Who directed that in his wards the students were to wash and disinfect there hands before going to examine a process women in labor and deliver infants?

Dr. Ignaz Semmelweis, a Hungarian practicing in Vienna, Austria, in 1847.

Dr. Oliver Wendell Holmes in Boston was the first to realize that puerperal fever, an often deadly infection contracted by women during or shortly after childbirth, was spread from one infected patient to other patients attended by the same doctor. He stated that a physician who had a patient with puerperal fever should purify his instruments, burn the clothing he had worn while assisting any woman who had died of the fever, and even abstain from obstetric practice for a period of at least six months. Holmes' contention conflicted with the established medical practices of the time (which did not yet include the spread of any disease by germ theory since Louis Pasteur had not yet discovered it), Respected doctors spoke out strongly against Holmes' theory and Holmes himself was primarily a professor and lecturer, not a practicing doctor, so his suggestions were not followed.

A few years later, Dr. Ignaz Semmelweis in Vienna would reach a similar conclusion regarding the spread of puerperal fever by contact from infected cadavers being autopsied to doctor to healthy patient. Semmelweiss suggestsed the simple practice of handwashing in chlorine solution by any person who would be assisting at a delivery and by everyone with whom he worked while doing autopsies. He was practicing at the Vienna Hospital at the time and so could put his theory to the test, with the doctors and other workers in one ward following his recommendation of handwashing and the workers in another ward following their usual practice. The lowered death rate in the ward that practiced handwashing should have provided evidence that Semmelweiss' suggestion was effective. Semmelweiss could not provide an explanation for his results (again, the germ theory had not yet been discovered) and that contributed to the vehement opposition to handwashing by the medical establishment. Semmelweiss lamented, " In published medical works my teachings are either ignored or attacked.". His term of employment at the hospital was not renewed. Semmelweiss' behavior became increasingly irration a few years later and in 1865 he was committed to a mental institution. He died two weeks later after being beaten by guards.

Semmelweiss' recommendation of prophylaxis (washing before treating patients) is now of course widespread, but it took Louis Pasteur's discovery of germ theory to make it accepted.