The Doctor's Plague

Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis

Sherwin B. Nuland (View Bio)
Hardcover: W. W. Norton & Co., 2003; Paperback: W . W. Norton & Co. , 2004.

"The story of how doctors used to spred childbed fever from woman to woman in lying-in hospitals is chilling enough; the story of how they persisted in doing so in the face of overwhelming evidence of their guilt is bloodcurdling; and the story of the flawed hero who tried to persuade them otherwise but was let down by his own character flaws is tragic. A great read." — Matt Ridley, author of GENOME and THE RED QUEEN

"THE DOCTOR'S PLAGUE is a fascinating and unusual book — the biography of a failed genius and also of a seminal idea. The genius is Ignác Semmelweis, the brooding, meticulous nineteenth-century Hungarian obstetrician who deduced solely through observation of his patients how to stop the fevers that had made childbirth womankind's single most common cause of death for centuries. The idea was nothing less than the germ theory of disease. Decades before Pasteur and Lister, Semmelweis had the story nearly whole. But he could convince almost no one of it. And only Sherwin Nuland — who, with Oliver Sacks, is the master medical storyteller of our time — could give this true tale of science its full richness, strangeness, sadness, and humanity." — Atul Gawande, author of COMPLICATIONS: A Surgeon's Notes on an Imperfect Science

"Nuland...is a distinguished biographer for Semmelweis. Continuing his research first published in a 1979 journal article, Nuland skillfully places Semmelweis in the context of 19th-century politics and scientific knowledge, and explores the probable sources of the physician's mysterious mental breakdown and death in an asylum. THE DOCTOR'S PLAGUE is a thoughtful rediscovery of a significant medical pioneer." — Library Journal

"Like Semmelweis himself, Nuland's book is short, intense and single-minded, and these larger themes and implications are left teeming underneath the text, for readers to peer in closely and uncover. 'To receive his due of honor,' Nuland writes, Semmelweis 'had to be rediscovered.' THE DOCTOR'S PLAGUE succeeds for exactly that reason: in telling the story of childbed fever, Nuland has managed to rediscover a critical moment in the history of medicine, the anxieties of which, although somewhat attenuated, persist today." — The New York Times Book Review

"In 1847, one out of every six women who delivered a baby in the First Division at the Allgemeine Krankenhaus hospital in Vienna died of childbed fever, a situation mirrored at other medical facilities in Europe and the U.S.... [Nuland] details in lively descriptive writing just how Ignac Semmelweis...uncovered the origin of this devastating epidemic.... Drawing on careful research...convincingly argue[d].... [An] engrossing story." — Publishers Weekly

"[An] admirable history of the life and work of Semmelweis." — New England Journal of Medicine

"This book is a verminophobe's worst nightmare, though in the mid-19th century the fear of germs wasn't a recognizable phobia: Medical science hadn't discovered germs yet, let alone understood their connection to sickness and disease.... The rudimentary ignorance of the recent medical past is still a shock.... But primitive procedures such as bleeding and leeches were still being used in mid-19th century Vienna, which was then the locus of medical knowledge and the setting for Sherwin B. Nuland's THE DOCTOR'S PLAGUE.... Semmelweis, a relatively obscure Hungarian obstetrician, concluded through careful investigation and a bit of fortuitous reasoning that childbed fever was being spread from patient to patient by none other than the doctors themselves, who would dash from being elbow-deep in pathology in the autopsy room to attend to patients without washing their hands. This idea caused upheaval and pitted the notions of many older physicians against those of their younger colleagues. There was not only a medical clash, but a political and social one as well. Semmelweis's reckless hostility toward the medical establishment and his self-destructive deterioration ended with others such as Pasteur, Lister and Koch defining the germ theory of disease and Semmelweis's untimely death in a mental institution.... THE DOCTOR'S PLAGUE has a compulsively readable storyline, and Nuland's instincts for exposition are on target, meaning that he does a superb job of clearly describing the social and medical atmosphere of that time. He also uses the right amount of scientific detail; not so much that a layperson would be frustrated or confused, yet enough so that the depth of the issues and conflicts were easily understandable.... Nuland's conclusions attempt to redefine the mythology that has attached itself to Semmelweis, who has been upheld as a lonely iconoclast fighting against the obtuseness of the established medical hierarchy. Although there is a bit of truth to that, by humanizing the doctor and recasting a story of scientific ignorance into a larger study of hubris and personal tragedy, Nuland makes clear how difficult the discovery really was." — San Francisco Chronicle

"In the first of Norton's New Discoveries series on scientific breakthroughs, NBA-winner Nuland puts into proper historical context the achievements of a pioneering obstetrician. The author has turned his considerable narrative talents to a signal moment in the history of medicine. Nuland opens with the dramatic account of a young woman's death after delivering her first child at a hospital in mid-19th-century Vienna. He then turns to the cause of her death, childbed fever, vividly showing its horrific effects on the body and detailing several erroneous, now laughable theories doctors had come up with to explain its origin.... Nuland provides enough medical history to show how Semmelweis's 1847 accomplishment reflected the revolutionary teachings in scientific logic then being introduced by the hospital's chief of surgical pathology and how these were opposed by the old guard.... A revealing account of a time, a place, and an unfortunate individual depicted here as his own worst enemy." — Kirkus Reviews

"A cleanly — and clearly — written biography.... Like the best biographers, Nuland is careful to offer a balanced portrait, diagnosing Semmelweis with the exactitude of a good clinician and avoiding the 'hero destroyed...by forces beyond his control' archetype.... [It is a] lesson in how discovery is pyramidial, based on a combination of circumstance, obsession, and the work of one's predecessors.... [It] demonstrate[s] how difficult it is — once a monumental discovery has been made — to get human beings to question their basic assumptions. If dunking your hands and forceps in a basin of chloride solution can save hundreds of thousands of lives, you can't help but wonder what simple, fundamental truths we are still missing. Books about great discoveries remind us how much there is left to discover, how we are only doing our best, fumbling through the darkness, toward an inacessible infinity of understanding." — Boston Globe