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I don't know what this means. Can you expand on your statement? Who is this person? What would we be farther forward to?



Doctors used to perform procedures with their bare hands, sometimes immediately after performing necropsies on dead bodies. This guy made the connection that such contamination was causing post-birth complications such as infections. He had his medical students wash their hands in an antiseptic solution, compiled statistics which showed lower mortality rates, was ignored, started publicly denouncing the negligence of the other doctors and ended up interned in some sanatorium and killed for his trouble.

Doctors used to believe they were such gentlemen their hands could not possibly be dirty and contaminated.


It wasn’t just doctors, “a gentleman never washes his hands because a gentleman’s hands are never dirty.” Was the common thought.

NB, not all men were considered gentlemen.

See also surgeons cuffs on coats (blazers), so as to avoid getting blood on one’s clothes when operating, which are still called the same thing today.


Clearly they mixed up cause and effect.

"A gentleman's hands are never dirty" should have meant that he keeps them clean, not that his gentlemanliness somehow keeps them from being dirty.


Doctors routinely washed their hands before Semmelweis, whose innovation was chlorinated hand washing; he ended up in a sanatorium because he went crazy (he likely had an advanced case of syphilis); the connection he made was that "cadaveric particles" were causing illness in hospitals, which is problematic because the phenomenon occurred in circumstances where no cadavers availed, but he was apparently absolutely hung up on the cadaveric nature of the threat.

He's a complicated dude.


> Doctors routinely washed their hands before Semmelweis

The cringeworthy "gentlemen don't wash their hands" culture contradicts that.

> he ended up in a sanatorium because he went crazy (he likely had an advanced case of syphilis)

I see no evidence of this so called "craziness". Even the people who speculated about the cause included "emotional exhaustion from overwork and stress" as a possibility. That's the simplest explanation, probably what happened and it's absolutely to be expected when you discover you've been unwittingly killing your patients due to the ignorance of mankind, successfully devise countermeasures and prove their effectiveness only to have your peers and the scientific community all band together to gaslight you. He ended up in an asylum because he "embarrassed" them.

> the connection he made was that "cadaveric particles" were causing illness in hospitals

Of course. More women died when he and his medical students delivered their children after working with corpses than when they didn't. The connection is there, the fact it did not fully explain the phenomena does not invalidate it. Nor does it invalidate the reduction in mortality after hand sanitization was implemented.

That this was denied despite reproducible statistical evidence is absolutely shameful for all involved and a heavy lesson for all time. Women died because of it. Don't minimize it.


You can just go look this up instead of trying to rebut it through axiomatic derivation from a meme. Doctors washed their hands in Semmelweiss's time. There's a reason writeups of his contributions often include the recipe for his decontamination solution; that's the novelty, of antiseptic washes versus ordinary soap and water.

Similarly, you can just go look up Semmelweis' mental state at the time of his commitment.

The difference between Semmelweis's incorrect theory of what was causing childbed fever and reality is a big part of why his interventions were rejected (that, and the fact that he was apparently an unholy asshole) --- he was trying to convince his colleagues to disinfect their hands from particles that sometimes could not have existed, and the colleagues noticed that. If you're trying to evangelize a new medical intervention, don't get hung up on an explanation that can't possibly be correct, is one lesson to take from this.

Complicated dude. Read more about him than you have. It's interesting stuff. His story is more than just the airport bookstore management parable that it's become.

later

As a quick PS: the "gentleman's hands" thing came up on an AskHistorians thread I just read, and it's apparently a misquote. It's not "gentleman don't wash their hands"; it's "a gentleman's hands are clean". As in, doctors already keep their hands clean. What they didn't do was chlorinate the water they used (or clean all that hard).

That's obviously false! The contagionists and aseptics were right, the spontaneous generation people were wrong, and obviously aseptic procedure before Gordon and later Holmes and later Semmelweis was inadequate. I'm not defending the guy who said that. But he didn't say what you think he said.


The incompleteness of the theory is completely irrelevant. He published results and reproduced his findings. He correlated a rise in mortality to the time the necropsies started, and he demonstrated a decrease in mortality after implementing his hand sanitization method twice. That's more trustworthy than quite a bit of what passses for science even today. Doesn't matter how much of an asshole he was, when faced with that undeniable evidence clearly showing that women were dying less the last thing those scientists should have done was dismiss it out of hand and condemn women to death for their negligence. To me it sounds like they deserved every bit of denouncing they got and then some.


All of this matters. You write as if he provided a succinct record of a series of experiments he conducted; in fact, he infamously wrote ponderous and impenetrable litanies on the precise cadaveric origin of the particles he thought he was combating. I understand the message board rhetorical strategy of trying to put me on the other side of the aseptic revolution, but (1) no and (2) that has nothing to do with what I'm writing. The bar you need to clear here is much higher than "Semmelweis was correct about chlorinated lime".


> he infamously wrote ponderous and impenetrable litanies on the precise cadaveric origin of the particles he thought he was combating

Which doesn't invalidate the fact that women provably died less after his methods of combating those particles were implemented and published. Faced with that evidence, they should have accepted the method even if they don't agree simply because you can't argue with results. They could have saved women and followed up with further study on the exact nature of the problem which would only become clear when Pasteur came along. They chose to institutionalize him out of embarrassment.

I'm not "putting you on the other side" of anything. I don't agree with your minimization of the guy's achievements nor with your characterization of him as "crazy".


The scholarly debate about Semmelweiss is whether he had syphilis or young-onset dementia. He was not committed to a sanitarium out of pique over his demands that people chlorinate water. Again: you can just look this stuff up!

These points might seem kind of nitpicky, but Semmelweis has become a sort of patron saint for brooding nerds with strong but iconoclastic ideas, a shibboleth for "history will show I was right all along". Semmelweis was not, in fact, right all along, and his evident failure to persuade his peers --- stemming from what was in a sense an opposition to the germ theory of disease --- probably set science back a little bit, on margin. Not by much, though; Semmelweis was in his time one of several people expounding the same intervention.


> Semmelweis was not, in fact, right all along

His results have NOT been refuted. Sanitizing hands saved lives. Not sanitizing hands cost lives.

https://pubmed.ncbi.nlm.nih.gov/17553179/

https://pubmed.ncbi.nlm.nih.gov/35486338/

Whether or not it happened due to "cadaveric particles" is a completely irrelevant detail. People died less. That's enough for public health policy decisions even today. The fact his contemporaries did not accept it would be criminal negligence today.

The "scholarly debate" about his mental state is mere speculation. Here's the first result of looking it up:

> It is impossible to appraise the nature of Semmelweis's disorder.

> It might have been Alzheimer's disease, a type of dementia, which is associated with rapid cognitive decline and mood changes.

> It might have been third-stage syphilis, a then-common disease of obstetricians who examined thousands of women at gratis institutions

> or it might have been emotional exhaustion from overwork and stress.

You clearly believe the first two options. I don't believe that even for a second.

> He was not committed to a sanitarium out of pique over his demands that people chlorinate water.

Here's the second result of looking it up:

> With this etiology, Semmelweis identified childbed fever as purely an iatrogenic disease — that is, one caused by doctors.

> Friedrich Wilhelm Scanzoni von Lichtenfels took personal offense at this, and never forgave Semmelweis for it

> Scanzoni remained one of the most ardent critics of Semmelweis.

The third result of looking it up:

> Semmelweis also angered his conservative medical colleagues — and especially his boss, Johann Klein, who was head of the Department of Obstetrics and Gynecology

> Klein rejected Semmelweis' arguments concerning cleanliness, as did his colleagues.

> He probably felt angry that this precocious Hungarian was making orthodox practices and practitioners look not only ridiculous but also dangerous.

> It was Klein, incidentally, who had insisted that medical students examine cadavers in the first place, and it was he who had relaxed constraints on conducting vaginal examinations during labor.

> Semmelweis seemed to be saying that Klein's policies were the direct cause of the epidemic

> When Semmelweis' temporary appointment came up for renewal in March 1849, Klein blocked his application, despite appeals from senior medical colleagues

> The second part [of his publication] attacked his critics. This was the part that got him into serious trouble. Many leaders in obstetrics in Europe were vilified.

> While the book collected all of Semmelweis' investigations into one volume for the first time, it met with harsh reviews and had little impact in preventing the dreaded puerperal fever.

> Probably as a consequence, Semmelweis' mental state deteriorated.

> He roamed the streets of Budapest muttering to himself and distributing pamphlets directed against those who refused to follow his teachings.

> He seemed to swing from periods of excitement and energy to periods of paralyzed depression. By July 1865, he was clearly deranged.

They clearly hated this guy and found several ways punish him for his insubordination. It's entirely possible and very likely that this was the reason he ended up in the asylum where he was killed.


1. Childbed fever was not, in fact, caused by cadaveric particles.

2. Nobody here disputes aseptic technique.

3. You've misconstrued the point about Semmelweis' commitment. Alzheimers, syphilis, exhaustion: the point is that he was symptomatic, as you yourself just quoted.

I don't think anybody else is reading us at this point.


https://en.m.wikipedia.org/wiki/Ignaz_Semmelweis

He had very sensible ideas about hand washing a hundred years before it was accepted by most doctors. He was a bit weird though, and ended up being ignored.


Weird as in saying the common practices are not correct, and here is my proposal for a better practice, as supported by statistics.


I can just imagine both how desperate you might feel when you discover that you've been (unwillingly) killing your patients, how you might refuse this reality of being a vector of health instead of the saviour or helper you picture yourself as and also how personable and convincing you'd need to be to get people past that.

Semmelweiss was apparently lacking in social graces, but I wouldn't be able to behave normally if I'd discovered what he discovered.

(Edit for coquilles and spacing)


I've seen a doctor literally commit suicide when faced with the mere possibility that he caused harm to another human being.


Here's a tip for the future: typing a name into Wikipedia usually yields great results.


Why would you waste the chance to tell the story of Ignaz Semmelweis? I wish people asked about him more often.




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