A Wikihole: The Other Taj Mahal, Louis Pasteur, and Maternal Mortality

To stop myself procrastinating, I use a redirector plugin in Firefox so that when I visit certain pages, I am redirected to https://en.wikipedia.org/wiki/Special:Random. Sometimes this works well, and reminds me to get back to work. Other times, I end up going down the Wiki hole and learning some interesting facts. I decided to start writing them down–this is the first one (and probably last :-)).

This time, I started at the list of tourist attractions in Aurangabad, and ended up at a lecture by Louis Pasteur which marked the beginning of the decline in maternal mortality, accounting for millions of saved lives.

Bibi Ka Maqbara: Not the Taj Mahal

The Wikihole begins at the List of tourist attractions in Aurangabad, which is already productivity-destroyingly full of reading material. However, you may notice a picture in the sidebar which looks awfully familiar.

This is actually Bibi Ka Maqbara, not the Taj Mahal. But you’d be forgiven for mistaking one for the other:

An interesting aside is that Bibi Ka Maqbara is in a sense the child of the Taj Mahal. Compare these Taj Mahal facts:

• Built by Shah Jahan (5th Emperor of the Mughal Empire)
• The tomb of his favourite wife, Mumtaz Mahal
• Architect Ustad Ahmad Lahori

To these Bibi Ka Maqbara facts:

• Aurangzeb, (6th Emperor of the Mughal Empire)
• The tomb of his favourite wife, Dilras Banu Begum
• Architect Ataullah Rashidi (the son of Ustad Ahmad Lahori!)

So not only was Bibi Ka Maqbara built by the emperor succeeding that of the Taj Mahal, its architect was the son of the architect of the Taj Mahal!

That aside, when I read the passage below, something caught my eye.

After giving birth to her fifth child, Muhammad Akbar, Dilras Banu Begum possibly suffered from puerperal fever, due to complications caused by the delivery and died a month after the birth of her son on 8 October 1657

What the heck is “Puerperal Fever”?

Puerperal Fever and Maternal Mortality

tl;dr: Puerperal Fever seems to be an old term for postpartum infection. Given that childbirth is quite a violent affair, it seems that infection must have been unfortunately quite common before antibiotics. We should therefore expect a sharp drop in the mortality rate around the time that Pencillin began being widely used. This chart from OurWorldInData seems to confirm it:

We can see a sharp dropoff in maternal mortality since the mid-1940s, at least in the nations listed. (It seems that, sadly, this is not the case everywhere in the world.)

But even before the decline in mortality after the introduction of penicillin, maternal mortality had been slowly decreasing. Eyeballing the chart, it looks like this began around 1880. What could have been causing this? It seems that the answer boils down to the mainstream acceptance of the germ theory of disease.

Semmelweiss, The Germ Theory of Disease, and Pasteur

Many are familiar with the sad tale of Ignaz Semmelweis, who argued for disinfection to prevent puerperal fever. Despite showing that hand disinfection with chlorinated water reduced maternal mortality rate, he died with his ideas largely ignored. (The full story is even more sad, and I strongly recommend reading his Wikipedia page).

Semmelweis died in 1865; too early to account for start in the decline of maternal mortality. So when did the Germ theory of disease begin to gain acceptance? Quoth Wikipedia:

(Semmelweis’) findings earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory, giving Semmelweis’ observations a theoretical explanation, and Joseph Lister, acting on Pasteur’s research, practised and operated using hygienic methods, with great success.

The answer seems to be a letter buried in a References section. In short, in 1880–our guess of the start of the decline in maternal mortality–Louis Pasteur published this paper. It describes a number of experiments describing the role played by “microscopic organisms” in puerperal fever. The paper is a wonderful read. Here, I’ll link it again..

So it seems this may have been the point that the germ theory of disease became mainstream, finally vindicating Semmelweis. In concluding, Pasteur writes

The antiseptic method I believe likely to be sovereign in the vast majority of cases.

And that’s how you go from The Other Taj Mahal to a letter by Louis Pasteur marking the start of the decline in maternal mortality.