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Semmelweis's exposure to the childbed fever was concurrent with his appointment to the Vienna maternity hospital in 1846. Like many similar hospitals and clinics in the major cities of nineteenth-century Europe and America, where death rates from the illness sometimes climbed as high as 40 percent of admitted patients, the Viennese wards were ravaged by the fever. Intensely troubled by the tragic and baffling loss of so many young mothers, Semmelweis sought answers. The Etiology was testimony to his success. Based on overwhelming personal evidence, it constituted a classic description of a disease, its causes, and its prevention. It also allowed a necessary response to the obstetrician's already vocal, rabid, and perhaps predictable critics. For Semmelweis's central thesis was a startling one - the fever, he correctly surmised, was caused not by epidemic or endemic influences but by unsterilized and thus often contaminated hands of the attending physicians themselves.
In the nineteenth century, tens of thousands of women died each year from childbed fever. The Carters describe birthing conditions and medical practices in Vienna during the time when young Semmelweis began to work in a maternity clinic there. He discovered that childbed fever arose because medical personnel did not wash adequately after dissecting corpses before doing vaginal examinations of women in labor. After he required students to disinfect themselves, the mortality rate immediately dropped. However, Semmelweis's views were not accepted by the senior physicians who believed the disease was due to a variety of causes. After strident attempts to persuade skeptics, Semmelweis was committed to a Viennese insane asylum where he died at age 42, possibly from beatings by asylum guards. Childbed fever, now called puerperal infection, continues to be a leading cause of maternal mortality, in spite of the best efforts of modern physicians.
The fascinating story of Ignaz Semmelweis, a nineteenth-century obstetrician ostracized for his strident advocacy of disinfection as a way to prevent childbed fever In Genius Belabored: Childbed Fever and the Tragic Life of Ignaz Semmelweis, Theodore G. Obenchain traces the life story of a nineteenth-century Hungarian obstetrician who was shunned and marginalized by the medical establishment for advancing a far-sighted but unorthodox solution to the appalling mortality rates that plagued new mothers of the day. In engrossing detail, Obenchain recreates for readers the sights, smells, and activities within a hospital of that day. In an era before the acceptance of modern germ science, physicians saw little need for cleanliness or hygiene. As a consequence, antiseptic measures were lax and rudimentary. Especially vulnerable to contamination were new mothers, who frequently contracted and died from childbed fever (puerperal fever). Genius Belabored follows Semmelweis’s awakening to the insight that many of these deaths could be avoided with basic antiseptic measures like hand washing. The medical establishment, intellectually unprepared for Semmelweis’s prescient hypothesis, rejected it for a number of reasons. It was unorthodox and went against the lingering Christian tradition that the dangers of childbirth were inherent to the lives of women. Complicating matters, colleagues did not consider Semmelweis an easy physician to work with. His peers described him as strange and eccentric. Obenchain offers an empathetic and insightful argument that Semmelweis suffered from bipolar disorder and illuminates how his colleagues, however dedicated to empirical science they might have been, misjudged Semmelweis’s methods based upon ignorance and their emotional discomfort with him. In Genius Belabored, Obenchain identifies Semmelweis’s rightful place in the pantheon of scientists and physicians whose discoveries have saved the lives of millions. Obenchain’s biography of Semmelweis offers unique insights into the practice of medicine and the mindsets of physicians working in the premodern era. This fascinating study offers much of interest to general readers as well as those interested in germ theory, the history of medicine and obstetrics, or anyone wishing to better understand the trajectory of modern medicine.
A narrative of one of the key turning points in medical history.
Oliver Wendell Holmes Sr., (1809-1894) was a physician by profession but achieved fame as a writer. He was one of the best regarded American poets of the 19th century. In 1833 Holmes attended the famed Ecole de Medecine in Paris. He pursued his medical studies in the Parisian hospital system. He first attained national prominence with his poem Old Ironsides. One of his most popular works was The Autocrat of the Breakfast Table (1857). He was one of the five members of the group known as the Fireside Poets. He contributed poems and essays to the Atlantic Monthly from its inception, and also published novels. Holmes is also known for his writing of several beautiful hymns. In 1846, Holmes coined the word anesthesia. He also developed the popular model of the stereoscope. Amongst his other works are Elsie Venner (1861), The Guardian Angel (1867), The Poet at the Breakfast-Table (1872), John Lothrop Motley: A Memoir (1879), Medical Essays (1883), A Mortal Antipathy: First Opening of the New Portfolio (1885) and Over the Teacups (1891).
Named as Choice Outstanding Academic Title 2012 From Hippocrates to Lillian Wald—the stories of scientists whose work changed the way we think about and treat infection. Describes the genesis of the germ theory of disease by a dozen seminal thinkers such as Jenner, Lister, and Ehrlich. Presents the "inside stories" of these pioneers' struggles to have their work accepted, which can inform strategies for tackling current crises in infectious diseases and motivate and support today's scientists. Relevant to anyone interested in microbiology, infectious disease, or how medical discoveries shape our modern understanding
First edition published in 2002. Second edition published in 2008.
The most comprehensive evidence-based guide to both obstetrics and gynecology Aimed at practicing obstetricians, gynecologists, and trainees in the specialty, Evidence-based Obstetrics and Gynecology concentrates on the clinical practice areas of diagnosis, investigation and management. The first section of the book discusses evidence-based medicine methodology in the context of the two specialties. The second and third sections cover all the major conditions in obstetrics and gynecology, with each chapter reviewing the best available evidence for management of the particular condition. The chapters are structured in line with EBM methodology, meaning the cases generate the relevant clinical questions. Evidence-based Obstetrics and Gynecology provides in-depth chapter coverage of abnormal vaginal bleeding; ectopic pregnancy; pelvic pain; lower genital tract infections; contraception and sterilization; breast diseases; urogynecology; endocrinology and infertility; puberty and precocious puberty; cervical dysplasia and HPV; cervical, vaginal, vulvar, uterine, and ovarian cancer; preconception care; prenatal care and diagnosis; drugs and medications in pregnancy; maternal complications; chronic hypertension; diabetes mellitus; thyroid disease; neurologic disease; psychiatric disease; postterm pregnancy; fetal complications; preeclampsia; and more. First book to address evidence-based practice for obstetrics and gynecology combined EBM is a highly relevant approach for this high risk specialty Edited by leading US specialist involved in the evidence-based medicine movement Evidence-Based Obstetrics and Gynecology is an important text for obstetricians and gynecologists in practice and in training, as well as for specialist nurses.
This book provides an evidence-based, practical approach to the diagnosis and treatment of the most frequent fungal infections in a general hospital. It offers a comprehensive overview of the basic medical and scientific background of fungal infections and carefully explains and discusses epidemiology, pathogenesis, and clinical presentation. Readers will acquire a good and clear perception of invasive fungal infections, including diagnosis and treatment. This user-friendly resource not only serves as a valuable tool in clinical management, but also provides the basis for further research questions and studies in this particular field. It will be a useful companion for midwives as well as for doctors, medical and pharmacy students, nurses and other healthcare professionals.
Randomized controlled trials are one of the most powerful and revolutionary tools of research. This book is a convenient and accessible description of the underlying principles and practice of randomized controlled trials and their role in clinical decision-making. Structured in a jargon-free question-and-answer format, each chapter provides concise and understandable information on a different aspect of randomized controlled trials, from the basics of trial design and terminology to the interpretation of results and their use in driving evidence-based medicine. The authors end each chapter with their musings, going beyond the evidence or citations, and sometimes even beyond orthodox correctness to share their thoughts and concerns about different aspects of randomized controlled trials, and their role within the health system. Updated to include insights from the last decade, this second edition challenges over-reliance on randomized controlled trials by debating their strengths and limitations and discussing their optimal use in modern healthcare. It also includes a new and increasingly relevant chapter on the ethics of randomized trials. World renowned writers and thinkers Drs Jadad and Enkin bring you this invaluable book for busy health professionals who wish to understand the theory of randomized controlled trials and their influence on clinical, research or policy decisions.