This article ponders why Semmelweis went insane. While it’s possible, likely perhaps, that medical issues were involved (injecting yourself with Syphilis is rarely a good idea), how would it feel to watch women, new mothers die every day before your eyes, while you know the solution, but the people around you refuse to believe you, and refuse to take action, basically out of pure pride and arrogance.

Imagine watching mother after mother die in front of you. Imagine knowing the solution. Imagine the people around you ignoring it. Surely that would be enough to drive any normal man insane, or to alcoholism, or some other escape from reality

Semmelweis did not go insane.

He was actually one of the fathers of evidence-based medicine by counting number of death in hospitals after child-birth.

He discovered that when women where treated by doctors MORE deaths occurred than when women where treated by nurses. The reason for this might have been that the doctors also dissected corpses at university and brought germs from this when examining women.

That was the problem of the message: He postulated that his peers, the noble doctors were directly responsible for a high number of deaths. This was a message nobody wanted to hear.

Since he became more and more outspoken and angry that nobody believed him, they shut him up by luring him into an asylum where he died.

Later his methods were approved, since the young students had no bad conscience about having indirectly killed women in their career.

The Wikipedia article kind of suggests he was railroaded due to people not liking his ideas:

In 1865, János Balassa wrote a document referring Semmelweis to a mental institution. On July 30, Ferdinand Ritter von Hebra lured him, under the pretense of visiting one of Hebra's "new Institutes", to a Viennese insane asylum located in Lazarettgasse (Landes-Irren-Anstalt in der Lazarettgasse).[60] Semmelweis surmised what was happening and tried to leave. He was severely beaten by several guards, secured in a straitjacket, and confined to a darkened cell. Apart from the straitjacket, treatments at the mental institution included dousing with cold water and administering castor oil, a laxative. He died after two weeks, on August 13, 1865, aged 47, from a gangrenous wound, due to an infection on his right hand which might have been caused by the struggle. The autopsy gave the cause of death as pyemia—blood poisoning.

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

I wonder who are today's Semmelweis. Privacy advocats? Paper lobbyists? Climate activits?

And how to no go insane and drown in Cassandra syndrome?

Climate activists? Really? While the causes of most climate activists are pretty valid and usually based on plenty of science, the comparison is absurd. Semmelweis was almost universally derided by all professional and public sectors for his findings. Most climate activism on the other hand is pretty much a default media-friendly, celebrity-friendly, widely socially and scientifically supported stance that has enormous popular appeal. I mean, you seriously think the two contexts are comparable? It's a disservice to what Semmelweis really had to deal with in his time.

Privacy advocates are a bit closer to the mark but though they have much less popular voice than climate activists, they're also widely listened to (even if few organizations do much to apply their advice).

I honestly have no idea what a paper lobbyist is.

Think of the climate people in the 80ies.

> paper lobbyist

one who wants to slow down datafication of all aspects of life. Both private and public. I took paper as a symbol.

Even in the 80's and we could go as far back as the 70's, climate activism was robustly supported by many sectors of society, media and popular culture. Not as much as it is today but far ahead of a doctor being literally destroyed and later killed through negligent detention for his views.

I've never heard of paper activism as an actual cause. Interesting, and definitely less known than the others it seems.

Indeed, the grim fate of Semmelweis is extreme. But think, for example, of Ken Saro-Wiwa, who fought Big Oil and was executed.

As for paper - I suspect that written letter communication leaves a much smaller footprint than sending emails and printing on demand. However, I have no evidence of this yet.

But https://solar.lowtechmagazine.com/ has something about the rebound effect exceeding the initial savings.

Constant Anxiety Won't Save the World: https://www.theatlantic.com/health/archive/2017/08/constant-...

Indeed. Last year I resolved to only get upset about things I can change. The challenge now is to tell the difference.

One example today relates to teaching (in college). Most instructors (~75%) predominantly lecture, even though hundreds of studies have shown that increases the failure rate of students by 55% on average compared to teaching with some active learning. https://doi.org/10.1073/pnas.1319030111 We're losing hundreds of thousands of STEM major students because of that alone, disproportionately students from underrepresented groups. https://www.pnas.org/content/117/12/6476

To a degree the early people in the western countries who called for wearing masks. Ironically they were laughed at due to a cargo cult based on Semmelweis‘s insights.

> cargo cult based on Semmelweis‘s insights.

Uh, how so?

Pierre Kory: https://podcastaddict.com/episode/123865326

Aaron Shwartz also covered it here:

http://www.aaronsw.com/weblog/semmelweis

He also mentions why the doctors didn't accept his findings. They simple weren't willing to accept their roles in the death of mothers.

There is a rather chilling quote related to this that has stuck in my mind. Many doctors at the time were opposed to hand washing, and one famously summed it up this way:

"Doctors are gentlemen and a gentleman's hands are clean."

A search for this phrase finds many related articles:

https://www.google.com/search?q=doctors+are+gentlemen+and+a+...

Also, the reason men didn't wash their hands is that dirty hands were a symbol of status.

The true symbol of a reputable obstetrician was to have working hands. This meant touching exposed tissue while being covered with...necrotic tissue.

My recollection is somewhat different. Here in the US, the advice was not that masks were useless, but that they were in such short supply (especially N95 masks) that it was best to reserve them for medical professionals who were at the greatest risk.

A cottage industry developed quickly of people making masks at home and giving/selling to their neighbors. I remember buying several from a high school graduate in the neighborhood, very early in the pandemic.

Your recollection does not match my recollection.

From what I remember, initially they were saying masks are not useful to protect against disease because of various different reasons. Some of them were that general public would not wear masks properly and it would lead to increase in touching your face.

This "anti mask" approach was there until they managed to get enough masks, then changing their guidelines to include masks or even mandate masks. This was publicly admitted.

In my opinion, this whole process was a big mistake as it led to confusion and increase in public distrust of the health officials. How can you suggests masks don't work then change it to masks work but we had to keep them for ourselves.

Second problem is how does the mask not work if the virus spreads through droplets - if masks don't work then it is spread as an aerosol which was initially dismissed.

Here's one example leaning more toward the other way (from Canada [edit: from March 2020]):

https://montrealgazette.com/news/local-news/coronavirus-why-...

This matches more with what I remember - that the concern was incorrect usage and replacement of masks was going to create a bigger transmission vector than what the masks prevented. I.e. there was never strong doubt the masks could do something about it rather there was doubt the masks could do more good than harm with what was known about the virus at the time.

Once the amount of airborne transmission and asymptotic carriers seemed a higher factor in spread than initially expected the consensus on to whether to wear them changed but not the consensus they would help with airborne transition in the first place.

So was the initial advice wrong with current understanding? Yes, pretty concretely so at this point, but precisely because it was data driven advice instead of a retrospective or fear based thinking.

Even that was fairly pro mask: “When are they useful?

Studies done during the SARS epidemic of 2003 found that for medical professionals, wearing any type of mask compared with none can reduce chances of getting sick by about 80 per cent. The N95 mask, which gives better facial coverage and guards against smaller droplets, appears to be somewhat more effective than standard surgical masks. But medical professionals follow strict guidelines in taking masks on and off, discard them after each use, and use additional safeguards like eye protection and gowns to shield themselves. They can help to prevent sick individuals from transmitting the virus by blocking droplets.”

The real story wasn’t masks it was hand washing. Early on it was assumed surface contact would be a major vector, but that turned out not to be the case.

“Don’t think that masks are the miracle solution,” he said. “They are useful for those who are sick to not contaminate others. It’s all about hygiene of the hands.”

Some past relevant threads:

The history of economic growth is a tale of cleanliness - https://news.ycombinator.com/item?id=24021044 - Aug 2020 (47 comments)

A doctor who championed hand-washing and briefly saved lives (2015) - https://news.ycombinator.com/item?id=23802761 - July 2020 (88 comments)

Sanitation conquered disease long before vaccines or antibiotics - https://news.ycombinator.com/item?id=22173638 - Jan 2020 (71 comments)

The Doctor Who Championed Hand-Washing and Briefly Saved Lives - https://news.ycombinator.com/item?id=8897387 - Jan 2015 (41 comments)

Look at yourself objectively - https://news.ycombinator.com/item?id=4438828 - Aug 2012 (77 comments)

AUG. 28, 2013

Study: Doctors don't wash hands properly 40% of the time

https://www.upi.com/Health_News/2013/08/28/Study-Doctors-don...

Why don't doctors wash their hands? A correlational study of thinking styles and hand hygiene

https://www.sciencedirect.com/science/article/abs/pii/S01966...

Amazingly, his advice is to this day only fitfully obeyed in possibly a majority of American hospitals. Compliance with hand-washing rules has been very hard to enforce.

But nitrile gloves are often used, instead, in many places, which takes much of the pressure off.

Ironically, today it’s hand washing experts contributing to morbidity and loss of life by stonewalling airborne transmission precautions: masks that actually filter small particles and fit seal, building ventilation upgrades, and switching the the school year to outdoor classes during the summer. All blocked by hand washing experts whose groupthink egos refuse to accept basic laws of physics and evidence based policy that countries like Japan have auctioned since the very beginning of the pandemic.

Sources please.

Last spring, a bunch of aerosol experts like K. Prather were saying, "hey guys, Covid is airborne."

Crickets from the "real" experts on Covid.

It took hundreds of thousands of deaths for people to sort of get that it's airborne, and even now the ramifications of that -- for example, that all healthcare workers should wear N95's instead of surgical masks -- have not really been understood and accepted.

It's the same thing all over again.

The same 3 words killed hundreds of thousands of people in 2020: Wash your hands. Don't wear a mask.

Naive question:

How likely is it that the constant use of hand sanitizers due to the pandemic (which might stay on as a habit) has negative side effects for the population as whole or individuals, e.g. killing "good bacteria", creating resistances, weakening the immune system?

Probably not good for individuals. I am a germophobe and my immune system is a lot weaker than my friends who share drinks, eat stuff off the floor, eat street food, kiss random strangers etc[0]

Probably great for the population and likely to increase Earth’s carrying capacity of humans, as is the case with most technological progress (hand washing, plumbing, agricultural techniques increasing food production per hectare, micronutrient fortification). We become dependent on these things and as long as they stick around as reliable infrastructure then we are good

It is important to keep in mind, however, that exposing oneself to pathogens from other humans is distinct from exposing oneself to various neutral microorganisms from the environment that help diversify your micro biome and generally make your immune system stronger. “What doesn’t kill you makes you stronger” does not apply to oneself and Ebola or HIV or even malaria in a very practical sense. Perhaps most relatable to Hacker News folks is that each infection in one’s body offers a nonzero chance of lowering one’s IQ. That should suffice as reason to avoid disease

Edit: [0] I get sick a lot more easily than they do, and uh, it took me 9 months to recover from Covid (long Covid)

I'm not looking forward to the X-resistant bugs that come out of all the covid focus on sanitizer/etc. Soap and water, once we had a handle best bet. Not easy for retail, but helps.

My understanding is that once the antibacterial products stop getting used the resistance to them is no longer selected for.

But most hand soap is only antibacterial insomuch as the soap chemically binds to them and the water washes it away.

Hopefully we go back to letting things be and not requiring sterile public spaces.

this was one of the major causes of the polio epidemic. after the discovery of germs, parents stopped letting their babies get exposed to dirt and germs when they were young and still had their placental super immune system. This meant they didn’t develop resistance to Polio and other diseases, and were much more susceptible to it at an older age

I don't know if it's ok to link to reddit from here, but here's a good explanation why Semmelweis ideas were not accepted from the beginning: https://www.reddit.com/r/badhistory/comments/2bnsjx/ignaz_se...

tldr: it was a very radical idea and he was a difficult, unliked man. I read that as "kind of a jerk", but that's my interpretation. We might react the same way if the person you dislike for being a smartass comes with an idea that there are invisible tiny things killing people.

I think there's a lesson here, it's not enough to be right. You need to sell your ideas well. Especially if you're selling to a group that already dislike you due to previous interactions.

>You need to sell your ideas well. Especially if you're selling to a group that already dislike you due to previous interactions.

Alternatively, be nice to people, making it easier for them to like your ideas.

This is like the first few chapters of "How to Win Friends & Influence People". Mostly never criticize people, it just makes them want to save face.

I think it says to criticize in private and laud in public. We are all emotional beings, so I think it's good advice.

Not just emotional. My biggest takeaway is that everyone wants to feel important, that they matter. And it's true whether you are a president or a petty criminal. It's a very strong emotion.

It seems logical to me that good ideas could be available to intolerable people.

> tldr: it was a very radical idea and he was a difficult, unliked man. I read that as "kind of a jerk", but that's my interpretation. We might react the same way if the person you dislike for being a smartass comes with an idea that there are invisible tiny things killing people.

Semmelweiss didn't know what it was that killed people. He had some results that suggested a correlation between hand washing and mothers surviving. But he couldn't explain what the mechanism was. It was quite easy for the scientific establishment to dismiss his results as a peculiarity of the ward he was working on.

Muslims are ordered to wash their hands (and feet) 5 times daily AT LEAST!

Since ~570 AD

Such an amazing work by Dr. Semmelweis! These days we are making medical discoveries at a fast pace. My gut feeling is that it made possible because of FOSS software. If in the days of Dr. Semmelweis, if microscope lens making technology was more freely available then more fascinating medical discoveries could have been made. A big shout out to FOSS contributors!

been thinking about open-source software a lot recently?

The power of testing an idea, and finding out if it worked.

https://en.wikipedia.org/wiki/Empirical_evidence

Great but of history, but the title is just... dumbed down. I'm pretty sure Semmelweis didn't speak English and never once said those three words.

It's an English language article written for an English speaking audience.

I don't think using a translation of what he actually said is dumbing it down, it just makes it more accessible for readers of English.

Dr. Semmelweis Ignác Fülöp was Hungarian of German descent. It would have been "mossa kezét" (most likely using the formal third-person). Since he was not churlish, he would have approached such statements as a request, not an order.

He worked in Austria and published his work in German, so it seems highly unlikely he would have said it in Hungarian.

Also, contrary to your claims about churlishness, the article states multiple times that he was a rather rude man