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The History And The Importance of Handwashing.
-Diganta Datta
What is Childbed Fever ?
Childbed Fever can be described as a disease that occurs mainly as a result of bacterial infection in the uterine tract of women after giving birth or undergoing an abortion. Childbed Fever was devastating. It affected women within the first three days after childbirth and progressed rapidly, causing acute symptoms of severe abdominal pain, fever and debility.
Doctor Who Saved Life of Many
Reanalyzing Dr.Ignaz's Data
As we load our data we can see there are 4 columns which are 'year','births','deaths','clinics'.
So, lets talk about this dataset.
The data was being recorded each year from 1841- 1845, there are two clinics from which data is being collected that is Clinic 1 and Clinic 2
1. Deaths
Deaths are inevitable, yet the certain number of deaths are causes by some human errors. So in this dataset we have made a Proportional Deaths column to see the intensity of deaths per birth.
Proportional Death = Number of Birth / Number of Death
Lets take a look at the dataset after creating Proportional Death Column.
Now lets plot the data of Proportional Death for Clinic 1 vs Clinic 2 to see the intensity of deaths in each clinic.
So, if we see the data it indicates an interesting fact that Clinic 2 is much safer than Clinic 1. Why is the proportion of deaths constantly so much higher in Clinic 1?
2. Investigating the High Morbidity for Clinic 1
Semmelweis saw the same pattern and was puzzled and distressed. The only difference between the clinics was that many medical students served at Clinic 1, while mostly midwife students served at Clinic 2. While the midwives only tended to the women giving birth, the medical students also spent time in the autopsy rooms examining corpses.
Semmelweis started to suspect that something on the corpses, spread from the hands of the medical students, caused childbed fever. So in a desperate attempt to stop the high mortality rates, he decreed: Wash your hands! This was an unorthodox and controversial request, nobody in Vienna knew about bacteria at this point in time.
3. Effect of Handwashing
We can now look at the proportion of deaths over time. In the plot below we haven't marked where obligatory handwashing started, but it reduced the proportion of deaths to such a degree that you should be able to spot it!
6. The effect of handwashing highlighted
So we can easily see as Handwashing was made compulsory the Proportional Deaths decreases with time.
Starting from the summer of 1847 the proportion of deaths is drastically reduced and, yes, this was when Semmelweis made handwashing obligatory.
The effect of handwashing is made even more clear if we highlight this in the graph.
Conclusion
So handwashing reduced the proportion of deaths by between 6.7 and 10 percentage points, according to a 95% confidence interval. All in all, it would seem that Semmelweis had solid evidence that handwashing was a simple but highly effective procedure that could save many lives.
The tragedy is that, despite the evidence, Semmelweis' theory — that childbed fever was caused by some "substance" (what we today know as bacteria) from autopsy room corpses — was ridiculed by contemporary scientists. The medical community largely rejected his discovery and in 1849 he was forced to leave the Vienna General Hospital for good.
One reason for this was that statistics and statistical arguments were uncommon in medical science in the 1800s. Semmelweis only published his data as long tables of raw data, but he didn't show any graphs nor confidence intervals. If he would have had access to the analysis we've just put together he might have been more successful in getting the Viennese doctors to wash their hands.
The tragedy is that, despite the evidence, Semmelweis' theory — that childbed fever was caused by some "substance" (what we today know as bacteria) from autopsy room corpses — was ridiculed by contemporary scientists. The medical community largely rejected his discovery and in 1849 he was forced to leave the Vienna General Hospital for good.
One reason for this was that statistics and statistical arguments were uncommon in medical science in the 1800s. Semmelweis only published his data as long tables of raw data, but he didn't show any graphs nor confidence intervals. If he would have had access to the analysis we've just put together he might have been more successful in getting the Viennese doctors to wash their hands.
