Semmelweis Reflex – The reflex-like tendency to reject new evidence or new knowledge because it contradicts established norms, beliefs, or paradigms(1).
The story of Ignaz Philipp Semmelweis, the Hungarian obstetrician (1818-1865), the founder of bacteriology, along with Pasteur and Koch, is very tragic and instructive. But are we ready to learning from history?
Semmelweis found that the incidence of postpartum fever can be drastically reduced by hand disinfection in obstetric clinics. Postpartum fever was common in hospitals in the mid 19th century and was often fatal. Semmelweis proposed practicing hand washing with chlorinated lime in 1847 while working at the First Obstetric Clinic of the Vienna General Hospital, where there were three times more deaths in the wards of doctors than in the wards of midwives.
At the time, doctors considered washing their hands before examining patients beneath their dignity(2). Semmelweis published his findings in a book “Etiology, Concept and Prophylaxis of Childbed Fever”(3).
However, the Semmelweis hypothesis was not accepted at the time.
Source: U.S. National Library of Medicine
Semmelweis could not give an acceptable scientific explanation for his conclusions (Germ theory of disease was not discovered until years after his death), and therefore his ideas were recognized as “anti-scientific” and rejected by the medical community, as they contradicted the established scientific and medical ideas of the time.
It is noteworthy that obstetrics in traditional folk medicine has very deep roots. Ancient Egypt(4), Ancient Greece(5), China and Middle East. Even in most ancient written sources, in sacred books of Hindus, Egyptians and Jews, midwives are mentioned as a special class of specialists.
Hygiene in obstetrics in traditional medicine was often based on ritual purity, but as we see it today – this ancient folk wisdom, only after a scientific justification by modern science in the late 19th century, began to be applied by conventional medicine.
The discovery of Semmelweis caused a sharp wave of criticism both against his discovery and against himself – his colleagues ridiculed Semmelweis and even bullied him. The director of the clinic, Dr. Klein, forbade Semmelweis to publish statistics on mortality reduction after the introduction of hand sterilization and fired him, even though the mortality rate in the clinic dropped sharply.
The ending of those persecutions is more than tragic. His colleague at the University of Pest drew up a document according to which it was recommended that Semmelweis will be sent to a psychiatric hospital. Another famous scientist tricked Semmelweis into visiting a psychiatric clinic in Döbling near Vienna. When Semmelweis understood what is going on and tried to escape, the hospital staff brutally beat him, put him in a straitjacket and placed him in a dark room. He was treated by laxative and cold water dousing. Two weeks later, he died from injuries sustained in beating during hospitalization.
During the 19th century, a conflict has arisen between surgeons and midwives, when doctors began to argue that their modern scientific methods were better for mothers and babies than traditional medicine, which is practiced by midwives. As a result, tens and even hundreds of thousands of women died during the 19th century as a result of postpartum fever, largely since scientific medicine of that time was not ready to accept the centuries-old wisdom and experience of traditional medicine.
Have we learned this historical lesson today? Today, conventional medicine is very skeptical of acupuncture, herbal medicine, manual therapy, and other traditional medicine methods(6). But maybe we still do not deeply understand all the factors affecting the body and its vital functions? And as a result of the development of science, the “folk remedies” at some point will be scientifically substantiated, as happened with asepsis?
- R. N. Braun: Wo die angewandte Medizin heute steht oder der Semmelweis-Effekt. In: Der Allgemeinarzt. 1984, Heft 8.
- [Carter, K. Codell; Carter, Barbara R. (February 1, 2005), Childbed fever. A scientific biography of Ignaz Semmelweis, Transaction Publishers, ISBN 978-1-4128-0467-7],[Hanninen, O.; Farago, M.; Monos, E. (September–October 1983), “Ignaz Philipp Semmelweis, the prophet of bacteriology”, Infection Control, 4 (5): 367–370].
- Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers, 1861.
- Jean Towler and Joan Bramall, Midwives in History and Society (London: Croom Helm, 1986), p. 9.
- Greenhill, William Alexander (1867). “Agnodice”. In Smith, William (ed.),. Dictionary of Greek and Roman Biography and Mythology. 1. Boston: Little, Brown and Company. p. 74.
- For example: Abdulla, Sara (May 13, 1999). “Phytotherapy – good science or big business?”. Nature, https://doi.org/10.1038/news990513-8
Featured image: Portrait of Semmelweis. public domain work of art.