were initially limited. It took the efforts of Janos Balassa, a topmost physician, surgeon and linked to the revolutionary movements to surround himself with a team of medical mean, including Semmelweis. It is likely that Balassa recommended Semmelweis take up the role of obstetrician at the St Rochus Hospital in Pest in 1851. Here, Semmelweis was to further prove his ideas when only 8 out of 933 case died of child-bed fever.

In late 1854, the professorship in obstetrics at Petst Universtiy became vacant and Semmweis applied for the role and occupied the chair till August 1855.  In holding both roles of university chair and chief obstetrician, at St Rochus, Semmelweis was wealthy enough to settle down. In 1857, a the age of 39 he married Maria Eleonora Weidenhoffer, (who was 20). The couple resided in a huge apartment on the fashionable Vaci Street.

Maria and Ignaz Semmelweis

Debate and Criticism

By the 1860s, Semmelweis was a successful and respected member of the Hugarian medical society, a university professor, head physician and a leading figure in obstetrics. During 1860, Semmelweis completed his monograph on child-bed fever and published it under the title, 'The Etiology, Concept and Prophylaxis of Childbed Fever. Although it gave a good account of Semmelweis's discoveries, it also contained attacks on some of his opponents' theories as well. The result was that his ideas were regarded as mere absurdity by parts of the medical community. The main criticism from the medical community was that Semmelweis had argued a single cause for Child-bed Fever when they had come across seemingly different cases. Semmelweis identified that although the remains pathologically were different, the cause of the disease in itself was the same. To further arguments, Semmelweis published two open letters to professors of obstetrics backing his views.

Decline and death

Perhaps due to the workload or Semmelweis's determination to prove his ideas, life took a toll on Semmelweis. In the spring of 1865, his behavior suddenly changed. He began to eat immoderately and his relationships with his family cooled and worse, he was accused of inappropriate behavour at his workplace. With the signatures of colleagues  including Balassa, he was declared mentally ill. On  30th July 1865, Semmelweis, accompanied by his wife, and friends, he was taken to the Lower Austrian district Asylum in Bronnfield. In less than two weeks, Ignaz Semmelweiss died. The exact cause of death has been a matter of debate. The rapid aging gave ground to interpret Semmelweis' illness as Alzheimers disease. However, other theories include third stage syphilis following autopsy. This was common amongst obstetricians in the 19th Century. The syphilis led to paralysis progressiva which ended Semmelweis's life.

Legacy

By the time of Semmelweis' death, his principles were not generally recognised by the wider medical profession. It took at least a couple of decades before Semmelweis's ideas were incorporated into 'germ theory with the use of microscopic investigations.Investigation was one thing, practical application was another. Semmelweis had been successful in puttng into practice his theories in the delivery room- an approach later terms as the asceptic method.  

Quite possibly at the time that Semmelweis passed away, in Great Britain, Joseph Lister was introducing carbolic acid solutions for irrigating wounds . Lister later applied wide antiseptic means that included spraying dressings  and surgical instruments and even the air with the chemical solution. His arguments too into account the latest publications of Pasteur and others in microbiology and won him international praise. Towards the end of the 19th Century, Lister emphasised his admiration of Semmelweis on various occasions and it is likely that Semmelweis's ideas influenced Lister.

Twenty six years after Semmelweis passed away, a Memorial executive committee was established  to explore and disseminate Semmelweis's ideas. Work also gained momentum on establishing Semmelweis's name internationally, memorials and a place within the national pantheon of great Hungarians set aside for Semmelweis- which was unveiled on the 2nd September 1894. Semmelweis's character by this time was portrayed as a misunderstood fervent scientist tand the saviour of millions of mothers. By the 1930s he had become a world-wide role model for he self-sacrificing, life -saving doctors. His popularity and richness of his cult are evidenced by a number of biographies, films and theatrical plays.