Comment Re:Trust but verify. (Score 1) 122
This is not a new problem. Ignaz Semmelweis discovered that washing one’s hands before delivering a baby substantially lowered infant mortality https://en.wikipedia.org/wiki/... . His results were empirical and reproducible. Yet they were rejected by the medical community at large in his lifetime, to the point where Semmelweis was committed to an asylum where he died. Which science should people have trusted? The “quack” Semmelweis with his data, or “the medical community at large” that rejected it?
Semmelweis the tormented handwashing genius is a myth in the same way that 'Columbus discovered the Earth is round' is a myth. Both people believed something totally and obviously false, but later writers in search of a martyr projected a different (and modern) belief upon them to make a better story.
Semmelweis' actual belief was "childbed fever is caused exclusively by corpse pieces getting into women, and therefore is only spread by doctors who do dissections before treating women, therefore handwashing with lye will remove those corpse particles.'
Other doctors asked the obvious questions
Question A) So are you saying that childbed fever is a contagious disease, like smallpox?
Semmelweis answer (verbatim): "Childbed fever is not a contagious disease. A contagious disease is one that produces the contagion by which the disease is spread. This contagion rings about only the same disease in other individuals
Question B) Why do we see this disease at the same rates at hospitals that do dissections as the ones that don't do dissections?
Semmelweis answer: - None found -
Question C) Can you show us your data on incidence rates? It is well known that childbed fever appears in rare outbreaks of many cases, with long intervals between when they happen, so we need a fairly long time period to show that the intervention has an effect instead of just starting your intervention after an outbreak and noticing one of the lull periods.
Semmelweis answer: Total silence for fourteen years, not publishing or sharing his data.
14 years later, when Semmelweis publishes again, it turns out that his handwashing ward had an outbreak of childbed fever, showing the intervention didn't prevent outbreaks.
Question D) So, your handwashing method didn't prevent outbreaks, and you've said that childbed fever is only spread by corpse particles from dissections. Why do we see the disease at the same rate in your hospitals before and after intervention.
Semmelweis answer: Well, when I said 'cadaverous particles', I didn't mean actually particles from corpses, obviously you can produce these corpse particles inside living people. Why, there was a lady with uterine cancer on the same floor of my clinic as those poor women who got childbed fever. That cancer produced corpse particles inside her body and they got out somehow and that made the other women in the hospital sick. The same goes for all those other non-dissecting hospitals you asked about earlier!
Now, should Semmelweis get partial credit for coming up with an ineffective treatment based on a batshit and wrong medical theory, because he was at least the first person to suggest regular handwashing?
No. Semmelweis was late to the punch. James Young Simpson suggested handwashing as regular practice ten years earlier.
Simpson is also known for being the first person to publish about using chloroform as an anesthetic in humans, and use anesthesia in obstetrics, and his discovery of chloroform as a useful medical drug was based on sitting around a table with his friends and huffing random chemicals until they found a good one ( https://books.google.com/books... ). A much better research scientist overall, and - realizing that some people were already citing religious objections to taking away pain on moral grounds - he preemptively lead with a huge PR push to make sure anesthetics had the upper hand in the debate.
Objections to its use were raised on religious, moral, and medical grounds. The religious objections appear to us now - a - days to have been very foolish ; but at the time they had a very real influence in delaying the use of anæsthetics. Quotations against taking away pain were sought in the Bible; but Simpson was as earnest a student of his Bible as any of the objectors. He there fore found no difficulty in quoting texts in support of his position to the confounding of his adversaries. Perhaps his most powerful argument was taken from Genesis ii . 21 ; " and the Lord God caused a deep sleep to fall upon Adam , and he slept ; and He took one of his ribs and closed up the flesh instead thereof."
Simpson's PR push utterly crushed any objections, and was absurdly successful, to the point where some later historians thought he might have been trying to drum up controversy by falsely claiming that there were people stupid enough to object to so obviously useful a drug. I think given current circumstances we can see that Simpson was well-founded in assuming he had to get ahead of antidrug sentiment and keep pushing.
