Semmelweis: ID hero

You may or may not be familiar with the name Ignaz Semmelweis. It’s not one that’s typically taught to school children, like Koch or Pasteur may be. He even tends to get glossed over in upper-level biology courses. But Semmelweis was an important figure in the history of microbiology (indeed, I picked his work as the greatest experiment in my field). Here’s what I wrote about him in that post:

Semmelweis was a physician in Vienna in the 1840s, with an interested in “childbed fever,” a leading cause of mortality in women who’d given birth. During this time, he noticed that the mortality rate from this disease in a hospital division where medical students delivered babies was 16%, while in a division where midwives delivered them was ~2%. It was also known that childbed fever was rare when women gave birth at home. Semmelweis thought there was something the med students were doing that served to raise the rates of childbed fever in those divisions.

In 1847, Semmelweis’ friend, another physician, died due to a wound acquired while performing an autopsy. Semmelweis examined the tissues of his friend, and noticed the pathology there was similar to those in women who’d died of childbed fever. According to history, this led to his “eureka” moment: medical students performed autopsies, and midwives did not. The students must be bringing some contagious agent from the autopsy room back to the delivery room.

To test this, Semmelweis instituted a procedure, requiring students to wash their hands in a chlorine solution before entering the maternity ward. Mortality dropped dramatically, and Semmelweis extended the procedure to include surgical instruments as well. However, colleagues scoffed. Semmelweis actually lost his job, and took a position in Budapest–where he again instituted his handwashing protocol, with similar incredible results. Sadly, he died in 1865 in an asylum, disgraced.

Of course, many of you realilze that IDers love to tell the stories of scientists who were persecuted and scorned when they first proposed their idea, only to have history vindicate them. They compare their own ID supporters to Galileo, Barry Marshall, and other noted scientists (and, of course, Dembski’s been called the “Isaac Newton of information theory,”) and like to pretend that, like these esteemed scientists, history will give them the last laugh. Well, it seems that Semmelweis also has become something of an iconic figure to some who support “intelligent design.” More after the jump.

I first ran across this comparison in the comments of a quote-mining post at Uncommon Descent. A commenter there suggested that the genius of science is that it is self-correcting, and another commenter noted:

I just got done reading a mini-biographical sketch of Semmelweiss, the physician responsible for identifying the fact that a microscopic pathogen (then considered a fairy-tale by science because we didn’t yet have the ability to see them) was responsible for the deaths of millions of women after childbirth. It was nauseating and sad to read the descriptions of the opponents of his theory, who couldn’t be troubled to wash their hands after dissecting corpses before delivering babies. Semmelweiss suffered discharge and ignominy but was ultimately vindicated. How many women died while this self-correction took place? It doesn’t bear contemplation.

she continues,

What is tragic to me about this example is the way it so perfectly illustrates the stupidity of the arrogance associated with the notion that at any given time, our knowledge of natural processes is practically complete. The students and surgeons whom Semmelweiss took to task, begging them to wash their bloody hands before touching women in childbirth, were outraged at the inconvenience of the called-for measure, and certain that his silly notions of transmissible illness were just fairy stories. After all, everyone knows that…(fill in blanks with certainty of choice) Of course when pressed, scientists always rush to assure us of the deep deep humility and intrinsically provisional nature of scientific knowledge. But in practice, of course, a long history of terrifically wrong and confidently made pronouncements has been precisely recorded.

And, of course, evolution is just the latest in the line of “terrifically wrong and confidently made pronouncements” by scientists.

Doing some googling, I see this isn’t the first time the example of Semmelweis was used to suggest that scientists are currently wrong about ID and ID advocates:

Did Semmelweis’s peers have scientific justification for their sarcastic dismissal of his work? Hardly. His findings simply did not fit their very limited and na├»ve view of things. It was only after Louis Pasteur’s germ theory of disease received wide acceptance that anyone recognized the brilliance of Semmelweis’s insights. Likewise, it might take some time before science comes to an appreciation of a William Dembski.

However, there is a glaring difference in the story of Semmelweis and that of Dembski, Behe, Gonzalez, or any other ID advocate. The treatment that Semmelweis received from many peers was horrible, indeed, but the reason his ideas eventually prevailed is because they were supported by the evidence, and specifically, because he took the time to create and test an intervention (handwashing) that he could document repeatedly as being successful. He had a hypothesis, he tested it, he reported his data, and he was right in the end. His ideas weren’t accepted based solely on his own hunches or beliefs, and they weren’t accepted due to a massive public relations campaign aimed at getting handwashing into medical school curriculum. Creationists can beat the drum of “scorned” scientists whose ideas were later validated until they turn blue, but it won’t change the fact that the only reason the ideas were accepted is because they were followed with evidence. All ID has is a bunch of sound and fury, signifying nothing.

Image from http://www.semmelweis-miskolc.hu/507aad40.jpg

Comments

  1. #1 Dave S.
    September 13, 2006

    The importance of an empirically testable model in science cannot be overstated. It seems the good folks over at UD just can’t seem to wrap their brains around the concept that having your ideas attacked doesn’t by itself mean they are correct. All new ideas are attacked in science, and only when one makes predictions based on a positive model that are confirmed does that idea have the legs to become accepted – something ID can’t do since it doesn’t even have a model to draw potential hypotheses from.

    Science accepts stuff that actually works…that lets us find new things about nature. Arguments to ignorance like the current crop of ID arguments are scientifically sterile and uninteresting, not to mention non-productive knowledge wise. In fact, they act to stymie the process of uncovering knowledge if anything.

  2. #2 pwe
    September 13, 2006

    Interesting, very interesting.

    I looked up the article linked to by Isaac Newton of information theory.

    It’s an ad for Dembski’s book Intelligent Design: The Bridge Between Science & Theology.

    This reminds me of the title Monism as Connecting Religion and Science of a book by Ernst Haeckel. The same Haeckel who is ever so accused of connecting between Darwin and Hitler.

  3. #3 J-Dog
    September 13, 2006

    I think the “take home lesson” here is that ID can be contagious, and to prevent future Dembski’s, scrape all ID tracts off the bottom of your shoes before entering the house. You should also, always wash away the stink of an ID proponent from your mind in an achoholic solution, preferably one stored in a 12 year old oaken vat.

  4. #4 G. Shelley
    September 13, 2006

    Rather than ask why he was eventually accepted, I would wonder why he was rejected initially. Of course, we all know why ID is rejected – it is a vacuous, empty idea with nothing to offer. whos leading proponents seem to show little understanding of science and less interest in any advances which show their claims to be false. What reason was given then? Was it just that people couldn’t understand why his method worked?

  5. #5 Gary
    September 13, 2006

    G. Shelley asks a really interesting question. There is a fair amount of literature (and debate) on what it takes to get people to change their minds about a concept. The short story is that people always filter new information through their exisiting conceptions about how the world works. When confronted with new data that aren’t explained by their exisiting conceptions, everyone’s first reaction is to try to modify the data to see if they can somehow fit it into their conceptions. If that doesn’t work, the next response is to explain it away. The third response is to just ignore it. It isn’t just ignorance or stubborness or bloody-mindedness, it is a way to avoid just accepting every new thing that comes along. There are an infinite number of new ideas. Nearly all turn out to be wrong. So, it usually is safer to not accept new information (you will usually be right).
    One thing that takes a long time to learn in science to be able set your preconceptions aside temporarily and judge the data on their merits, and to admit that your preconceptions might be wrong. It ain’t easy to do.

  6. #6 Steve
    September 13, 2006

    fyi…Semmelweis there is interesting review/essay and back and forth response in the NY Review of Books:

    http://www.nybooks.com/articles/16914

    http://www.nybooks.com/articles/17009

    The cultural/social/econimic/political context in which both disease (e.g., childbed fever) occurs and Semmelweis makes his observations and interventions are fascinating. Which subset of women have births in hospital, but examined by multiple physicians and trainees? How much was Semmelweis rejected by Austrian elite because he was Jewsih and/or Hungarian? How much because he was a difficult personality? How much because it was change in paradigm and status quo?

  7. #7 Jim Harrison
    September 13, 2006

    Semmelweis was indeed a tragic case, but his lack of success was caused as much by his extreme reluctance to publish as from the virulence of his enemies or any ethnic prejudice. I guess the ID folks have reason to feel a kinship with him, although their inability to publish reflects the absence of reproducible results while Semmelweis was apparently just neurotic about it. He had lots to say.

  8. #8 Steve Verdon
    September 13, 2006

    There is actually a good article on this kind of thing that includes Semmelweiss amongst other instances of where a break through was resisted. The gist of the article is that there is a fair amount of subjectivity in science and yet it is often unstated and that explicitly stating these subjective beliefs is one way to reduce this problem.

    In Semmelweiss’ case there was hard evidence supporting his hypothesis that med students were bringing in some sort of contagion from the autopsies. The problem was that people refused to look at that evidence and incorporate it into their beliefs. Making these beliefs explicit and using a method to update our beliefs as new evidence comes available is the suggested solution.

  9. #9 Reed A. Cartwright
    September 13, 2006

    Why exactly was Semmelweis dismissed by his collegues? Given the time in which it occured, I suspect that some form of theology may have played a roll in it, e.g. hand washing can’t get rid of the evil spirits that cause disease.

  10. #10 Stephen
    September 13, 2006

    Semmelweis had results on his side. It *should* have been enough.

    Here’s another example, though.

    Around the time of the American Revolution, a doctor (no idea who) had this theory that when a soldier was wounded in battle, the right thing to do was to “treat the weapon”. Now, i’ve no idea what treatment that the weapon recieved, but the general idea was that the soldier was not treated. From today’s perspective, it’s ludicrous. However, this doctor was able to show that, statistically, soldiers under his care did better than those subjected to other doctors of the day.

    OK, so medicine in 1776 was pretty awful. But my point is that you can have a better treatment even with a theory that is fundamentally wrong.

  11. #11 DrSteve
    September 13, 2006

    I hate that arguement of “I must be right becuase Semmelweis, Gallileo etc, were initially ridiculed.” This lacks a denominator – how many stupid ideas were shot down becuase they really were stupid vs. how many eventually proved to be revolutionary?

  12. #12 Coin
    September 13, 2006

    Intelligent Design: perfectly equipped for and tirelessly devoted to fighting the intellectual battles of the 1840s.

  13. #13 Dave S.
    September 13, 2006

    Stephen –

    I was not aware of the treatment option you mention in the historical record. Perhaps it has something to do with the surgury of the time, which was in many cases only made things worse. By treating the weapon (and if shot at by a Redcoat, I wonder how you even got the weapon let alone what you did with it once you did get it) you at least weren’t “treating” the soldier. That alone may have been the ticket.

    In any event, before ideas were overturned, people did believe them, and presumably they did so for what they believed was good cause. New ideas need time in order for it to be shown that they are in fact superior to the existing paradigm. But in the case of ID, there is nothing to see. It’s as vacuous now as it ever was, and in fact has been losing ground, as any argument to ignorance does as knowledge accumulates without it, while evolution continues to score.

  14. #14 Tara C. Smith
    September 13, 2006

    Why exactly was Semmelweis dismissed by his collegues? Given the time in which it occured, I suspect that some form of theology may have played a roll in it, e.g. hand washing can’t get rid of the evil spirits that cause disease.

    He worked at a time when there was still a lot of resistance to the germ theory of disease. Pasteur and Koch’s experiments were yet to come, and many people simply thought the idea that something living and unseen caused disease was unfathomable and silly. The sanitation movement was gaining ground but still somewhat in its infancy, and there were still a lot of powerful physicians who were advocates of the miasma theory rather than contagionism.

    I’ve not read the book referenced above, so I don’t know how much his own personality played a role in this as well.

  15. #15 Paul Orwin
    September 13, 2006

    Interestingly, in the very NYRB exchange, Nuland says Semmelweis wasn’t Jewish (sort of nixes the anti-semitism argument). He was Hungarian, however. I read the book and love the story (tragic as it is). I’d say that it is best explained by a combination of the typical recalcitrance that people display toward being shown their mistakes (i.e. other doctor’s not wanting to admit that their lack of understanding caused the deaths) combined with Semmelweis’s acknowledged eccentricities. However, using this as evidence for ID? Silly.

    I agree with the comment above about the lack of a denominator. The persecuted prophet is a common theme in all fringe science. Every one of them is the next Einstein toiling away in the patent office, waiting to be discovered.

  16. #16 Badger
    September 13, 2006

    Dave S. wrote “I was not aware of the treatment option you mention in the historical record. Perhaps it has something to do with the surgury of the time, which was in many cases only made things worse.”

    Cauterizing was the common treatment for bullet wounds. A British army doctor during the War of 1812 had a similar observation, caused by some exigency that prevented him from cauterizing wounds as he normally would have. The fact that his patients recovered more quickly (and probably fewer died as well)was impressive enough to report.

  17. #17 Nat
    September 13, 2006

    The other problem with this analogy is that physicians are NOT scientists. Some are certainly both. But Med students are emphatically not Scientists. The rigours of their professional (not scientific) training do not allow much more than stuffing facts and procedures into their heads. Semmelweis may have been both a scientist and a physician but the lack of acceptance by his physician colleagues (In the 1840s!) has no usefulness for the discussion of scientific methods/acceptance because they were not scientists.

  18. #18 entlord
    September 13, 2006

    Semmelweis first came to my attention while researching medical staff bylaws and their applicability to various classes of medical staff, in which he is cited as the example of a professional who is disgraced, blackballed, expelled or disciplined, not because of a lack of professional skill or knowledge, but because of his inability to “play politics” within social and professional networks.

  19. #19 Alon Levy
    September 13, 2006

    What I’ve read is that Semmelweis’s ideas were initially rejected because doctors and medical students refused to accept the fact that they were killing people instead of saving them.

  20. #20 susannah
    September 13, 2006

    **Well, it seems that Semmelweis also has become something of an iconic figure to some who support “intelligent design.” **

    How dare they! He based his “ideas” (as if they were just opinions) on the overwhelming evidence presented to him. His naysayers would be the equivalent of the IDiots, who don’t need or want evidence; arrogance is enough of a reason for them.

    (Semmelweiss has been my hero for nearly half a century.)

  21. #21 Coin
    September 13, 2006

    A British army doctor during the War of 1812 had a similar observation, caused by some exigency that prevented him from cauterizing wounds as he normally would have. The fact that his patients recovered more quickly (and probably fewer died as well)was impressive enough to report.

    On a distantly related note, something that mildly fascinates me is speculation that James A. Garfield and maybe even Abraham Lincoln might have survived their assassination attempts had it not been for worse-than-nothing medical attempts to treat the wound (which in Lincoln’s case essentially involved sticking a coathanger into his brain in an attempt to get the bullet out).

  22. #22 Pierce R. Butler
    September 13, 2006

    The idea of treating the weapon instead of the wound which it caused goes back to Paracelsus (d. 1541). He apparently did get better results with this than did doctors who used other treatments common during that time – not too surprising considering those treatments, which could include packing a wound with manure (hey, it does wonders for gardens…).
    The big fad for Paracelsian medicine was long over by 1776; any doctor relying on same then must’ve been way out of touch (though the bleeding-as-universal-treatment concept in vogue then may have offered worse results than the “weapon-salve”).

  23. #23 _Arthur
    September 13, 2006

    During the Napoleonic wars, some doctors observed that maggot-infested wounds were much less likely to gangrene than regularly treated wounds.
    http://en.wikipedia.org/wiki/Maggot_therapy

    That approach was not in wide use; maybe because its high yuck factor. Maggot therapy is now used in very specific cases, in particular where antibiotics are ineffective.

    To resume the wikipedia article, maggots eat dead tissue, leaving living tissue intact, and while doing so, the maggots kill the necrotic bacteria they ingest, with a net antibiotic effect. The maggots themselves are harmless, although gross.

  24. #24 Pierce R. Butler
    September 13, 2006

    Apparently Semmelweis not only faced the social barriers of being a “low-born” Hungarian among Austrian elitiests, he added to them with an abrasive personality and an accusatory style. Rather than presenting his approach in terms of its advantages, he started and ended with harsh accusations that his colleagues were mass murderers: an approach apparently acceptable among modern Republican pundits & politicians, but not tolerated well among those less-advanced Viennese of 1847.

    Here’s one to calibrate your irony meters with: Semmelweis died of an infection contracted during surgery – in which he was the surgeon.

  25. #25 Chris Noble
    September 14, 2006

    Semmelweis is also a hero of the HIV/AIDS “rethinkers”. A lot of people compare Duesberg to Semmelweis.

    This is somewhat ironical when Duesberg denies that a virus can cause either AIDS or cancer. It is doubly ironical that lots of Duesberg followers also deny the “germ thoery of disease”.

  26. #26 Dave S.
    September 14, 2006

    On a distantly related note, something that mildly fascinates me is speculation that James A. Garfield and maybe even Abraham Lincoln might have survived their assassination attempts had it not been for worse-than-nothing medical attempts to treat the wound (which in Lincoln’s case essentially involved sticking a coathanger into his brain in an attempt to get the bullet out).

    Garfireld lived for some 80 days after he was shot, and never lost consciousness. More than a dozen doctors were consulted, and each seemed to contribute to make the situation worse. The first one proceeded to stick his (unsterile) finger and an unsterile probe into the hole, the only result being the creation of a second wound track which was confused to be the bullet track by the succeeding doctors. This track lead towards the liver, as each doctor in turn with unsanitary finger concluded. When it became clear the probing attempts weren’t going to work, they tried a high-tech approach.

    Alexander Graham Bell coupled his telephone technology to that of Simon Newcomb, who had found that when you passed electricity though a coil and piece of metal was near, the coil made a faint hum. Bell’s idea was to use his own apparatus to amplify the hum. They tested the contraption by hiding bullets in each others bodies (under the armpit say) and on soldiers with known bullets still inside and it did work. But when they tried it on the President, the hum was there no matter where on his body they checked. What Bell had detected turned out to be the metal coils in the the mattress. He was vilified for this failure by his enemies, but to be fair, metal coil mattresses had just been invented and practically nobody had heard of them.

    Naturally the canal became infected (and he had pneumonia), and the infection became increasingly worse. Eventually he died of a massive heart attack, possibly a ruptured aneurism in the spleen. On autopsy the bullet was found encased in a cyst nowhere near his liver, and in all probability Garfield would have recovered had they just left it alone.

    The assassin Guiteau actually tried to argue that he didn’t kill Garfield, the bumbling of the doctor’s did. But this defense got nowhere and he was hanged.

  27. #27 Dan R.
    September 14, 2006

    A good modern example of this phenomena was Barry Marshal and Robin Warren — who in 1982 discovered that stomach ulcers were caused by H. Pylori, and not stress, etc.

    Originally called quacks, it took 15-20 years until their research was truly embraced and even then only after extraordinary proof (Dr. Warren infecting himself and then curing himself).

    That said, they (deservedly IMHO) won the Nobel Prize in Medicine in 2005.

  28. #28 _Arthur
    September 15, 2006

    Here’s an article in Marshal & Warren discovery:
    http://skeptically.org/skeptics/id7.html
    Athough the notion that Warren & Marshall were laughed at is widespread, tenants of this notion have trouble finding documented evidence they were actually ridiculed.
    So that position may be be overstated.

    Their proposition *was* met with solid skepticism. They overcome it by presenting evidence.

    And it is an egg on the face of Medecine that the association between antibiotics as an ulcer cure was not observed carefully enough to serve as the basis for a theory and a new treatment way before. The certainty that no bacteria could possibly survive the acidity of the stomach played a role.

  29. #29 twincats
    September 15, 2006

    The IDiots are taking the names of numerous scientists in vain! No doubt the dead ones are spinning in their graves.

    I don’t even understand how ID has gotten as far as it has. I am just an ordinary person who learned about the scientific method in 7th grade (in a Lutheran parochial school, ironicially enough!) and nothing I’ve seen or read indicates that the “theory” of ID has gotten to within a stone’s throw of the scientific method because it’s simply not science.

  30. #30 Aerik
    September 17, 2006

    Overall a good thread. But can somebody please point out to blog authors that the reference to the Shakespearian sililoquey is “… full of sound and fury, signifying nothing.” ?

  31. #31 Monado
    May 11, 2007

    Re treating the weapon instead of the soldier. I have read that soldiers left on the battlefield for a few days did better than soldiers treated right away. This was offered as one of the observations leading to the use of [cleanly raised] fly maggots to clean every scrap of dead tissue from a wound or burn.

  32. #32 Monado
    May 11, 2007

    Re treating the weapon instead of the soldier: I have read that soldiers left on the battlefield for a few days did better than soldiers treated right away. This was offered as one of the observations leading to the use of [cleanly raised] fly maggots to clean every scrap of dead tissue from a wound or burn.