The Semmelweis Reflex: Why May We Be Wrong?

 March 18, 2012

Not long ago I was thrilled by this story of a Hungarian doctor who lived in the heat of the scientific revolution and seemed to have gone so far ahead of his time that it destroyed his life.

His name was Ignaz Semmelweis, he was 29 when in 1847 he began his work as an assistant to the professor of the maternity clinic at the Vienna General Hospital in Austria (Benedek 1983). Just at the time there was a sharp rise in death rates among midwives as well as female patients right after giving birth. The nature of what was called puerperal, or childbed fever was attributed to very specific causes that, as it was believed, varied uniquely from case to case and could not be explained by a universal theory since every human being is unique.

Semmelweis was the only physician to propose that all the cases went down to one cause – the lack of cleanliness leading to the accumulation of cadaverous particles on one’s hands and causing contamination of a person who comes in contact with them (Benedek 1983). He observed that many doctors were alternating the delivery of babies with performing autopsies in post-mortem examinations. Ultimately, he suggested that the doctors and midwives simply wash their hands in chlorine lime solutions before each procedure (Hanninen 1983:370).

Although the results were immediate (the mortality rates dropped by 90% within months) Semmelweis soon had faced fierce opposition on the part of the major medical community as the very idea of causing death by a simple touch was at the time perceived similarly to witchcraft and sorcery! Soon he lost his job at the clinic, though for political reasons, and moved back to Hungary where he wrote down his hypotheses in his book Etiology, Concept and Prophylaxis of Childbed Fever (1859).

To understand such fierce reaction from doctors it is important to look back at the time when this was happening. The early 19th century saw the blossoming of the industrial revolution, with the shift of the scientific paradigm from the idealistic to the mechanical worldview established by Isaac Newton. The world had begun to be viewed as a gigantic mechanism whose capstone was PHYSICAL FORCE, which implied that the extent of physical damage could only be measured in physical units. 

Simultaneously, the newly-formed scientific society had begun to move away from the medieval interpretations and practices of curing diseases. With the triumph of reason methods such as herbs, health potions, sorcery along with prayer, sprinkling of holy water were now deemed as irrational and soon became tabooed by materialists. Inevitably, those who practiced such methods were ridiculed. So was Semmelweis who in the eyes of his contemporaries, all medical intellectuals and renowned practitioners, was reverting to medieval times. He was criticized, mocked and harassed by the medical community. Moreover, as K. Carter notes, some doctors were offended at the suggestion that they should wash their hands; they felt that their social status as gentlemen was inconsistent with the idea that their hands could be unclean (Carter 2005).

So it wasn’t until several decades later that Louis Pasteur confirmed the germ theory that led to the establishing of bacteriology as a science and acquitted Semmelweis in the eyes of the scientific community. Unfortunately, Semmelweis wasn’t able to enjoy the celebration of his ideas. After two weeks in the mental asylum where he had been placed at the urging of his counterparts who believed him to have lost his mind he allegedly died of septicaemia, the very disease he had fought for so long. According to other reports, he was murdered by the guards.

There is no doubt that the Enlightment era advanced the world a great deal: steam engine, lever, gear wheel, thermodynamics laws – all this was great. However, these inventions do not apply to everything there is. Battling one superstition those scientists fell into another, not realizing that human organism is a way more complicated structure then they thought. Now we live in a materialistic humanistic society where scientists believe that G-d is a superstition, not only He but many other things such as marriage, premarital purity and physical abstention. But can it turn out that we are killing a woman in labor with our unclean hands? While for many people it’s not a question anymore, others should stop for a moment and seriously ask themselves: may we be wrong?

Read also: 

Medical History: Semmelweis and the Great Handwashing Mystery